Validation of the Brief Developmental Assessment in pre-school children with heart disease

Brown, Kate; Ridout, Deborah; Pagel, Christina; Lakhanpaul, Monica; Kakat, Suzan; Banks, Victoria; Franklin, Rodney; Witter, Thomas; Lakhani, Rhian; Tibby, Shane M.; Anderson, David; Tsang, Victor; Hoskote, Aparna; Wray, Jo

doi:10.1017/s1047951117002773

Cited by 7 publications

(9 citation statements)

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“…This study is a secondary analysis of a prospectively collected multicentre cross-sectional dataset. The age structure and sub-groups within the sample reflect the primary study objective of developing and validating the BDA (25,26). The study protocol was approved by the London City Road Research Ethics Committee (study number 14-LO-1442).…”

Section: Methodsmentioning

confidence: 99%

“…weeks, 17-34.9 weeks, 35-60 weeks, 15 months-2.9 years and 3.0-4.9 years, recruiting until the target number (within age band) was achieved (25). All participating children were assessed with the Mullen Scales of Early Learning (MSEL) (27) by a small team of trained psychology assistants under the supervision of a single senior psychology researcher (JW) and a medical lead (AH).…”

Section: Study Populationmentioning

confidence: 99%

“…As part of a wider NIHR-funded research project to explore morbidities following paediatric cardiac surgery (24), we undertook a study to validate an early recognition toolbrief developmental assessment (BDA)for child development in pre-school children with HD. This study entailed assessment of neurodevelopmental status using validated measures in a representative convenience sample of pre-school children with HD in 3 tertiary cardiac programmes in London, UK (25). This dataset provided an opportunity for a secondary analysis that aimed to: ascertain the prevalence of neurodevelopment issues, explore service provision and associations between patient factors and DD in order to identify a high-risk group for targeted follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Neurodevelopmental status and follow-up in preschool children with heart disease in London, UK

et al. 2020

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ObjectiveTo describe neurodevelopment and follow-up services in preschool children with heart disease (HD).DesignSecondary analysis of a prospectively collected multicentre dataset.SettingThree London tertiary cardiac centres.PatientsPreschool children<5 years of age: both inpatients and outpatients.MethodsWe analysed results of Mullen Scales of Early Learning (MSEL) and parental report of follow-up services in a representative convenience sample evaluated between January 2014 and July 2015 within a previous study.ResultsOf 971 preschool children: 577 (59.4%) had ≥1 heart operation, 236 (24.3%) had a known diagnosis linked to developmental delay (DD) (‘known group’) and 130 (13.4%) had history of clinical event linked to DD. On MSEL assessment, 643 (66.2%) had normal development, 181 (18.6%) had borderline scores and 147 (15.1%) had scores indicative of DD. Of 971 children, 609 (62.7%) were not receiving follow-up linked to child development and were more likely to be under these services with a known group diagnosis, history of clinical event linked to DD and DD (defined by MSEL). Of 236 in known group, parents of 77 (32.6%) and of 48 children not in a known group but with DD 29 (60.4%), reported no child development related follow-up. DD defined by MSEL assessment was more likely with a known group and older age at assessment.ConclusionsOur findings indicate that a ‘structured neurodevelopmental follow-up pathway’ in preschool children with HD should be considered for development and evaluation as children get older, with particular focus on those at higher risk.

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Section: Methodsmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neurodevelopmental status and follow-up in preschool children with heart disease in London, UK

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“…This age bracket has been chosen as the BDA was validated in this age group. 23 Alongside each scenario, respondents were sent a relevant example of the BDA along with standard information to be shared with all relevant health professionals. Scenario 1 described a child with amber BDA admitted to the tertiary centre for an intervention (surgery or catheter treatment), who is found to have developmental concerns on the BDA (score of amber=not fulfilling some of the milestones based on population norms, equivocal result).…”

Section: Methods Recruitment and Selection Of The Delphi Panelmentioning

confidence: 99%

“…development process of the delphi survey A 4-step process was followed in the development of the Delphi survey. A core team-AH, KB, JW-developed the Delphi survey based on findings from two previously published studies in which the BDA was developed 22 and then validated 23 (funded by NIHR Health Services and Delivery Research). This draft survey was refined by the fourth author-ML.…”

Section: Methods Recruitment and Selection Of The Delphi Panelmentioning

confidence: 99%

A referral pathway for potentially abnormal neurodevelopment in children with heart disease in the United Kingdom: a Delphi consensus

Hoskote

Wray

Banks

et al. 2020

bmjpo

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IntroductionChildren with congenital heart disease have complex medical and neurodevelopmental needs. We aimed to develop a multi-professional consensus-based referral pathway applicable to action the results of the brief developmental assessment (BDA), a validated early recognition tool, that categorises the neurodevelopmental status as green (appropriate for age), amber (equivocal) or red (delayed) in children aged between 4 months and 5 years.MethodsA Delphi consensus survey detailing two scenarios—a child categorised as delayed (red) and another as equivocal (amber) on administration of the BDA at the time of discharge from the tertiary centre—was sent to 80 expert professionals from primary, secondary and tertiary care seeking agreement on next steps and referral pathways. An iterative process was proposed with a pre-defined rule of 75% for consensus.ResultsThe survey was completed by 77 Delphi panel experts in Round 1, 73 in Round 2 and 70 in Round 3. Consensus was achieved (1) for the child with amber or red BDA, the child should be under the care of a paediatrician with expertise in cardiology (PEC) (or general paediatrician if no PEC) based at their local hospital, (2) for the child with red BDA, the PEC should initiate referral to community services at first assessment, (3) for child with amber BDA, a re-assessment by the health visitor should occur within 1–2 months, with referral to community services and notification to the PEC if on-going concerns.ConclusionsThe Delphi process enabled a consensus to be reached between health professionals on referral pathways for specialist neurodevelopmental assessment/treatment for children with heart disease, in response to amber or red BDA results. The agreed referral pathway, if implemented, could underpin a national guideline to address and intervene on the neurodevelopmental difficulties in children with heart disease.

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Neurodevelopmental Outcomes in Children with Congenital Heart Disease

Patel

Ilardi

Kochilas

2023

Clinics in Perinatology

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Validation of the Brief Developmental Assessment in pre-school children with heart disease

Cited by 7 publications

References 32 publications

Neurodevelopmental status and follow-up in preschool children with heart disease in London, UK

Neurodevelopmental status and follow-up in preschool children with heart disease in London, UK

A referral pathway for potentially abnormal neurodevelopment in children with heart disease in the United Kingdom: a Delphi consensus

Neurodevelopmental Outcomes in Children with Congenital Heart Disease

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