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This study examined the effects of autistic behaviors and individual emotional and behavioral problems on parenting stress in caregivers of children with autism. Caregivers were interviewed with the Childhood Autism Rating Scale and completed the Strength and Difficulties Questionnaire and the Parenting Stress Index Short Form. Results revealed that caregivers of children with mild/moderate autistic behavior problems perceived lower parenting stress than did those of children with no or severe problems. In addition, prosocial behaviors and conduct problems respectively predicted stress in the parent--child relationship and child-related stress. The findings can provide guidance in evaluations and interventions with a focus on mitigating parenting stress in caregivers of children with autism.

Aim: This study aimed at improving the utility of the fine motor subscale of the comprehensive developmental inventory for infants and toddlers (CDIIT) by developing a computerized adaptive test of fine motor skills. Methods: We built an item bank for the computerized adaptive test of fine motor skills using the fine motor subscale of the CDIIT items fitting the Rasch model. We also examined the psychometric properties and efficiency of the computerized adaptive test of fine motor skills with simulated computerized adaptive tests. Results and conclusions: Data from 1742 children with suspected developmental delays were retrieved. The mean scores of the fine motor subscale of the CDIIT increased along with age groups (mean scores = 1.36-36.97). The computerized adaptive test of fine motor skills contains 31 items meeting the Rasch model’s assumptions (infit mean square = 0.57-1.21, outfit mean square = 0.11-1.17). For children of 6-71 months, the computerized adaptive test of fine motor skills had high Rasch person reliability (average reliability >0.90), high concurrent validity (rs = 0.67-0.99), adequate to excellent diagnostic accuracy (area under receiver operating characteristic = 0.71-1.00), and large responsiveness (effect size = 1.05-3.93). The computerized adaptive test of fine motor skills used 48-84% fewer items than the fine motor subscale of the CDIIT. The computerized adaptive test of fine motor skills used fewer items for assessment but was as reliable and valid as the fine motor subscale of the CDIIT. Implications for Rehabilitation: We developed a computerized adaptive test based on the comprehensive developmental inventory for infants and toddlers (CDIIT) for assessing fine motor skills. The computerized adaptive test has been shown to be efficient because it uses fewer items than the original measure and automatically presents the results right after the test is completed. The computerized adaptive test is as reliable and valid as the CDIIT. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to apply the International Classification of Functioning, Disability and Health - Child and Youth (ICF-CY) framework to identify the factors related to the participation of children with autism. Method: A convenience sample included 162 preschool children with autism ages 36 to 72 months. The raters collected data using the ICF-CY-based questionnaire as an instrument to construct the structural equation modeling of factors associated with participation. Results: The internal structure of the model was acceptable, indicating that the observed variables would suffice in accounting for latent variables. The structural model showed that the performance of participation in children with autism was influenced by body functions and personal factors. All the variables accounted for 77% of the explained variance for activities and for participation by 71% of the children with autism. Conclusion: These findings may provide critical information pertaining to predictive factors of participation for parents, educators, and professionals who work with children with autism. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study was to develop an International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY) based questionnaire for children with autism, investigate the inter-rater reliability of the questionnaire and assess functional performance in children with autism. Method: The ICF-CY based questionnaire for children with autism comprised 118 items was designed with reference the ICF-CY structure. The study protocol was divided into two parts. In the first part, the inter-rater reliability of the questionnaire was investigated using information from 26 children (aged 3-6 years) with autism and using the intra-class correlation coefficients to estimate reliability. The second part of the study aimed to assess functional performance of another independent sample (136 children, aged 3-6 years) utilizing the questionnaire. Mean scores were compared by nonparametric statistic. Results: The inter-rater reliability for each domains of the questionnaire was found to be moderate to high (intra-class correlation coefficients ranged from 0.72 to 0.97). Children with autism had major problems in voice and speech functions. They had high dependency when executing individual activities of learning and applied knowledge. They also required maximal assistance while engaging in social activities related to conversation and major life categories. Conclusions: This preliminary study shows that ICF-CY based questionnaire has good reliability and can reflect the functional profile of preschool children with autism. However, further study is needed to confirm other psychometric characteristics. [ABSTRACT FROM AUTHOR]

The aim of this study was to discuss the influence of age, gender, obesity status, joint laxity, and the W-sitting habit on flatfoot in preschool-aged children. A total of 1,598 children (833 boys and 765 girls) between 3 and 6 years of age from kindergartens in the central area of Taiwan were studied. The children were divided into a normal group (n = 733), a unilateral flatfoot group (n = 266), and a bilateral flatfoot group (n = 599), and a multinomial logistic regression model was used to analyze the data. The prevalence of flatfoot decreased significantly with increasing age: 54.5% of 3-year-old but only 21% for 6-year-old children had bilateral flatfoot. In the bilateral flatfoot group, the risk decreased with increased age, increased with increasing weight beyond the normal range, and was higher for boys than girls. Age and obesity status were not significantly influential in the unilateral flatfoot group. Children with higher joint laxity and a habit of W-sitting also experienced higher risk in both flatfoot groups. In conclusion, this study demonstrates a significant association of age, gender, obesity status, joint laxity, and the W-sitting habit with the bilateral flatfoot in preschool-aged children. Children with unilateral flatfoot differ from those with normal feet and bilateral flatfoot. It is suggested that the unilateral flatfoot deserves special attention in future studies. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to examine the responsiveness of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) in children with developmental disabilities (DD)., Methods: The responsiveness of a measure is its ability to detect change over time, and it is fundamental to an outcome measure for detecting changes over time. We compared the responsiveness of four types of scores (ie, raw scores, developmental ages [DAs], percentile ranks [PRs], and developmental quotients [DQs]) in the five subtests of the CDIIT. The CDIIT was administrated three times at intervals of 3 months on 32 children with DD aged between 5 months and 64 months (mean =30.6, standard deviation [SD] =17.8). The CDIIT is a pediatric norm-referenced assessment commonly used for clinical diagnosis of developmental delays in five developmental areas: cognition, language, motor, social, and self-care skills. The responsiveness was analyzed using three methods: effect size, standardized response mean, and paired t-test., Results: The effect size results showed that at the 3-month and 6-month follow-ups, responsiveness was small or moderate in the raw scores and DAs of most of the subtest scores of the CDIIT, but the level of responsiveness varied in the PRs and DQs. The standardized response mean results of the 3-month and 6-month follow-ups showed that most of the subtest scores of the CDIIT had respectively moderate and large responsiveness in raw scores and DAs, but the responsiveness varied (from no to large) in PRs and DQs., Conclusion: The findings generally support the use of the CDIIT as an outcome measure. We also suggest using the raw scores and DAs when using a norm-referenced pediatric developmental assessment to evaluate developmental changes and program effectiveness in children with DD.

Purpose: This study aimed to establish 1) whether a group difference exists in the motor competence of preschool children at risk for developmental delays with intelligence quotient discrepancy (IQD; refers to difference between verbal intelligence quotient [VIQ] and performance intelligence quotient [PIQ]) and 2) whether an association exists between IQD and motor competence., Methods: Children's motor competence and IQD were determined with the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers and Wechsler Preschool and Primary Scale of Intelligence™ - Fourth Edition. A total of 291 children were included in three groups: NON-IQD (n=213; IQD within 1 standard deviation [SD]), VIQ>PIQ (n=39; VIQ>PIQ greater than 1 SD), and PIQ>VIQ (n=39; PIQ>VIQ greater than 1 SD)., Results: The results of one-way analysis of variance indicated significant differences among the subgroups for the "Gross and fine motor" subdomains of the Comprehensive Developmental Inventory for Infants and Toddlers, especially on the subtests of "body-movement coordination" (F=3.87, P<0.05) and "visual-motor coordination" (F=6.90, P<0.05). Motor competence was significantly worse in the VIQ>PIQ group than in the NON and PIQ>VIQ groups. Significant negative correlations between IQD and most of the motor subtests (r=0.31-0.46, P<0.01) were found only in the VIQ>PIQ group., Conclusion: This study demonstrates that 1) IQD indicates the level of motor competence in preschoolers at risk for developmental delays and 2) IQD is negatively associated with motor competence in preschoolers with significant VIQ>PIQ discrepancy. The first finding was that preschoolers with VIQ>PIQ discrepancy greater than 1 SD performed significantly worse on motor competence than did preschoolers without significant IQD and preschoolers with PIQ>VIQ discrepancy greater than 1 SD. However, preschoolers with significant PIQ>VIQ discrepancy performed better on motor competence than did preschoolers without significant IQD, though the difference was not statistically significant. The second finding was that preschoolers with larger VIQ>PIQ discrepancy had worse motor competence in visual-motor integration and body-movement coordination. Professionals should pay attention to the motor development of children with VIQ>PIQ discrepancy and evaluate children's IQD along with their motor competence.

Background: Articulation disorders in young children are due to defects occurring at a certain stage in sensory and motor development. Some children with functional articulation disorders may also have sensory integration dysfunction (SID). We hypothesized that speech therapy would be less efficacious in children with SID than in those without SID. Hence, the purpose of this study was to compare the efficacy of speech therapy in two groups of children with functional articulation disorders: those without and those with SID., Method: A total of 30 young children with functional articulation disorders were divided into two groups, the no-SID group (15 children) and the SID group (15 children). The number of pronunciation mistakes was evaluated before and after speech therapy., Results: There were no statistically significant differences in age, sex, sibling order, education of parents, and pretest number of mistakes in pronunciation between the two groups (P > 0.05). The mean and standard deviation in the pre- and post-test number of mistakes in pronunciation were 10.5 ± 3.2 and 3.3 ± 3.3 in the no-SID group, and 10.1 ± 2.9 and 6.9 ± 3.5 in the SID group, respectively. Results showed great changes after speech therapy treatment (F = 70.393; P < 0.001) and interaction between the pre/post speech therapy treatment and groups (F = 11.119; P = 0.002)., Conclusions: Speech therapy can improve the articulation performance of children who have functional articulation disorders whether or not they have SID, but it results in significantly greater improvement in children without SID. SID may affect the treatment efficiency of speech therapy in young children with articulation disorders.

Objective: To investigate the association between drooling in children with cerebral palsy (CP) and their health-related quality of life (HRQOL), as well as the possible variables that predict their HRQOL., Method: A cross-sectional design was used for this study. Children with CP, without other identified disease, aged 2 to 6 years, who drool (n = 33) or did not drool (n = 14), were included. The dependent variables were the physical health summary scores and the psychosocial health summary scores of the Pediatric Quality of Life Inventory version 4.0. The t test, Pearson product-moment correlation, Mann-Whitney U test and stepwise regression analysis were used for statistical analysis., Results: The physical health and psychosocial health summary scores of the children that drooled (16.29 ± 15.97 and 42.92 ± 17.57, respectively) were lower than for the children that did not drool (31.97 ± 22.22 and 57.09 ± 12.21, respectively; P < 0.01). The drooling ranking score was negatively correlated with the physical health summary score (r = -0.355; P < 0.05) and the psychosocial health summary score (r = -0.381; P < 0.01). The stepwise regression showed that gross motor development and the drooling ranking score predicted 56.6% of the variability of the physical health summary score (R(2) = 0.566; P < 0.01). The language development score predicted 25.6% of the variability of the psychosocial health summary score (R(2) = 0.256; P < 0.01)., Conclusion: Drooling was associated with a lower HRQOL. Prediction of the physical health summary score was more closely associated with gross motor development and the drooling ranking scores. Prediction of the psychosocial health summary score was more closely associated with the language development of children with CP aged 2 to 6 years.