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Nayeb, L., Lagerberg, D., Westerlund, M., Sarkadi, A., Lucas, S. & Eriksson, M. (2019). Modifying a language screening tool for three-year-old children identified severe language disorders six months earlier. Acta Paediatrica, 108(9), 1642-1648
Open this publication in new window or tab >>Modifying a language screening tool for three-year-old children identified severe language disorders six months earlier
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 9, p. 1642-1648Article in journal (Refereed) Published
Abstract [en]

Aim We examined if routine Swedish language screening for developmental language disorder (DLD) carried out at three years of age could be performed as effectively six months earlier. Methods This study observed 105 monolingual Swedish-speaking children (53% boys) aged 29-31 months at three Swedish child health centres. We compared their ability to combine three words, as per the existing protocol, and two words. They also underwent a comprehension task. Speech and language pathologists clinically assessed the children for DLD and their results were compared with the nurse-led screening. Results The results for the three-word and two-word criterion were the following: sensitivity (100% versus 91%) specificity (81% versus 91%), positive predictive (38% versus 56%) and negative predictive value (100% versus 99%). The three-word criterion identified 29 children with possible DLD, including 11 cases later confirmed, and the two-word criterion identified 18 possible cases, including 10 confirmed cases. DLD was overrepresented in the 10% of children who did not cooperate with the nurse-led screening. Conclusion Changing the required word combinations from three to two words worked well. The three-word test identified one extra confirmed case, but resulted in 10 more false positives. Lack of cooperation during screening constituted an increased risk for DLD.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
Childhealth care, Developmental language disorder, Language screening, Monolingual children, Word production
National Category
General Language Studies and Linguistics Pediatrics
Identifiers
urn:nbn:se:uu:diva-393651 (URN)10.1111/apa.14790 (DOI)000479320100015 ()30896050 (PubMedID)
Available from: 2019-09-25 Created: 2019-09-25 Last updated: 2019-09-25Bibliographically approved
Fäldt, A., Nordlund, H., Holmqvist, U., Lucas, S. & Fabian, H. (2019). Nurses' experiences of screening for communication difficulties at 18 months of age. Acta Paediatrica, 108(4), 662-669
Open this publication in new window or tab >>Nurses' experiences of screening for communication difficulties at 18 months of age
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 4, p. 662-669Article in journal (Refereed) Published
Abstract [en]

Aim: Early identification of communication disorders is important and may be possible through screening in the child health services. The aim of the study was to investigate nurses' experiences and sense of competence when using the Infant-Toddler Checklist (ITC) communication screening at the 18-month health visit.

Methods: A mixed-methods design including three focus group interviews (n = 14) and a web-based survey (n = 22) among nurses using the ITC or the standard method. Interview data were analysed through systematic text condensation and a deductive analysis based on implementation theory. Groups were compared using Mann-Whitney tests.

Result: Three themes emerged: Using a structured evaluation of communication changes, the dynamic, ITC is a beneficial tool and Implementation of the ITC faces a few challenges. Nurses who used the ITC perceived to a greater extent that they used a structured method (p = 0.003, r = 0.9) and felt more secure in describing the child's communication and language development to parents (p = 0.006, r = 0.83) compared to the standard method group.

Conclusion: Using the ITC supported the nurses in their assessment of communication at 18 months. Nurses' sense of competence was higher when using the ITC, both in their assessment and in communicating with parents.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
Autism spectrum disorder, Child Health Surveillance, Developmental disorder, Developmental language disorder, Screening
National Category
Nursing Pediatrics
Identifiers
urn:nbn:se:uu:diva-380432 (URN)10.1111/apa.14557 (DOI)000461014600013 ()30153364 (PubMedID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-03-29Bibliographically approved
Fäldt, A., Fabian, H., Thunberg, G. & Lucas, S. (2019). The study design of ComAlong Toddler: a randomised controlled trial of an early communication intervention. Scandinavian Journal of Public Health, Article ID 1403494819834755.
Open this publication in new window or tab >>The study design of ComAlong Toddler: a randomised controlled trial of an early communication intervention
2019 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, article id 1403494819834755Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: This study design article aims to describe a research study focused on evaluating the use of the Infant-Toddler Checklist to identify children at 18 months with early communication difficulties, and to study the ComAlong Toddler intervention for parents to support their child's communication development.

BACKGROUND: Communication disorders are a common public health problem affecting up to 20% of children. Evidence points to the importance of early detection and intervention to improve young children's communicative abilities and decrease developmental delay. Early identification of communication difficulties is possible with instruments such as Infant-Toddler Checklist. The ComAlong Toddler intervention is tailored to the needs of parents of young children with communication delay before definitive diagnosis. The parents are provided with guidance in communication enhancing strategies during home visit and five group sessions.

METHODS: The study uses a prospective cohort design. Children were consecutively recruited during 2015-2017, and data will be collected 2015-2023. The screening was performed at the child health centre through use of the Infant-Toddler Checklist. An assessment and first consultation were then performed by a speech and language therapist for children with suspected communication delay according to the screen as well as for children referred for other reasons before the age of 2.5 years. Children with confirmed communication delay were randomised between two interventions: the ComAlong Toddler parental course or a telephone follow-up. Outcome measures include child communication and language skills and use of augmentative and alternative communication. To gain insight into the participants' perspectives, surveys have been collected from parents.

CONCLUSION: The study will provide information regarding identification and intervention for 18-month old children with communication delay.

TRIAL REGISTRATION: ISRCTN13330627.

Keywords
Communication development, early communication intervention, parental intervention, randomised controlled trial, screening instrument
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-384412 (URN)10.1177/1403494819834755 (DOI)31068096 (PubMedID)
Available from: 2019-06-05 Created: 2019-06-05 Last updated: 2019-06-12Bibliographically approved
Otterman, G., Lahne, K., Arkema, E., Lucas, S., Janson, S. & Hellström-Westas, L. (2018). Childhood death rates declined in Sweden from 2000 to 2014 but deaths from external causes were not always investigated. Acta Paediatrica
Open this publication in new window or tab >>Childhood death rates declined in Sweden from 2000 to 2014 but deaths from external causes were not always investigated
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2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
National Category
Medical and Health Sciences
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-347798 (URN)
Funder
The Swedish Crime Victim Compensation and Support Authority
Available from: 2018-04-07 Created: 2018-04-07 Last updated: 2018-04-07
Otterman, G., Lahne, K., Arkema, E. V., Lucas, S., Janson, S. & Hellström-Westas, L. (2018). Childhood death rates declined in Sweden from 2000-2014 but deaths from external causes were not always investigated.. Acta Paediatrica, 108(1), 160-168
Open this publication in new window or tab >>Childhood death rates declined in Sweden from 2000-2014 but deaths from external causes were not always investigated.
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2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 1, p. 160-168Article in journal (Refereed) Published
Abstract [en]

AIM: Countries that conduct systematic child death reviews report a high proportion of modifiable characteristics among deaths from external causes and this study examined the trends in Sweden.

METHODS: We analysed individual level data on external, ill-defined and unknown causes from the Swedish cause of death register from 2000-2014 and mortality rates were estimated for children under the age of one and for those aged 1-14 and 15-17 years.

RESULTS: Child deaths from all causes were 7,914 and 2,006 (25%) were from external, ill-defined and unknown causes: 610 (30%) were infants, 692 (34%) were 1-14 and 704 (35%) were 15-17. The annual average was 134 cases (range 99-156) during the study period. Mortality rates from external, ill-defined and unknown causes in children under 18 fell 19%, from 7.4 to 6.0 per 100,000 population. A sizeable number of infant deaths (8.0%) were registered without a death certificate during the study period, but these counts were lower in children aged 1-14 (1.3%) and 15-17 (0.9%).

CONCLUSION: Childhood deaths showed a sustained decline from 2000-2014 in Sweden and a quarter were from external, ill-defined or unknown causes. Systematic, interagency death reviews could yield information that could prevent future deaths. This article is protected by copyright. All rights reserved.

Keywords
Cause of death, Child death review, Child mortality, Register data, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-347800 (URN)10.1111/apa.14309 (DOI)000452620600028 ()29520820 (PubMedID)
Funder
The Swedish Crime Victim Compensation and Support Authority
Available from: 2018-04-07 Created: 2018-04-07 Last updated: 2019-12-06Bibliographically approved
Fängström, K., Sarkadi, A., Lucas, S., Calam, R. & Eriksson, M. (2017). “And they gave me a shot, it really hurt” – Evaluative content in investigative interviews with young children. Children and youth services review, 82, 434-443
Open this publication in new window or tab >>“And they gave me a shot, it really hurt” – Evaluative content in investigative interviews with young children
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2017 (English)In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 82, p. 434-443Article in journal (Refereed) Published
Abstract [en]

Research is scarce on the suitability of the evidence-based components of child investigative interviews when used in non-forensic contexts such as social work or school, particularly in relation to children’s reports on emotional content.

This explorative study investigated to what extent a structured forensic interview protocol aids children in verbalizing negative emotional experiences of distress or discomfort. To do this we assessed and compared children’s displayed distress or discomfort during a video-recorded health visit with the verbalized distress or discomfort in interviews 2-4 weeks later about this visit. The children, aged 4 and 5 years (N = 26), were interviewed with a forensic interview protocol. Children’s statements regarding distress and discomfort and the interviewer questions preceding these statements were analyzed qualitatively.

The results showed that 46% of the 4-year-olds and 39 % of the 5-year-olds displayed discomfort or distress during their health visit. In the interviews, open-ended questions were posed to all children, however, these questions were sufficient to aid only some children (n = 6) to share evaluative content. None of the children who displayed distress or discomfort during the visit verbalized such experiences after an invitation only. Most children who described experiences of distress or discomfort did so in relation to evaluative questions.

The results suggest that more research is warranted to investigate exactly how and when evaluative questions should be posed and whether this differs depending on severity of experience or the child’s age. The need for protocol development and its suitability when used in other fields of practice is discussed.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
investigative interviews, evaluative, emotion, question, distress
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-328585 (URN)10.1016/j.childyouth.2017.10.017 (DOI)000417964300049 ()
Funder
Swedish Research Council, 259-2012-68
Note

Forskningsfinansiär: Allmänna Barnhuset, FB13-0014

Available from: 2017-10-11 Created: 2017-10-11 Last updated: 2018-01-29Bibliographically approved
Johansen, K., Persson, K., Sonnander, K., Magnusson, M., Sarkadi, A. & Lucas, S. (2017). Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services. PLoS ONE, 12(7), Article ID e0181398.
Open this publication in new window or tab >>Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 7, article id e0181398Article in journal (Refereed) Published
Abstract [en]

Aim: This study aimed to evaluate the clinical utility of the Structured Observation of Motor Performance in Infants (SOMP-I) when used by nurses in routine child healthcare by analyzing the nurses' SOMP-I assessments and the actions taken when motor problems were suspected.

Method: Infants from three child health centers in Uppsala County, Sweden, were consecutively enrolled in a longitudinal study. The 242 infants were assessed using SOMP-I by the nurse responsible for the infant as part of the regular well-child visits at as close to 2, 4, 6 and 10 months of age as possible. The nurses noted actions taken such as giving advice, scheduling an extra follow-up or referring the infant to specialized care. The infants' motor development was reassessed at 18 months of age through review of medical records or parental report.

Results: The assessments of level of motor development at 2 and 10 months showed a distribution corresponding to the percentile distribution of the SOMP-I method. Fewer infants than expected were assessed as delayed at 4 and 6 months or deficient in quality at all assessment ages. When an infant was assessed as delayed in level or deficient in quality, the likelihood of the nurse taking actions increased. This increased further if both delay and quality deficit were found at the same assessment or if one or both were found at repeated assessments. The reassessment of the motor development at 18 months did not reveal any missed infants with major motor impairments.

Interpretation: The use of SOMP-I appears to demonstrate favorable clinical utility in routine child healthcare as tested here. Child health nurses can assess early motor performance using this standardized assessment method, and using the method appears to support them the clinical decision-making.

National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-316404 (URN)10.1371/journal.pone.0181398 (DOI)000406067800048 ()28723929 (PubMedID)
Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2017-11-29Bibliographically approved
Jernbro, C., Otterman, G., Lucas, S., Tindberg, Y. & Janson, S. (2017). Disclosure of Child Physical Abuse and Perceived Adult Support among Swedish Adolescents. Child Abuse Review, 26(6), 451-464
Open this publication in new window or tab >>Disclosure of Child Physical Abuse and Perceived Adult Support among Swedish Adolescents
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2017 (English)In: Child Abuse Review, ISSN 0952-9136, E-ISSN 1099-0852, Vol. 26, no 6, p. 451-464Article in journal (Refereed) Published
Abstract [en]

Compared to child sexual abuse (CSA), little is known about disclosure of child physical abuse (CPA). Enhancing the understanding of the characteristics of disclosure is necessary for improved child protection. The aim of the present study was to examine disclosure of CPA and perceived adult support using both quantitative and qualitative data from a survey of child maltreatment carried out among a nationally representative sample of Swedish adolescents (n = 3202). We found that adolescents who experienced any child maltreatment (CPA, emotional abuse, neglect and witnessing intimate partner violence) were less likely to be able to identify an adult confidant compared to those without a history of abuse. Among the adolescents who reported severe CPA, 52 per cent had disclosed the abuse and the most frequent recipient of disclosure was a peer or sibling. Eleven per cent had disclosed to professionals within school, child protective services or law enforcement. Lack of trust in adults appeared to be the most prominent reason for non- disclosure. Several adolescents who had disclosed abuse to professionals perceived an ineffective response, primarily because of professionals' lack of a child perspective. Some respondents experienced supportive interventions, specifically from school social workers. These patterns showed close similarity to disclosure of CSA.

Keywords
child maltreatment, child physical abuse, disclosure, social support, adolescents
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-343325 (URN)10.1002/car.2443 (DOI)000416432500005 ()
Available from: 2018-03-08 Created: 2018-03-08 Last updated: 2018-04-17Bibliographically approved
Montgomery, C., Johansen, K., Lucas, S., Strömberg, B. & Persson, K. (2017). The Structured Observation of Motor Performance in Infants can detect cerebral palsy early in neonatal intensive care recipients. Early Human Development, 113, 31-39
Open this publication in new window or tab >>The Structured Observation of Motor Performance in Infants can detect cerebral palsy early in neonatal intensive care recipients
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2017 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 113, p. 31-39Article in journal (Refereed) Published
Abstract [en]

Background

The detection of motor problems in infancy requires a detailed assessment method that measures both the infants' level of motor development and movement quality.

Aim

To evaluate the ability of the Structured Observation of Motor Performance in Infants (SOMP-I) to detect cerebral palsy (CP) in neonatal intensive care recipients.

Study design

Prospective cohort study analyzed retrospectively.

Subjects

212 (girls: 96) neonatal intensive care recipients (mean gestational age 34 weeks, range: 23–43). Twenty infants were diagnosed with CP.

Outcome measures

The infants were assessed using SOMP-I at 2, 4, 6 and 10 months' corrected age. Accuracy measures were calculated for level of motor development, quality of motor performance and a combination of the two to detect CP at single and repeated assessments.

Results

At 2 months, 17 of 20 infants with CP were detected, giving a sensitivity of 85% (95% CI 62–97%) and a specificity of 48% (95% CI 40–55%), while the negative likelihood ratio was 0.3 (95% CI 0.1–0.9) and the positive likelihood ratio was 1.6 (95% CI 1.3–2.0). At 6 months all infants with CP were detected using SOMP-I, and all infants had repeatedly been assessed outside the cut-offs. Specificity was generally lower for all assessment ages, however, for repeated assessments sensitivity reached 90% (95% CI 68–99%) and specificity 85% (95% CI 79–90%).

Conclusions

SOMP-I is sensitive for detecting CP early, but using the chosen cut-off can lead to false positives for CP. Assessing level and quality in combination and at repeated assessments improved predictive ability.

National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-316405 (URN)10.1016/j.earlhumdev.2017.07.009 (DOI)000415776000006 ()28728014 (PubMedID)
Note

Cecilia Montgomery and Kine Johansen share first authorship

Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2018-02-26Bibliographically approved
Lucas, S., Bärtås, A., Bonamy, A.-K. E., Tornudd, L., Wide, P. & Otterman, G. (2017). The way forward in addressing abusive head trauma in infants: current perspectives from Sweden. Acta Paediatrica, 106(7), 1033-1035
Open this publication in new window or tab >>The way forward in addressing abusive head trauma in infants: current perspectives from Sweden
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1033-1035Article in journal, Editorial material (Other academic) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-335811 (URN)10.1111/apa.13840 (DOI)000405216700005 ()28422325 (PubMedID)
Available from: 2018-01-22 Created: 2018-01-22 Last updated: 2018-01-22Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3409-2033

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