ESTABLISHMENT OF SHISHU BIKASH KENDRA
(Child Development Center)
Provide technical support for the Two-stage Child Disability Study among children 2-9 years, Bhutan, 2010-2011
The first stage of the survey was conducted as part of the Bhutan Multiple Indicator Survey (BMIS) 2010 which included a Ten Questions (TQ) module on disability in the household questionnaire to screened children 2-9 years old with the purpose identify children who were consider more likely to be living with a disability. Out of the sample of 11,370 children, 3,500 children were screened as having potentially a functional impairment or disability. In the second stage the 3,500 children screened positive in the first stage and additional 787 children randomly selected and representing 10% of the children who are screened negative were assessed. During the second stage, the assessors conducted the Rapid Neurodevelopmental Assessment (RNDA) and Rapid Functional Assessment (RFA) which is now named RNDA in a controlled standardized environment to the extent possible. The RNDA tool used was developing by the Bangladesh Protibondhi Foundation (BPF).
Professional’s and trainee’s from Bangladesh, Bhutan and Australia at the certificate giving ceremony of RNDA Training
Fieldwork in Bhutan
1 Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, USA.
2 Global Health Sciences, University of California, San Francisco, CA, USA.
3 Department of Pediatric
Neuroscience, Dhaka Shishu (Children's) Hospital, Dhaka, Bangladesh.
METHODS: We conducted a cross-sectional study of 77 infants (0-12 months) in rural Guatemala in July 2012 and July 2013. We assessed inter-rater reliability and predictive validity between the 27-item RNDA and the 325-item Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) and concurrent validity based on chronic malnutrition, a condition associated with neurodevelopmental impairments. For both RNDA and BSID-III, standardized scores below 80 were defined as borderline impairment.
RESULTS: Children came from rural households (92%), were born to indigenous women of Mayan descent (73%) and had moderate or severe growth stunting (43%). Inter-rater reliability for eight RNDA domains was of moderate to high reliability (weighted κ coefficients, 0.49-0.99). Children screened positive for impairment in fine motor (17%) and gross motor (14%) domains using the RNDA. The RNDA had good concurrent ability; infants who were growth stunted had higher mean levels of impairment in gross motor, speech and cognition domains (all p < 0.001). The RNDA took 20-30 min to complete compared with 45-60 min for BSID-III.
CONCLUSIONS: Wide-scale implementation
of a simple, valid and reliable screening tool like the RNDA by community
health workers would facilitate early screening and referral of infants at-risk
for neurodevelopmental impairment.
Training in Bangladesh
Fieldwork in Guatemala:
Study name: Follow up of high risk infants
· RNDA manual, equipments, videos of administration of all items of Gross Motor, Fine Motor, Vision, Hearing, and Cognition were send to Haiti by Bangladesh Protibondhi Foundation (BPF). All videos showed children with normal responses.
· Instructions on using RNDA were also send to Haiti.
· All forms and instructions were translated in Haitian Kreyol language .
· Training was based on video
· Trainees: 40 (physicians, teachers, social workers and community health workers)
· In Zambia: RNDA is used in clinic settings
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