• Clinical and Experimental Pediatrics
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• v.60 no.10
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• pp.312-319
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• 2017

Purpose: To evaluate the usefulness of the Korean Developmental Screening Test (K-DST) for infants and children for developmental delay assessment. Methods: This study was based on retrospective studies of the results of the K-DST, Preschool Receptive-Expressive Language Scale (PRES), Sequenced Language Scale for Infants (SELSI), Childhood Autism Rating Scale (CARS), Modified Checklist for Autism in Toddlers (M-CHAT), electroencephalography, magnetic resonance imaging, and extensive tests conducted in 209 of 1,403 patients, of whom 758 underwent the K-DST at the Korea University Guro Hospital between January 2015 and December 2016 and 645 were referred from local clinics between January 2015 and June 2016. Results: Based on the K-DST results, the male children significantly more frequently required further or follow-up examination than the female children in most test sections, except for gross motor. The male children had notably lower mean scores than the female children. The PRES/SELSI results showed that when more further or follow-up evaluations were required in the K-DST communication section, significantly more problems in language delay or disorder emerged. When further or follow-up evaluation was required in the cognitive section in the CARS/M-CHAT, the possibility of autism increased significantly. A child tended to score low in the CARS test and show autism when further or follow-up evaluation was recommended in the K-DST. Conclusion: This study demonstrated the usefulness of the K-DST as a screening test early in the development of infants and children in Korea. Data of normal control groups should be examined to determine the accuracy of this investigation.

• Clinical and Experimental Pediatrics
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• v.63 no.11
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• pp.438-446
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• 2020

Background: Most developmental screening tools in Korea are adopted from foreign tests. To ensure efficient screening of infants and children in Korea, a nationwide screening tool with high reliability and validity is needed. Purpose: This study aimed to independently develop, standardize, and validate the Korean Developmental Screening Test for Infants and Children (K-DST) for screening infants and children for neurodevelopmental disorders in Korea. Methods: The standardization and validation conducted in 2012-2014 of 3,284 subjects (4-71 months of age) resulted in the first edition of the K-DST. The restandardization and revalidation performed in 2015-2016 of 3.06 million attendees of the National Health Screening Program for Infants and Children resulted in the revised K-DST. We analyzed inter-item consistency and test-retest reliability for the reliability analysis. Regarding the validation of K-DST, we examined the construct validity, sensitivity and specificity, receiver operating characteristic curve analysis, and a criterion-related validity analysis. Results: We ultimately selected 8 questions in 6 developmental domains. For most age groups and each domain, internal consistency was 0.73-0.93 and test-retest reliability was 0.77-0.88. The revised K-DST had high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979. The test supported construct validity by distinguishing between normal and neurodevelopmentally delayed groups. The language and cognition domain of the revised K-DST was highly correlated with the K-Bayley Scales of Infant Development-II's Mental Age Quotient (r=0.766, 0.739), while the gross and fine motor domains were highly correlated with Motor Age Quotient (r=0.695, 0.668), respectively. The Verbal Intelligence Quotient of Korean Wechsler Preschool and Primary Scales of Intelligence was highly correlated with the K-DST cognition and language domains (r=0.701, 0.770), as was the performance intelligence quotient with the fine motor domain (r=0.700). Conclusion: The K-DST is reliable and valid, suggesting its good potential as an effective screening tool for infants and children with neurodevelopmental disorders in Korea.

• Clinical and Experimental Pediatrics
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• v.62 no.5
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• pp.187-192
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• 2019

Purpose: The importance of the neurodevelopmental outcomes of very-low-birth-weight (VLBW) infants has been emphasized as their mortality rate has markedly improved. This study aimed to assess the validity of the Korean Developmental Screening Test (K-DST), a developmental screening tool approved by the Korean Society of Pediatrics, for the timely diagnosis of neurodevelopmental delay in VLBW infants. Methods: Subjects included VLBW infants enrolled in the Korean Neonatal Network database between January 2012 and December 2014. The collected data were analyzed for sensitivity, specificity, positive predictive value, and negative predictive value (NPV) in the K-DST compared to those in the Bayley Scales of Infant Development-II for VLBW infants. Results: A total of 173 patients were enrolled. Their mean gestational age and mean birth weight were $27.5{\pm}2.8weeks$ and $980.5{\pm}272.1g$, respectively. The frequency of failed psychomotor developmental index (PDI) <85 was similar to that in at least one domain of K-DST <1 standard deviation. Failure in more than one K-DST domain compared with a mental developmental index (MDI) <85 showed a sensitivity and NPV of 73.2% and 75.0%, respectively. Failure in more than one K-DST domain compared with PDI <85 showed a sensitivity and NPV of 60.3% and 71.6%, respectively. Each K-DST domain had a stronger correlation with predicting a failing MDI <85 than a failing PDI <85 (P<0.05). Conclusion: K-DST could be a useful screening tool for predicting mental developmental delay in VLBW infants and referring them for neurodevelopmental assessments.

• Clinical and Experimental Pediatrics
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• v.59 no.12
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• pp.483-489
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• 2016

Purpose: We investigated the number of test takers of the Korean-Developmental Screening Test (K-DST) in a single children's hospital within a year, according to age, referral rate, and follow-up percentage. Methods: For this study, 4,062 children who visited and received K-DST at Woorisoa Children's Hospital between January and December 2015 were enrolled. Seven test sets were used according to the Korean National Health Screening Program for infants and children in the following age groups: 4 to 6, 9 to 12, 18 to 24, 30 to 36, 42 to 48, 54 to 60, and 66 to 71 months. The results of the K-DST were categorized into 4 groups as follows: further evaluation (<-2 standard deviation [-2SD]), follow-up test (-2SD to -1SD), peer level (-1SD to 1SD), and high level (>1SD). Results: The test participants' population and follow-up population were concentrated before the age of 24 months (2,532, 62.3%). The children most commonly referred for further evaluation were those in the 30- to 41-month age group. A mismatch was found between the results of the K-DST and the additional questions. Most of the infants and children with suspicious developmental delays showed catch-up development in their follow-up tests (43 of 55, 78.2%). Conclusion: The use of K-DST should be encouraged, especially among children aged over 24 months. Multiple-choice question format for the additional questions is recommended to avoid confusion. We suggest a nationwide study to evaluate and revise the K-DST.

• Journal of Korean Academy of Nursing
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• v.13 no.3
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• pp.34-50
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• 1983

The Denver Developmental Screening Test was devised to provide a simple method of evaluating the developmental status of infants and preschool children. To assess the development of Korean children, 667 children (390 boys and 277 girls) between the ages of 2 weeks and 6 years who live in Kwangju city and rural areas in Chonnam were examined according to the DDST. The ages at which 25%, 50%, 75%, and 90% of the children performed each item were calculated for the entire sample. The results of these were compared with the norms of Denver children and other related previous studies in Korea. The development of the boys was also compared with that of the girls, and further the test results of city children and country children were also compared. Girls performed the DDST items in personal-social, fine motor-adaptive and gross motor sectors slightly earlier than boys. In general, however, there were no significant differences in the developmental rate between boys and girls. In all four sectors of the DDST, urban children performed the items significantly earlier than rural children. In comparing Korean children and Denver children, Korean children tended to perform gross motor and personal-social items at a slightly earlier age than Denver children. In the language sector, Denver children tended to perform a little earlier than Korean children. But on the whole there were no significant differences in developmental status between Korean and Denver children. It should be noted that a few items, such as“Uses plurals”, needed to be changed due to the structure of Korean language.

• Child Health Nursing Research
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• v.16 no.2
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• pp.164-174
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• 2010

Purpose: The purpose of this study was to evaluate the physical growth and developmental status of infants and children of married immigrant women. Methods: The participants were 92 infants and children aged from birth to 6 yr whose mothers were married immigrant women living in one rural area. Physical growth and developmental status were evaluated by using anthropometric assessment, and Korean Denver II developmental screening test. Results: Of the participants, 10.8% were below the 3rd percentile for weight, 13.0% for length, 5.4% for head circumference, and from 69.6% to 79.3% were distributed below the 50th percentile on growth charts. Further, 18.5% were classified as having questionable development. Factors related to low physical growth in infants and children were mother's weight and mother's level in Korean language classes. Conclusion: The physical growth and developmental status of children is vulnerable and serious. The study results suggest a need for regular growth and developmental evaluations. Political support is important for these mothers. In addition, there also is a need to develop early intervention strategies to promote growth and development of the infants and children of these married immigrant women.

• Child Health Nursing Research
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• v.14 no.1
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• pp.44-52
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• 2008

Purpose: The purpose of this study was to evaluate and compared the growth and development of premature and full-term infants during the 2 years after birth. Method: The participants were 102 infants, 51 each for premature infants, and for healthy full-term infants. Participants in the premature group accounted for 17.5% of all premature infants who were registered at the public health center in G city. Developmental status was evaluated using the Korean Denver II. Results: The catch-up growth of the premature was 100% in weight and in height. Suspicious developmental delay according to the Korean Denver II was 3.9% in normal infants and 31.2% in premature infants. Factors related to the suspicious developmental delay in premature infants were their age and health state at birth. The rate of suspicious developmental delay was higher in infants over 6 months and infants unhealthy at birth. Conclusion: A premature follow-up program, which includes nutrition education to achieve catch-up growth and to prevention obesity, along with continuous developmental screening test for infants and children born prematurely is recommended. Provision for home visits and telephone counseling for premature infants and their families who do not to use the public health center should also be included.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.1
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• pp.16-23
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• 2022

Objectives: Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study's objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12-71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool's validity and cut-off. Methods: Multidisciplinary experts devised the "Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND)," an assessment method that comes in two versions depending on the age of the child: 12-36 months and 37-71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant-Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores. Results: A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach's alpha was positive (0.533-0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5-0.7 and specificity 0.7-0.9. Conclusion: The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12-36 months and 37-71 months.

• The Journal of Pediatrics of Korean Medicine
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• v.30 no.2
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• pp.10-22
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• 2016

Objectives This study is to analyze current guidelines for health check-ups in infants and children, and to develop better guidelines based on oriental medicine. Methods We analyzed The Manual of 2015's Health Examination for Infants and Children which is a Korean Developmental Screening Test for Infants and Children (K-DST). The statistics from the test was collected from 2010 to 2014 to figure out the problems of Health Examinations for Infants and Children. 20 articles from 2000 to 2014 from RISS, NDSL were also analyzed. Results The current guidelines for health examinations in infants and children didn't include major pediatric diseases such as allergy and asthma. Also, the pediatrics health education materials were mainly focused on hypernutrition but not so much on nutrition deficiency. The number of the centers for Health Examinations for Infants and Children was 52.2% of the number of NIP-Participating medical institutions for infants and children. Conclusions Oriental medicine can be useful to prevent major pediatric diseases and to promote general health in pediatrics. By legislating 'Geon-a-beop', which is a law for infants and children, we can increase the number of medical centers for infants and children to get health check-ups. Currently, there are 9,769 Korean medical institutions, and the rate of traditional medical doctors of public health doctors was 25.5%. Weak Children Questionnaire is developed, considered to be more useful when it is developed with 5-point scale rather than 2.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.309.1-309.13
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• 2018

Background: The aim of this study was to observe long-term outcomes of very low birth weight infants (VLBWIs) born between 2013 and 2014 in Korea, especially focusing on neurodevelopmental outcomes. Methods: The data were collected from Korean Neonatal Network (KNN) registry from 43 and 54 participating units in 2013 and 2014, respectively. A standardized electronic case report form containing 30 items related to long-term follow up was used after data validation. Results: Of 2,660 VLBWI, the mean gestational age and birth weight were $29^{1/7}{\pm}2^{6/7}$ weeks and $1,093{\pm}268g$ in 2013 and $29^{2/7}{\pm}2^{6/7}$ weeks and $1,125{\pm}261g$ in 2014, respectively. The post-discharge mortality rate was 1.2%-1.5%. Weight < 50th percentile was 46.5% in 2013 and 66.1% in 2014. The overall prevalence of cerebral palsy among the follow up infants was 6.2% in 2013 and 6.6% in 2014. The Bayley Scales of Infant Developmental Outcomes version II showed 14%-25% of infants had developmental delay and 3%-8% of infants in Bayley version III. For the Korean developmental screening test for infants and children, the area "Further evaluation needed" was 5%-12%. Blindness in both eyes was reported to be 0.2%-0.3%. For hearing impairment, 0.8%-1.9% showed bilateral hearing loss. Almost 50% were readmitted to hospital with respiratory illness as a leading cause. Conclusion: The overall prevalence of long-term outcomes was not largely different among the VLBWI born between 2013 and 2014. This study is the first large national data study of long-term outcomes.