Validity of The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS): a daily activity criterion checklist for infants and toddlers

Peyton, Colleen; Wroblewski, Kristen; Park, Jennifer; Crisante, Caitlin; Mariano, Kathleen; Lyon, Nancy; Baker, Christine P.; Rogers, Bonnie; Roistacher, J; Carter, Frances A.; Msall, Michael E.

doi:10.1038/s41390-020-01342-0

Cited by 13 publications

(5 citation statements)

References 19 publications

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“…The primary outcome was functional neurodevelopment at age 24 months, measured with the Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS), a 50-item questionnaire designed to assess adaptive skills including mobility, communication, social cognition, and self-care. The WIDEA-FS has good concurrent validity with the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) .…”

Section: Methodsmentioning

confidence: 99%

Safety of Early Discontinuation of Antiseizure Medication After Acute Symptomatic Neonatal Seizures

et al. 2021

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IMPORTANCE Antiseizure medication (ASM) treatment duration for acute symptomatic neonatal seizures is variable. A randomized clinical trial of phenobarbital compared with placebo after resolution of acute symptomatic seizures closed early owing to low enrollment.OBJECTIVE To assess whether ASM discontinuation after resolution of acute symptomatic neonatal seizures and before hospital discharge is associated with functional neurodevelopment or risk of epilepsy at age 24 months. DESIGN, SETTING, AND PARTICIPANTSThis comparative effectiveness study included 303 neonates with acute symptomatic seizures (282 with follow-up data and 270 with the primary outcome measure) from 9 US Neonatal Seizure Registry centers, born from July 2015 to March 2018. The centers all had level IV neonatal intensive care units and comprehensive pediatric epilepsy programs. Data were analyzed from June 2020 to February 2021.EXPOSURES The primary exposure was duration of ASM treatment dichotomized as ASM discontinued vs ASM maintained at the time of discharge from the neonatal seizure admission. To enhance causal association, each outcome risk was adjusted for propensity to receive ASM at discharge. Propensity for ASM maintenance was defined by a logistic regression model including seizure cause, gestational age, therapeutic hypothermia, worst electroencephalogram background, days of electroencephalogram seizures, and discharge examination (all P Յ .10 in a joint model except cause, which was included for face validity). MAIN OUTCOMES AND MEASURESFunctional neurodevelopment was assessed by the Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) at 24 months powered for propensity-adjusted noninferiority of early ASM discontinuation. Postneonatal epilepsy, a prespecified secondary outcome, was defined per International League Against Epilepsy criteria, determined by parent interview, and corroborated by medical records.RESULTS Most neonates (194 of 303 [64%]) had ASM maintained at the time of hospital discharge. Among 270 children evaluated at 24 months (mean [SD], 23.8 [0.7] months; 147 [54%] were male), the WIDEA-FS score was similar for the infants whose ASMs were discontinued (101 of 270 [37%]) compared with the infants with ASMs maintained (169 of 270 [63%]) at discharge (median score, 165 [interquartile range, 150-175] vs 161 [interquartile range, 129-174]; P = .09). The propensity-adjusted average difference was 4 points (90% CI, −3 to 11 points), which met the a priori noninferiority limit of −12 points. The epilepsy risk was similar (11% vs 14%; P = .49), with a propensity-adjusted odds ratio of 1.5 (95% CI, 0.7-3.4; P = .32). CONCLUSIONS AND RELEVANCEIn this comparative effectiveness study, no difference was found in functional neurodevelopment or epilepsy at age 24 months among children whose ASM was discontinued vs maintained at hospital discharge after resolution of acute symptomatic neonatal seizures. These results support discontinuation of ASM prior to hospital discharge for most infants wit...

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Section: Methodsmentioning

confidence: 99%

Safety of Early Discontinuation of Antiseizure Medication After Acute Symptomatic Neonatal Seizures

et al. 2021

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“…Self‐care included three categories: feeding, dressing, and diaper awareness. The WIDEA‐FS has been validated in comparison to the Bayley Scales of Infant and Toddler Development and the CAT/CLAMS in populations of children with and without developmental delay 30,31 …”

Section: Methodsmentioning

confidence: 99%

Early childhood developmental skills of children with tracheostomies and ventilators recently discharged home

Sobotka

Lynch

Msall

et al. 2022

Pediatric Pulmonology

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Background Infants who survive prematurity and critical illnesses but require ongoing invasive mechanical ventilation (IMV) are at high risk for developmental disabilities. However, their detailed developmental profiles are largely unknown. Objective To understand the developmental profiles of a cohort of young children with IMV after hospital‐to‐home transition. Design/methods Developmental testing was completed 1 month after hospital discharge to determine functioning within motor, cognitive, and communicative domains using (1) the Clinical Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS); (2) the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI‐CAT); and (3) The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA‐FS). To complement validated testing, semi‐structured interviews were conducted with parents to understand perceived influences on neurodevelopment. Results Twenty children were evaluated at median (range) age 11 (5–27) months. Nearly half (45%) were male, 40% non‐Hispanic Black, and 25% Hispanic. Sixteen (80%) children were survivors of prematurity. After gestational age correction, median (range) full‐scale developmental quotients (DQ) were 69.5 (8–119): CAT DQ 62.5 (3–113) and CLAMS DQ 71.5 (12–125). Parents described that prolonged restriction within the hospital crib away from caregivers, despite hospital therapists, impedes development. Home environments improve development primarily through increased time with parents, but also play outside of the crib. One month after hospital discharge only 10% were receiving early intervention therapies. Conclusions/significance Children with IMV display wide ranges of neurodevelopmental skills with a majority experiencing substantial delays in motor, communicative, and adaptive functioning. The degree and cross‐domain challenges highlight the need for targeted and timely therapeutic strategies.

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“…Functional neurodevelopment was measured via the Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA‐FS), administered at 24 months corrected age 25–28 …”

Section: Methodsmentioning

confidence: 99%

Early‐life epilepsy after acute symptomatic neonatal seizures: A prospective multicenter study

et al. 2021

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Objective We aimed to evaluate early‐life epilepsy incidence, seizure types, severity, risk factors, and treatments among survivors of acute neonatal seizures. Methods Neonates with acute symptomatic seizures born 7/2015‐3/2018 were prospectively enrolled at nine Neonatal Seizure Registry sites. One‐hour EEG was recorded at age three months. Post‐neonatal epilepsy and functional development (Warner Initial Developmental Evaluation of Adaptive and Functional Skills – WIDEA‐FS) were assessed. Cox regression was used to assess epilepsy‐free survival. Results Among 282 infants, 37 (13%) had post‐neonatal epilepsy by 24‐months [median age of onset 7‐months (IQR 3–14)]. Among those with post‐neonatal epilepsy, 13/37 (35%) had infantile spasms and 12/37 (32%) had drug‐resistant epilepsy. Most children with post‐neonatal epilepsy had abnormal neurodevelopment at 24‐months (WIDEA‐FS >2SD below normal population mean for 81% of children with epilepsy vs 27% without epilepsy, RR 7.9, 95% CI 3.6–17.3). Infants with severely abnormal neonatal EEG background patterns were more likely to develop epilepsy than those with mild/moderate abnormalities (HR 3.7, 95% CI 1.9–5.9). Neonatal EEG with ≥3 days of seizures also predicted hazard of epilepsy (HR 2.9, 95% CI 1.4–5.9). In an adjusted model, days of neonatal EEG‐confirmed seizures (HR 1.4 per day, 95% CI 1.2–1.6) and abnormal discharge examination (HR 3.9, 95% CI 1.9–7.8) were independently associated with time to epilepsy onset. Abnormal (vs. normal) three‐month EEG was not associated with epilepsy. Significance In this multicenter study, only 13% of infants with acute symptomatic neonatal seizures developed post‐neonatal epilepsy by age 24‐months. However, there was a high risk of severe neurodevelopmental impairment and drug‐resistant seizures among children with post‐neonatal epilepsy. Days of EEG‐confirmed neonatal seizures was a potentially modifiable epilepsy risk factor. An EEG at three months was not clinically useful for predicting epilepsy. These practice changing findings have implications for family counseling, clinical follow‐up planning, and future research to prevent post‐neonatal epilepsy.

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Validity of The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS): a daily activity criterion checklist for infants and toddlers

Cited by 13 publications

References 19 publications

Safety of Early Discontinuation of Antiseizure Medication After Acute Symptomatic Neonatal Seizures

Safety of Early Discontinuation of Antiseizure Medication After Acute Symptomatic Neonatal Seizures

Early childhood developmental skills of children with tracheostomies and ventilators recently discharged home

Early‐life epilepsy after acute symptomatic neonatal seizures: A prospective multicenter study

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