675 Non-Categorical Identification of Infants Who Are at Risk for Future Handicapping Conditions

Abstract

Since t h e v a l i d i t y of t h e DPDQ has been examined only i n predominantly White middle c l a s s populations i n Denver, CO, a prospective study was conducted t o a s s e s s the v a l i d i t y of t h e quest i o n n a i r e i n a predominantly indigent Black population. The eff e c t of an educational package i n increasing the accuracy of pare n t a l response t o DPDQ a s a l s o assessed.127 i n f a n t s were enrolled i n a longitudinal follow-up program from age 2 wks t o 1 yr. Parents i n a randomly s e l e c t e d experimental group observed an audiovisfial presentation describing progressive developmental behavior and were asked t o record t h e i r c h i l d ' s subsequent development.78 of t h e 127 i n f a n t s were followed f o r 3 mos, while 53 and 33 have been followed f o r 6 and 9 mos, respectively. The mean agreement scores between parental responses t o the DPDQ and the observed development v i a DDST were 93.6%, 93.2% and 91% a t 3, 6, and 9 mos, respectively. Tliere were no s i g n i f i c a n t d i f f e r e n c e s i n t h e item agreement scores of the experimental group vs t h e control group thereby demonstrating f a i l u r e of t h e educational program i n increasing t h e accuracy of parents. The o v e r r e f e r r a l r a t e was q u i t e low (12.8%).The r e s u l t s a t t e s t t o the v a l i d i t y , generality and f e a s i b il i t y of DPDQ i n a lower socioeconomic population and r a i s e some questions about parent education through audiovisual and w r i t t e n materials. EFFECT OF PROBLEM ORIENTED RECORD COMPONENTS ON671 HOSPITAL CARE. Carmi Z. Margolis, Wilhelmina Cohen, Nurit Barak. Faculty of Health Sciences, Ben Gurion University of t h e Negev, Primary Care Unit, Beersheba, I s r a e l .W e implemented a standardized d a t a base (SDB) and problem l i s t (PL) i n two 50-bed general p e d i a t r i c wards X and Y, and measured number of problems i d e n t i f i e d and amount of d a t a c o l l e c t e d i n 100 randomly sampled records from each ward before (period I ) , immedi a t e l y a f t e r (period 2 ) , and one year a f t e r implementation (period 3 ) .Mean subjective d a t a score a t periods 1,2 and 3 was 14.96+S.D. 5.57, 28.18*S.D.9.76 (p=<0.005) and 28.7tS.D.9.53 respectively, (maximum possible=50). Mean objective d a t a score a t periods 1,2 and 3 was 10.97*S.D.4.96, 17.64fS.D.1.78 (p=<0.005) and 17.48tS.D. 1.7, r e s p e c t i v e l y (maximum possible=21). There was no s i g n i f i c a n t d i f f e r e n c e between wards X and Y, mean number of problems i d e n t if i e d on admission t o ward X a t periods 1,2 and 3 was 2.22 (range 1-6; mode 1; median 2), 2.08 (range 1-5; mode 1; median 2), 2.17(range 1-6; mode 1 ; median 2 ) , 2.18 (range 1-6; mode 1; median 2), 2.17 (range 1-6; mode 1 ; median 2 ) . Percentage of records with 3 problems on discharge from ward X a t periods 1,2 and 3 was SO%, 40% and 52%, respectively, and f o r ward Y, 25%, 39% (p=<0.025) and 42%.An SDB can increase s i g n i f i c a n t l y amount of d a t a ...