Document Detail

Approaches to neurodevelopmental assessment in congenital diaphragmatic hernia survivors.
MedLine Citation:
PMID:  17560219     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Infants with congenital diaphragmatic hernia require complex surgical care and may have neurodevelopmental morbidity. We examined the performance of reports of motor functioning in 25 congenital diaphragmatic hernia survivors using the parent-completed Developmental Profile-II and a clinical evaluation by a neurodevelopmental pediatrician (MD) measured against the Bayley motor scale. METHODS: Bayley motor scores were dichotomized as normal or abnormal. Sensitivity and specificity were calculated for each test. RESULTS: The median age at assessment was 25 months. Bayley motor scores were abnormal in 77% of infants tested (10/13). The MD examinations detected motor problems in 92% (12/13). Sensitivity and specificity of the MD examination were 1.0 and 0.33, respectively. Developmental Profile-II physical scores were abnormal in 15% (2/13); sensitivity and specificity were 0.2 and 1.0, respectively. CONCLUSIONS: The high rate of abnormal motor findings in this study supports the need for ongoing screening and evaluation. The sensitivity of MD examinations was excellent, but hypotonia findings were not universally corroborated by the Bayley. Although specificity of parent-reported motor findings was high, parents underreported abnormal motor findings. Parental reports of neurodevelopmental problems should be heeded, and physicians should perform screening motor examinations. Bayley assessments may be warranted to determine the functional implications of observed abnormalities.
Catherine Chen; Sandra Friedman; Samantha Butler; Stefanie Jeruss; Norma Terrin; Hocine Tighiouart; Janice Ware; Jay M Wilson; Susan K Parsons
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  42     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-11     Completed Date:  2007-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1052-6; discussion 1056     Citation Subset:  IM    
Department of Surgery, Children's Hospital, Boston, MA 02115, USA.
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MeSH Terms
Abnormalities, Multiple / psychology,  surgery
Brain Damage, Chronic / diagnosis,  epidemiology,  etiology,  psychology
Child, Preschool
Cohort Studies
Developmental Disabilities / diagnosis,  epidemiology,  etiology*
Extracorporeal Membrane Oxygenation / adverse effects
Follow-Up Studies
Gastrointestinal Diseases / epidemiology
Heart Diseases / epidemiology
Hernia, Diaphragmatic / congenital*,  psychology,  surgery
Motor Skills Disorders / diagnosis,  epidemiology,  etiology*
Muscle Hypotonia / diagnosis,  epidemiology,  etiology
Neurologic Examination
Neuropsychological Tests
Parents / psychology
Pilot Projects
Postoperative Complications / diagnosis,  epidemiology,  etiology*
Psychomotor Disorders / diagnosis,  epidemiology,  etiology*
Respiration Disorders / epidemiology
Respiration, Artificial / utilization
Sensitivity and Specificity
Survivors / psychology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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