Developmental-Behavioural Paediatrics Division, Department of Paediatrics, Ankara University School of Medicine, Ankara, Turkey.
Ummeed Child Development Centre, Mumbai, India.
Acta Paediatr. 2019 Jun;108(6):1074-1086. doi: 10.1111/apa.14661. Epub 2018 Dec 14.
It is of critical importance to have internationally constructed tools to address early childhood development. The aim of this second phase of a two-phase study was to examine the sensitivity and specificity of the Guide for Monitoring Child Development (GMCD) in identifying developmental delay in four diverse countries.
The first phase of this 2011-2015 back-to-back study included 4949 children up to 42 months of age from primary healthcare centres in Argentina, India, South Africa and Turkey. Distribution curves were generated to show the ages when the children attained GMCD milestones and those that could be used across sexes and countries were placed in age ranges corresponding to the 85th and 97th percentile point estimates. Phase two examined a separately recruited sample of children in those countries to determine sensitivity and specificity of the GMCD.
The validation phase of the 85 milestones in the GMCD identified delayed development in 30% of the 1731 children in the four countries. The sensitivity and specificity ranged from 0.71-0.94 and 0.69-0.82, respectively, for the total sample and the different age groups.
The GMCD standardised in four diverse countries has appropriate accuracy for identification of children with developmental delay.
拥有国际化构建的工具来解决儿童早期发展问题至关重要。本研究分为两个阶段，这是第二阶段，旨在检验儿童发育监测指南（GMCD）在四个不同国家识别发育迟缓的敏感性和特异性。
该研究是一项 2011 年至 2015 年的连续研究，纳入了来自阿根廷、印度、南非和土耳其的 4949 名 42 个月以下的儿童。生成分布曲线以显示儿童达到 GMCD 里程碑的年龄，以及可在不同性别和国家使用的年龄范围，对应第 85 和第 97 个百分位数点估计值。第二阶段在这些国家单独招募了一组儿童，以确定 GMCD 的敏感性和特异性。
GMCD 中 85 个里程碑的验证阶段在四个国家的 1731 名儿童中发现了 30%的发育迟缓。总样本和不同年龄组的敏感性和特异性分别为 0.71-0.94 和 0.69-0.82。
在四个不同国家标准化的 GMCD 具有识别发育迟缓儿童的适当准确性。
