Entry into kindergarten marks the beginning of formal education and has the potential to pave the way for future academic success or failure. The transition into school is expected to be a challenging time for children and their families and these challenges are likely to be enhanced for children with developmental delays (DD). Despite the importance of this period, school transition for children with DD has not been well researched. Twenty-nine parents of preschool aged children with DD, and 17 parents of children without DD participated in three one-hour phone interviews throughout the course of the child’s transition into school. The Double ABCX Model was used as a framework for the current study to measure the outcome of transition (X) (using quality of life and school readiness), which is influenced by characteristics of the child (A), resources (B) and parental perceptions (C). The objectives of the study were to: 1) describe a sample of children and their families who were transitioning into school, investigate the similarities and differences between children with DD and without DD, and investigate changes over the course of transition; and 2) determine which factors contribute to a successful transition for children with and without DD. Results showed that children with DD had lower adaptive and higher maladaptive behaviour; and were utilizing more formal services and participating in less social activities than children without DD. Parents of children with DD reported lower family income, higher parental stress, different patterns and types of perceptions, and different use of coping. Very few variables changed over the course of transition. There were no significant predictors of the child’s quality of life; and only adaptive behaviour predicted all aspects of school readiness, with family income also predicting the child’s social and emotional well-being. Implications and directions for future research are discussed. / Thesis (Master, Psychology) -- Queen's University, 2008-09-03 00:38:05.333

There is minimal information available regarding test characteristics of the Rourke and the NDDS, two tools commonly used to screen for developmental delay. The objectives are to (a) generate preliminary descriptive data about the population and outcomes of interest, (b) determine test characteristics of the tools compared to the gold standard assessment, BSITD-III. Thirty-six month old children at high risk of developmental delay were recruited from the Perinatal Follow-up Program at the IWK Health Centre in Halifax, NS. The Rourke and NDDS results were obtained via parental report, the BSITD-III via clinical assessment. Results suggest that both tools may possess appropriate test characteristics to screen for developmental delay. Both perform more accurately when the criterion for delay is extended to two flagged areas of concern on the assessment tools. In conclusion, both tools appear to be sensitive to detecting developmental delay. Further investigation via a full scale study is warranted.

Background: Over 50% of HIV-infected children in South Africa have developmental delays. Early identification of affected children will lead to early intervention and favourable long-term outcome. Screening for developmental delay is not yet routine by many primary healthcare providers due to lack of locally available, rapid and sensitive screening tool s in busy Paediatric HIV clinics. A new screening tool was developed at the Red Cross War Memorial Children's Hospital (RCWMCH) for detecting moderate to severe global developmental delay among very young HIV infected children. The diagnostic accuracy and usefulness of the new tool was evaluated in this study. Objective: to validate the new RCWMCH developmental screening too l among HIV - infected South African children. Method: Forty-seven HIV-infected children in the age category 9-36 months attending the Infectious Disease Clinic (IDC) of the RCWMCH were screened using the new tool. Full developmental assessments of same children were performed using the Bayley Scale of Infant Development (BSID - III). Developmental Delay (global) was defined as composite scores 2 standard deviations below the mean in two or more developmental domains. Results: The sensitivity of the RCWMCH tool was 78.5%, specificity 54.6%, positive predictive value was 42.6%, and negative predictive value was 85. 7 %. Discussion: The RCWMCH screening tool was found to have sensitivity within the acceptable levels recommended for developmental screening tools. Its high negative predictive value will reduce unnecessary referrals for full developmental assessments in asymptomatic infants and toddlers. It is therefore recommended for screening for developmental delay among HIV-infected children from the age of 9 months to 3 years.

Abstract A revised Developmental Delay (DD) category became effective in Arizona on September 30, 2009 and allows children who demonstrate significant delays in at least two developmental areas to receive services in special education up to age 10. In order for the educational team to determine that a student meets the criteria for DD, an assessment in all five developmental areas, including cognitive, physical, communication, adaptive, and social/emotional must be completed. However, areas typically included in a neuropsychological assessment, like attention and executive functioning or memory and learning, are typically not part of an educational evaluation and have the potential to adversely affect learning when there are deficits in these areas. DD is a highly prevalent group that has a wide variety of genetic, environmental, and societal risk factors. The definition varies greatly in research, education, medical or health-related fields, as well as by culture. Since the DD category is viable until age 10, outcome studies have been conducted to find out if children with DD continue in special education and if so, under what categories. It has been found that children with DD generally stay in special education and continue receiving services, most often as students with specific learning disability, mild intellectual disability, and speech/language impairment, in addition to other categories. There is limited information in the available literature regarding the neuropsychological strengths and weaknesses for this prevalent group. Moreover, there is limited information available regarding the possible predictors of reading achievement for children with DD. The first aim of the study was to determine how much variability in performance there was for children who met the educational criteria for DD in Arizona as well as to assess strengths and weaknesses compared to normative means. The second aim of this study was to find out if two specific scores from a neuropsychological battery found to be significantly lower in children with a reading disorder were also significant predictors of reading performance in children with DD. A third aim involved an exploratory analysis to determine if there was evidence of a pattern of strengths and weaknesses by delay type. Thirty-three children with DD ages 5 to 9 years were recruited for this study from a single school district in Southern Arizona. Children were administered measures of cognition, attention and executive functioning, memory and learning, sensorimotor skills, and visuospatial processing, and reading. The parent/guardian of the child completed a structured developmental history. For the first aim, the total sample was split into two groups by presence of cognitive delay and analyzed separately. Qualitatively, the data in the form of box-plots was examined. Levene's and Nonparametric Levene's tests were used to quantitatively evaluate variance in score distributions. Single sample t-tests were used to compare group mean scale or subscale scores to the appropriate normative means. The second aim was analyzed using the total sample of children with DD. Stepwise linear regression models were used to determine if Speeded Naming and Inhibition Naming Total Completion Time scores significantly predicted reading performance as measured by the Reading Cluster score from the WJ IV ACH for all children with DD. Two other subtest scores, which were observed to be within normal limits in children with reading disorder on the NEPSY-II special group study, were also analyzed with stepwise linear regression to confirm that they did not predict reading in children with DD, namely Memory for Designs Total Score and Geometric Puzzles. Lastly, for the third aim, those with each delay type were analyzed separately from those without the delay type (e.g., no communication delay and communication delay). Like the first aim, box-plots were generated to visually represent the data. DD group mean scores of each scale or subscale were also compared to the appropriate normative means by single sample t-tests. Results from this study indicated that the variation in the scores was not significantly different between groups, except for a measure of graphomotor speed and precision. Children with DD with a cognitive delay were found to exhibit a wide range of deficits, including deficits in cognition, reading, attention and executive functioning, language, memory and learning, sensorimotor, and visuospatial processing. Children without cognitive impairment did not demonstrate impairments in cognition and reading and demonstrated specific skill deficits for sustained attention, speeded naming with accuracy, immediate and long-term visual memory, memory for organized verbal information, phonological short-term memory, and fine motor speed. When the total sample was analyzed together, three high reading scores were identified as outliers from group reading performance. Both predictor variables were found to be moderately related to reading whether the outliers were in or out. Only one of the two predictors were found to significantly contribute to the predictive model whether the outliers were in or out yet the strength of the prediction was weak, suggesting there are likely better predictors of reading for children with DD. In the analysis of the non-predictors, when the outlier scores were left in, Geometric Puzzles, a measure of visuospatial perception and mental rotation was indicated as a significant predictor of reading. When the outliers were removed, neither score was significantly related with reading. Lastly, meaningful group strengths and weaknesses were seen when the total sample of children with DD was broken into groups by delay, even when the majority performed below normative means. The results of this study indicate that children with DD are at increased risk for significant difficulties in many of the areas included in neuropsychological assessment. This points to the need for many of these areas, namely attention and executive functioning, memory and learning, and visuospatial processing to be included in a comprehensive evaluation in the school setting. Moreover, knowledge of group strengths and weaknesses can aid intervention selection and implementation in addition to appropriate accommodations to facilitate learning. This can inform intervention implementation and design. More research is needed in this area to have a better understanding of how neurocognitive skills relate to reading since the predictors selected for this study were not strong predictors of reading performance for children with DD. Visuospatial perception and mental rotation may be more highly related for children with DD that have higher reading skills.

Alcohol use during pregnancy is common and its consequences often result in a broad range of negative, lifelong developmental outcomes. This study describes the effects of prenatal alcohol exposure and interacting socio-demographic factors on early childhood development. One hundred and twenty one children from the Northern Cape, South Africa, were clinically examined using standard diagnostic procedures and assessed using the Griffiths Mental Development Scales (GMDS/ER) at 7-12 months (Time 1) and 5 years of age (Time 2). Participants were assigned to either: a Fetal Alcohol Syndrome (FAS/Partial Fetal Alcohol Syndrome (PFAS); a Prenatal Alcohol Exposed (PAE); or a Control group based on the diagnosis at 5 years. Mothers/caregivers were interviewed to ascertain socio-demographic information, including prenatal alcohol exposure. During infancy, the FAS/PFAS group showed significantly lower gross motor and language abilities, with delays in higher-order executive functioning becoming more apparent with age. No significant differences were noted during infancy between the PAE and Control groups over any developmental subscales. However, with age, higher-order executive function delays were reported in the PAE group. Performance on the infant and child versions of the GMDS was not significantly correlated, suggesting that the tests may be measuring different developmental constructs. Lower maternal education, unemployment and later recognition of pregnancy were associated with reduced social adaptive functioning, and language and eye hand coordination abilities, irrespective of amount of prenatal alcohol exposure over both time points. Larger anthropometric birth measurements and longer duration of breastfeeding were significantly related to increased performance on the GMDS at 5 years within the groups exposed to prenatal alcohol. Socio–demographic variables are likely to complicate developmental profiles for all three groups, with prenatal and postnatal nutrition emerging as possible protective factors for positive developmental outcomes at 5 years of age.

The purpose of the present study was to investigate the false memory rates for word and picture Deese-Roediger-McDermott (DRM) lists in children, adolescents and adults with autism spectrum disorder (ASD). Deese (1959), Roediger and McDermott (1995) developed the DRM paradigm as a method for testing the effects of semantic intrusion on the creation of false recollections. This method is used in the current thesis to test false memory in participants with Autism Spectrum Disorder (ASD), a disorder characterised by social, language and behavioural deficits. False memory studies of adults with this disorder have had conflicting results and found ASD participants have lower or similar false memory rates to controls. Experiment 1 compared false memory rates in 11 children, 11 adolescents and 5 adults with ASD to 15 children, 11 adolescents and 7 adult controls. ASD participants had higher false critical lure rates and lower studied item recognition rates than controls regardless of age. Adolescents had higher false and studied memory than children while adults had higher studied but lower false recognition rates than the younger groups. Due to the use of short DRM lists the adult participants recognised the fewest critical lures. In Experiment 2 there were 6 ASD children and 9 ASD adolescents compared with 6 control children and 9 control adolescents who were all tested both individually and in collaborative trios. Collaboration was beneficial to ASD adolescents and control children and adolescents by reducing false recognition and increasing studied item recognition. Collaboration was more beneficial for ASD adolescents and control children in the correct rejection of critical lures and for control adolescents in the recognition of studied items possibly due to decision making techniques. Critical lure recognition did not vary between collaborative trios and individuals and studied item recognition was decreased by collaboration in the ASD children. The observed decision making techniques employed revealed a clear pattern in social development and suggest ASD adolescents, but not ASD children, would benefit from group work. Overall the findings of this study, when taken into context with previous DRM studies, suggest that ASD participants have a delay in their social development and in the development of their association networks.

This study explored relationships between vocabulary size and self-regulation and joint engagement in 28 children with multi-system developmental delay (DD) aged 2;5 (years;months) to 5;6 and a language age-matched control group of 28 typically developing (TD) children aged 0;7 to 5;6 drawn from a larger sample of 77. Parents completed the ABASII, Second Edition (ABASII; Harrison & Oakland, 2003), with the Leisure, Self-direction, and Social subtests serving as measures of self-regulation and joint engagement. Vocabulary size was measured using an adaptation of the New Zealand version of the MacArthur Communicative Development Inventory: Toddlers (CDI; Reese & Read, 2000). Responses to the Language Use Inventory (O'Neill, 2007) were also collected for comparison with the CDI. Group differences on vocabulary size and the ABASII Social and Self-direction subtests were not significant. However, children with multi-system DD scored significantly higher on the Leisure subtest. Data from the children with multi-system DD revealed a medium, positive correlation between the CDI total score and the raw score of the Leisure subtest, r = 0.34, p = 0.075 and for the TD children a strong, positive correlation r = 0.51, p = 0.006. For the children with multi-system DD, there was a medium, positive correlation between the CDI total score and the raw score of the Self-direction subtest, r = 0.39, p = 0.038 and a strong, positive correlation for the TD children, r = 0.52, p = 0.005. Similarly, for the children with multi-system DD there was a medium, positive correlation between the CDI total score and the raw score of the Social subtest, r = 0.41, p = 0.032 and a strong, positive correlation for the TD children, r = 0.63, p < 0.001. The results suggest a positive correlation between self-regulation and joint engagement and vocabulary development in both groups of children.

Children with developmental delays often do not acquire perspective taking skills without training. These skills are imperative to the ability to relate to others socially and the development of appropriate social behavior. They may lack the ability to recognize that another person’s view may differ from their own, or that reality may differ from appearance. This study used deictic relational training to aid in the development of a ‘Theory of Mind’ and the acquisition of perspective taking skills. The PEAK relational training system was used in a special education classroom to train YOU and I relations, as well as YOU and I reversal, to two nine year old students with intellectual disability. Multiple exemplar training was then used to promote the generalization of these perspective taking skills to an in situ deceptive container task. One subject participated in the first two training phases, but was absent for the remainder of the study. The second subject successfully completed all training phases and was then able to correctly respond when asked to report what the perspective of another individual would be.

Young children with intellectual and developmental disabilities are at increased risk of developing persistent mental health and behavior problems. While the link between parenting behavior and the development of problem behavior is well understood in this population, there is a need for examination of key parent factors that affect parenting behavior and child problem behavior over time in families of children with developmental delay (DD). Private events such as parents’ feelings about their children and levels of dispositional optimism may impact parenting behavior through a variety of mechanisms, including experiential avoidance and relational schemas. As such, this study proposed to examine relations between parent feelings, optimism, parenting behavior, and child problem behavior for young children with developmental delay in a longitudinal context. Parents’ positive and negative feelings about their young children with developmental delay, dispositional optimism, and child problem behavior were assessed at three timepoints in 132 parent-child dyads. In addition, measures of observed effective parenting behavior during parent-child play interactions were collected at each timepoint. Negative feelings about the child significantly predicted child problem behavior across timepoints, with higher negative feelings predicting higher problem behavior. Positive feelings and optimism did not significantly predict problem behavior in the model including negative feelings, suggesting that correlations between these constructs and reduced problem behavior are primarily explained by reduced negative feelings. Increased negative feelings also significantly predicted a lower rate of praise across timepoints, indicating that parents with high negative feelings about their child with DD engaged in fewer praise statements during parent-child play interactions. These findings suggest that a strong and stable relationship between negative feelings and child problem behavior is present at a very early age for young children with developmental delay and that negative feelings may impact parents’ use of effective and positive parenting strategies. Future research should examine interventions designed to address both parent private events and child problem behavior as well as how these constructs develop both earlier and later in life.

Due to poverty and a lack of stimulation, many children living in Low- and Middle income countries suffer from developmental delay and do not develop to their full potential. Yet, remarkable recovery is often possible given that early interventions are available. The aim of this systematic literature review was to find out what could be done to decrease the gap between the current development and the developmental potential among children aged 0-8 years, living in Low –and Middle income countries. The research questions were the following: What intervention programs are provided by communities in Low- and Middle income counties with the intention of training parents´ to support their children reaching their developmental potential? What are the impacts of the interventions on children’s development, and what are the impacts of the interventions on parents´ knowledge about children`s development? Twelve studies were identified through a database search. After analyzing the data two different types of intervention programs emerged: parenting programs and stimulation programs. The gap between children´s current developmental levels and their developmental potential was not measured in the studies.  However, the intervention programs show to have positive effects on informing parents regarding child development, as well as making positive impacts on children’s cognitive development and social skills. The interventions mainly focus on children under the age of three, while interventions focusing on older children are few and need to be further researched. Simple matters, such as home-made toys and interactive communication with the children, can make a big impact on children’s development, which prepares children for future education.