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Papers by Babu George

Indian journal of child health, Dec 15, 2019

Background: Improved survival of preterm infants has resulted in increase in motor and cognitive ... more Background: Improved survival of preterm infants has resulted in increase in motor and cognitive dysfunctions which have reduced health-related quality of life. Objective: The objective of this study was to assess the receptive and expressive language (EL) development of very low birth weight (VLBW) babies at 2-year corrected age and compare it with normal birth weight (NBW) "at-risk" babies on developmental follow-up. Materials and Methods: This was a cross-sectional study which compared the language outcome which was measured using Receptive-Expressive Emergent Language Scale. Results: The study included 75 VLBW babies and a comparison group of 26 NBW babies. The mean receptive language quotient in VLBW and NBW babies was 91.37±8.35 and 97.19±7.07, respectively (p=0.002). The mean EL quotient in VLBW and NBW babies was 82.64±12.32 and 92.77±10.47, respectively (p<0.001). A total of 20% of VLBW children had a significant delay in EL as opposed to only 4% of the NBW children (p=0.019). Conclusion: VLBW infants have a significantly higher chance of expressive language delay compared to NBW children.

Indian Journal of Pediatrics

Wellcome Open Research, 2022

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical condi... more Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India based on the National Family Health Survey – 4 (NHFS-4). Methods Data from the NFHS 4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant–mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight <2500 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15–1.60), among mothers aged 13–19 years (aOR: 1.58, 95% CI: 1.22–2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: ...

International Journal of Medical Research & Review, 2020

Objective: To describe the clinical, socio-demographic, and functional profile of children with A... more Objective: To describe the clinical, socio-demographic, and functional profile of children with Attention Deficit Hyperactivity Disorder (ADHD) referred to a tertiary care center in Kerala, India. Methods: A retrospective descriptive study was conducted from records of developmental evaluation clinic over a period of one year. All-consecutive cases the first time diagnosed as ADHD were enrolled. Autism Spectrum Disorder, genetic disorders, and children with sensory impairments were excluded. Results: ADHD prevalence in a clinically referred sample was 12.7%. Boy to girl ratio was 6:1. The mean age of presentation was 8.2 years (SD 6.09). The most common presenting symptom was hyperactivity and behavioral problems followed by poor scholastic performance and poor memory. The functional status assessment showed major concerns in all six domains-Inattention, Hyperactivity, Learning Problem, Executive Functioning, Aggression, and Peer relation, in the majority of children. Conclusion: Course of childhood ADHD shows a consistent clinical and functional pattern. Early diagnosis and quantification of difficulties at the outset is suggested, which can help in providing early intervention and is likely to improve long-term outcome in these children.

Indian pediatrics, 2009

The study was conducted to compare growth status, blood pressure, self esteem and intelligence of... more The study was conducted to compare growth status, blood pressure, self esteem and intelligence of 200 low birthweight (LBW) and 224 normal birthweight (NBW) adolescents at 13 years of age. Intelligence scores at or below the 25th percentile (low performance) were observed among 51.4% LBW and 41.7% NBW adolescents (<0.05). Statistically significant lower scores for self esteem (mean difference 4.31, 95% CI 1.91-6.71) were observed among LBW adolescents. Height, weight and body mass index (BMI) were lower among all LBW adolescents and the difference reached statistical significance for weight and BMI among LBW adolescent girls.

Indian pediatrics, 2009

To observe and compare the markers of fetal onset adult diseases among low birthweight (<2500 ... more To observe and compare the markers of fetal onset adult diseases among low birthweight (<2500 grams, LBW) and normal birthweight (> or =2500 grams, NBW) babies at 16 years of age. Comparative cross sectional analysis of two groups of cohorts followed-up at 1 year and 16 years of age at Child Development Centre (CDC), Medical College, Thiruvananthapuram. 189 LBW babies formed the study group and 213 NBW babies formed the comparison group. At 16 years, the parameters used for assessment of both the groups were, body mass index (BMI) and the markers of fetal onset adult diseases fasting blood glucose level, fasting plasma insulin level, total cholesterol, low density lipoprotein, high density lipoprotein and triglycerides. High triglyceride values and overweight/obesity were significantly more in LBW adolescents when compared to NBW adolescents. This has policy implications in planning adolescent nutrition and care programs in India.

Indian journal of pediatrics, 2013

To compare the knowledge, attitude and practice of boys and girls on reproductive sexual health a... more To compare the knowledge, attitude and practice of boys and girls on reproductive sexual health and their perspective on the needs of adolescents on this aspect. This comparative study was conducted among boys and girls between 10 and 24 y in three districts of Kerala; through a cross sectional community survey using a pretested structured schedule with additional sexuality related questions for 15-24 y age group. Higher percentage of boys knew about condoms (95.1%, p 0.001) whereas higher percentage of girls (56.5%, p 0.001) knew about copper-T. Girls had a better knowledge on legal age of marriage (91%, p 0.001), that both the partners are equally responsible for the problem of infertility (89.7%, p 0.009) and that the gender of the baby is determined by male sperm (60.4%, p 0.001). Above 90% of boys and girls demanded adolescent care services and facilities for counseling. This comparative study on knowledge, attitude and practice of boys and girls between 10 and 24 y has shown t...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018

Autism Spectrum Disorders (ASD) are characterised by a range of clinical features that can vary f... more Autism Spectrum Disorders (ASD) are characterised by a range of clinical features that can vary from individual to individual in both degree of severity and variability of the clinical presentation. The aetiology or causation of ASD has been a widely debated issue for several decades; however, the exact cause of autism is still unknown. Research has suggested that ASD may be caused by genetic and/or environmental factors. Among those, children with low genetic susceptibility, some maternal and obstetric factors have an independent role in autism aetiology, whereas among genetically susceptible children, these factors appear to play a lesser role. It was observed that there is an increased risk of ASD due to: (i) advanced maternal age; (ii) advanced paternal age; (iii) duration of gestation; (iv) intrapartum hypoxia; and (v) birth weight. Recent evidence also suggests potential links of immune dysfunction, dietary, metabolic and gastrointestinal factors.

Indian pediatrics, 2009

To study the effectiveness of Child Development Centre (CDC) model early stimulation therapy done... more To study the effectiveness of Child Development Centre (CDC) model early stimulation therapy done in the first year of postnatal life, in improving the developmental outcome of at-risk neonates at one and two years of age. Randomized controlled trial. The study participants included a consecutive sample of 800 babies discharged alive from the level II nursery of Medical College, Thiruvananthapuram. The control group received routine postnatal check-up as per hospital practice. Intervention group in addition received CDC model early stimulation therapy (home-based). The intervention group of babies had a statistically significant higher score for mental developmental index (MDI) and psychomotor developmental index (PDI) at one and two years of age. After adjusting all significant risk factors for development, the babies who had intervention had significantly higher Bayley scores, 5.8 units at one year and 2.8 units at two year, as compared to control babies. Early stimulation therapy...

Indian pediatrics, 2009

To evaluate the efficacy of pyritinol in improving the neurodevelopmental outcome at one year of ... more To evaluate the efficacy of pyritinol in improving the neurodevelopmental outcome at one year of age among term babies with post-asphyxial encephalopathy. Level II Neonatal Nursery and Child Development Centre, Medical College, Thiruvananthapuram. Randomised placebo controlled double blind trial. 108 term babies with post-asphyxial encephalopathy, stratified into three grades based on clinical criteria. The treatment group (n=54) received pyritinol and the control group (n=54) received placebo, in exactly the same increasing dosage schedule of 1 to 5 mL liquid drug (20-100 mg) from 8th postnatal day until the end of six months. Mean Mental Development Index (MDI) and mean Psychomotor Development Index (PDI) measured on Bayley Scales of Infant Development at one year of age. No statistically significant difference was observed in MDI or PDI scores at one year between the treatment and control groups. The confidence interval for the differences ranged from -6.3 to 8.7 for MDI and from...

Indian pediatrics, 2009

This study was done to validate the screening tool Home Screening Questionnaire (HSQ) against the... more This study was done to validate the screening tool Home Screening Questionnaire (HSQ) against the gold standard Home Observation for the Measurement of Environment (HOME) inventory, using diagnostic test evaluation. Both HOME inventory and HSQ were administered by separate observers, with children less than 3 years of age, among 200 families belonging to 14 anganwadi areas. There was a high sensitivity of 83 and a high specificity of 82 observed for a cutoff point of less than or equal to 19 on HSQ against HOME Inventory as Gold Standard, as was also observed in the Receiver Operating Characteristic (ROC) curve. The likelihood ratio (LR) for positive test was 4.6 (95 % CI, 3.3 to 6.9) which implies that the families with poor home environment are 4.6 times more likely to have the HSQ score less than or equal to 19 as compared to normal families. The results of this study imply that we can confidently apply the HSQ in developmental evaluation clinics and reserve HOME inventory for re...

Indian pediatrics, 2009

This study was done to determine the mental and motor development and developmental psychopatholo... more This study was done to determine the mental and motor development and developmental psychopathology problems at 12 years of age, among term babies with hypoxic ischemic encephalopathy (HIE) at birth. 48 children with HIE at birth were assessed at 12 years of age, to find out the developmental status. Among 41 children, who had grade I HIE at birth, 15 (36 %) had normal intelligence and only 4 (9.8%) had mental retardation. Among the rest of 7 babies who had grade 2 and 3 HIE, 2 children had mental retardation, 3 had borderline IQ and 2 had low average IQ. Hyperkinesis (23%) and somatic disorders (17%) were the commonest developmental psychopathology problems among all the three grades of HIE together. There was also an increased incidence of visual abnormality, cerebral palsy and various psychopathology problems in children who had grade 2 and 3 HIE.

Indian pediatrics, 2009

We conducted this study to assess the prevalence of developmental delay, deformity and disability... more We conducted this study to assess the prevalence of developmental delay, deformity and disability among 0-5 age group childrenn in Pattanakkad rural ICDS block, selected at random from among the ICDS blocks in Alappuzha District, Kerala, India. Of 12520 children upto 5 years in this block, there were a total of 311 children with developmental delay, deviation, deformity or disability giving a prevalence of 2.5 % (95 % CI, 2.22 to 2.77). The prevalence of developmental disabilities up to 2 years was 2.31 (95 % CI, 1.91 to .71) and from 2 to 5 years 2.62 % (95 % CI, 2.25 to 2.99). The prevalence obtained in the study has important policy implications for identifying childhood disabilities in the community.

Indian pediatrics, 2009

We describe our five year experience of conducting developmental evaluation clinic at CDC. We hav... more We describe our five year experience of conducting developmental evaluation clinic at CDC. We have also assessed the prevalence of developmental delay (defined as delay in any two areas in Denver Development Screening Test II [DDST II]), documented the possible prenatal, natal, postnatal risk factors for developmental delay and, also identified the pattern of developmental disorders. A total of 2111 children were screened. DDST II results were abnormal for 953 (45.1 %) children. On multivariate analysis, delayed cry at birth, increasing age of the child, presence of feeding problems, assisted delivery, and birth injury were found to be associated with increasingly abnormal DDST II results. Nearly 50 % of referred babies had developmental delay without a specific clinical diagnosis, 13.9 % had speech problems, 9.5 % had neurological problems and 5.2 % had chromosomal anomalies. Birth related events are important risk factors for developmental delay.

The Indian Journal of Pediatrics, 2014

Objective To assess the effectiveness of Trivandrum Developmental Screening Chart (TDSC) items ba... more Objective To assess the effectiveness of Trivandrum Developmental Screening Chart (TDSC) items based intervention package developed at Child Development Centre, Kerala on the developmental outcome of children at 18 mo of age using Developmental Assessment Scale for Indian Infants (DASII) and compare the same in different birth weight groups. Methods Five hundred consecutive discharges from the Neonatal Intensive Care Unit (NICU), Sree Avittam Thirunal hospital, were recruited and followed up till 18 mo of age including 240 low birth weight (LBW; <2,500 g) babies and 260 normal birth weight babies. All 240 LBW babies were offered early intervention at monthly intervals till 12 mo of age, whereas the normal birth weight (NBW) group received only immunization service as per the routine of the hospital. The early intervention package for the low birth weight group was designed based on Trivandrum Developmental Screening Chart (TDSC 0-2 y) items delay. At 18 mo of age both the groups were offered developmental assessment using DASII by specially trained and experienced developmental therapists who were blind to the intervention status of the babies. Results It was observed that the LBW (<2,500 g) group, who received intervention had a DASII mental age of 18.31 as against 18.16 in the NBW (≥2,500 g) group and mental DQ 101.84 (LBW group) and 98.65 (NBW group) and the observed differences were not statistically significant. Similarly, the LBW, who received intervention group had a DASII motor age of 18.68 as against 18.47 in the NBW group and motor DQ 139.40 (LBW group) and 135.39 (NBW group) and the observed differences were not statistically significant. Conclusions The results of this TDSC based intervention package among low birth weight babies showed that at 18 mo of age there was no statistically significant difference in the developmental outcome using DASII, between low birth weight babies on intervention and the normal birth weight babies without any intervention.

Indian journal of child health, Dec 15, 2019

Background: Improved survival of preterm infants has resulted in increase in motor and cognitive ... more Background: Improved survival of preterm infants has resulted in increase in motor and cognitive dysfunctions which have reduced health-related quality of life. Objective: The objective of this study was to assess the receptive and expressive language (EL) development of very low birth weight (VLBW) babies at 2-year corrected age and compare it with normal birth weight (NBW) "at-risk" babies on developmental follow-up. Materials and Methods: This was a cross-sectional study which compared the language outcome which was measured using Receptive-Expressive Emergent Language Scale. Results: The study included 75 VLBW babies and a comparison group of 26 NBW babies. The mean receptive language quotient in VLBW and NBW babies was 91.37±8.35 and 97.19±7.07, respectively (p=0.002). The mean EL quotient in VLBW and NBW babies was 82.64±12.32 and 92.77±10.47, respectively (p<0.001). A total of 20% of VLBW children had a significant delay in EL as opposed to only 4% of the NBW children (p=0.019). Conclusion: VLBW infants have a significantly higher chance of expressive language delay compared to NBW children.

Indian Journal of Pediatrics

Wellcome Open Research, 2022

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical condi... more Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India based on the National Family Health Survey – 4 (NHFS-4). Methods Data from the NFHS 4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant–mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight <2500 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15–1.60), among mothers aged 13–19 years (aOR: 1.58, 95% CI: 1.22–2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: ...

International Journal of Medical Research & Review, 2020

Objective: To describe the clinical, socio-demographic, and functional profile of children with A... more Objective: To describe the clinical, socio-demographic, and functional profile of children with Attention Deficit Hyperactivity Disorder (ADHD) referred to a tertiary care center in Kerala, India. Methods: A retrospective descriptive study was conducted from records of developmental evaluation clinic over a period of one year. All-consecutive cases the first time diagnosed as ADHD were enrolled. Autism Spectrum Disorder, genetic disorders, and children with sensory impairments were excluded. Results: ADHD prevalence in a clinically referred sample was 12.7%. Boy to girl ratio was 6:1. The mean age of presentation was 8.2 years (SD 6.09). The most common presenting symptom was hyperactivity and behavioral problems followed by poor scholastic performance and poor memory. The functional status assessment showed major concerns in all six domains-Inattention, Hyperactivity, Learning Problem, Executive Functioning, Aggression, and Peer relation, in the majority of children. Conclusion: Course of childhood ADHD shows a consistent clinical and functional pattern. Early diagnosis and quantification of difficulties at the outset is suggested, which can help in providing early intervention and is likely to improve long-term outcome in these children.

Indian pediatrics, 2009

The study was conducted to compare growth status, blood pressure, self esteem and intelligence of... more The study was conducted to compare growth status, blood pressure, self esteem and intelligence of 200 low birthweight (LBW) and 224 normal birthweight (NBW) adolescents at 13 years of age. Intelligence scores at or below the 25th percentile (low performance) were observed among 51.4% LBW and 41.7% NBW adolescents (<0.05). Statistically significant lower scores for self esteem (mean difference 4.31, 95% CI 1.91-6.71) were observed among LBW adolescents. Height, weight and body mass index (BMI) were lower among all LBW adolescents and the difference reached statistical significance for weight and BMI among LBW adolescent girls.

Indian pediatrics, 2009

To observe and compare the markers of fetal onset adult diseases among low birthweight (<2500 ... more To observe and compare the markers of fetal onset adult diseases among low birthweight (<2500 grams, LBW) and normal birthweight (> or =2500 grams, NBW) babies at 16 years of age. Comparative cross sectional analysis of two groups of cohorts followed-up at 1 year and 16 years of age at Child Development Centre (CDC), Medical College, Thiruvananthapuram. 189 LBW babies formed the study group and 213 NBW babies formed the comparison group. At 16 years, the parameters used for assessment of both the groups were, body mass index (BMI) and the markers of fetal onset adult diseases fasting blood glucose level, fasting plasma insulin level, total cholesterol, low density lipoprotein, high density lipoprotein and triglycerides. High triglyceride values and overweight/obesity were significantly more in LBW adolescents when compared to NBW adolescents. This has policy implications in planning adolescent nutrition and care programs in India.

Indian journal of pediatrics, 2013

To compare the knowledge, attitude and practice of boys and girls on reproductive sexual health a... more To compare the knowledge, attitude and practice of boys and girls on reproductive sexual health and their perspective on the needs of adolescents on this aspect. This comparative study was conducted among boys and girls between 10 and 24 y in three districts of Kerala; through a cross sectional community survey using a pretested structured schedule with additional sexuality related questions for 15-24 y age group. Higher percentage of boys knew about condoms (95.1%, p 0.001) whereas higher percentage of girls (56.5%, p 0.001) knew about copper-T. Girls had a better knowledge on legal age of marriage (91%, p 0.001), that both the partners are equally responsible for the problem of infertility (89.7%, p 0.009) and that the gender of the baby is determined by male sperm (60.4%, p 0.001). Above 90% of boys and girls demanded adolescent care services and facilities for counseling. This comparative study on knowledge, attitude and practice of boys and girls between 10 and 24 y has shown t...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018

Autism Spectrum Disorders (ASD) are characterised by a range of clinical features that can vary f... more Autism Spectrum Disorders (ASD) are characterised by a range of clinical features that can vary from individual to individual in both degree of severity and variability of the clinical presentation. The aetiology or causation of ASD has been a widely debated issue for several decades; however, the exact cause of autism is still unknown. Research has suggested that ASD may be caused by genetic and/or environmental factors. Among those, children with low genetic susceptibility, some maternal and obstetric factors have an independent role in autism aetiology, whereas among genetically susceptible children, these factors appear to play a lesser role. It was observed that there is an increased risk of ASD due to: (i) advanced maternal age; (ii) advanced paternal age; (iii) duration of gestation; (iv) intrapartum hypoxia; and (v) birth weight. Recent evidence also suggests potential links of immune dysfunction, dietary, metabolic and gastrointestinal factors.

Indian pediatrics, 2009

To study the effectiveness of Child Development Centre (CDC) model early stimulation therapy done... more To study the effectiveness of Child Development Centre (CDC) model early stimulation therapy done in the first year of postnatal life, in improving the developmental outcome of at-risk neonates at one and two years of age. Randomized controlled trial. The study participants included a consecutive sample of 800 babies discharged alive from the level II nursery of Medical College, Thiruvananthapuram. The control group received routine postnatal check-up as per hospital practice. Intervention group in addition received CDC model early stimulation therapy (home-based). The intervention group of babies had a statistically significant higher score for mental developmental index (MDI) and psychomotor developmental index (PDI) at one and two years of age. After adjusting all significant risk factors for development, the babies who had intervention had significantly higher Bayley scores, 5.8 units at one year and 2.8 units at two year, as compared to control babies. Early stimulation therapy...

Indian pediatrics, 2009

To evaluate the efficacy of pyritinol in improving the neurodevelopmental outcome at one year of ... more To evaluate the efficacy of pyritinol in improving the neurodevelopmental outcome at one year of age among term babies with post-asphyxial encephalopathy. Level II Neonatal Nursery and Child Development Centre, Medical College, Thiruvananthapuram. Randomised placebo controlled double blind trial. 108 term babies with post-asphyxial encephalopathy, stratified into three grades based on clinical criteria. The treatment group (n=54) received pyritinol and the control group (n=54) received placebo, in exactly the same increasing dosage schedule of 1 to 5 mL liquid drug (20-100 mg) from 8th postnatal day until the end of six months. Mean Mental Development Index (MDI) and mean Psychomotor Development Index (PDI) measured on Bayley Scales of Infant Development at one year of age. No statistically significant difference was observed in MDI or PDI scores at one year between the treatment and control groups. The confidence interval for the differences ranged from -6.3 to 8.7 for MDI and from...

Indian pediatrics, 2009

This study was done to validate the screening tool Home Screening Questionnaire (HSQ) against the... more This study was done to validate the screening tool Home Screening Questionnaire (HSQ) against the gold standard Home Observation for the Measurement of Environment (HOME) inventory, using diagnostic test evaluation. Both HOME inventory and HSQ were administered by separate observers, with children less than 3 years of age, among 200 families belonging to 14 anganwadi areas. There was a high sensitivity of 83 and a high specificity of 82 observed for a cutoff point of less than or equal to 19 on HSQ against HOME Inventory as Gold Standard, as was also observed in the Receiver Operating Characteristic (ROC) curve. The likelihood ratio (LR) for positive test was 4.6 (95 % CI, 3.3 to 6.9) which implies that the families with poor home environment are 4.6 times more likely to have the HSQ score less than or equal to 19 as compared to normal families. The results of this study imply that we can confidently apply the HSQ in developmental evaluation clinics and reserve HOME inventory for re...

Indian pediatrics, 2009

This study was done to determine the mental and motor development and developmental psychopatholo... more This study was done to determine the mental and motor development and developmental psychopathology problems at 12 years of age, among term babies with hypoxic ischemic encephalopathy (HIE) at birth. 48 children with HIE at birth were assessed at 12 years of age, to find out the developmental status. Among 41 children, who had grade I HIE at birth, 15 (36 %) had normal intelligence and only 4 (9.8%) had mental retardation. Among the rest of 7 babies who had grade 2 and 3 HIE, 2 children had mental retardation, 3 had borderline IQ and 2 had low average IQ. Hyperkinesis (23%) and somatic disorders (17%) were the commonest developmental psychopathology problems among all the three grades of HIE together. There was also an increased incidence of visual abnormality, cerebral palsy and various psychopathology problems in children who had grade 2 and 3 HIE.

Indian pediatrics, 2009

We conducted this study to assess the prevalence of developmental delay, deformity and disability... more We conducted this study to assess the prevalence of developmental delay, deformity and disability among 0-5 age group childrenn in Pattanakkad rural ICDS block, selected at random from among the ICDS blocks in Alappuzha District, Kerala, India. Of 12520 children upto 5 years in this block, there were a total of 311 children with developmental delay, deviation, deformity or disability giving a prevalence of 2.5 % (95 % CI, 2.22 to 2.77). The prevalence of developmental disabilities up to 2 years was 2.31 (95 % CI, 1.91 to .71) and from 2 to 5 years 2.62 % (95 % CI, 2.25 to 2.99). The prevalence obtained in the study has important policy implications for identifying childhood disabilities in the community.

Indian pediatrics, 2009

We describe our five year experience of conducting developmental evaluation clinic at CDC. We hav... more We describe our five year experience of conducting developmental evaluation clinic at CDC. We have also assessed the prevalence of developmental delay (defined as delay in any two areas in Denver Development Screening Test II [DDST II]), documented the possible prenatal, natal, postnatal risk factors for developmental delay and, also identified the pattern of developmental disorders. A total of 2111 children were screened. DDST II results were abnormal for 953 (45.1 %) children. On multivariate analysis, delayed cry at birth, increasing age of the child, presence of feeding problems, assisted delivery, and birth injury were found to be associated with increasingly abnormal DDST II results. Nearly 50 % of referred babies had developmental delay without a specific clinical diagnosis, 13.9 % had speech problems, 9.5 % had neurological problems and 5.2 % had chromosomal anomalies. Birth related events are important risk factors for developmental delay.

The Indian Journal of Pediatrics, 2014

Objective To assess the effectiveness of Trivandrum Developmental Screening Chart (TDSC) items ba... more Objective To assess the effectiveness of Trivandrum Developmental Screening Chart (TDSC) items based intervention package developed at Child Development Centre, Kerala on the developmental outcome of children at 18 mo of age using Developmental Assessment Scale for Indian Infants (DASII) and compare the same in different birth weight groups. Methods Five hundred consecutive discharges from the Neonatal Intensive Care Unit (NICU), Sree Avittam Thirunal hospital, were recruited and followed up till 18 mo of age including 240 low birth weight (LBW; <2,500 g) babies and 260 normal birth weight babies. All 240 LBW babies were offered early intervention at monthly intervals till 12 mo of age, whereas the normal birth weight (NBW) group received only immunization service as per the routine of the hospital. The early intervention package for the low birth weight group was designed based on Trivandrum Developmental Screening Chart (TDSC 0-2 y) items delay. At 18 mo of age both the groups were offered developmental assessment using DASII by specially trained and experienced developmental therapists who were blind to the intervention status of the babies. Results It was observed that the LBW (<2,500 g) group, who received intervention had a DASII mental age of 18.31 as against 18.16 in the NBW (≥2,500 g) group and mental DQ 101.84 (LBW group) and 98.65 (NBW group) and the observed differences were not statistically significant. Similarly, the LBW, who received intervention group had a DASII motor age of 18.68 as against 18.47 in the NBW group and motor DQ 139.40 (LBW group) and 135.39 (NBW group) and the observed differences were not statistically significant. Conclusions The results of this TDSC based intervention package among low birth weight babies showed that at 18 mo of age there was no statistically significant difference in the developmental outcome using DASII, between low birth weight babies on intervention and the normal birth weight babies without any intervention.