الفهرس 
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Abstract
There are an estimated 200 million children in the world who have a disability, and the bulk of these children live in low and middle income countries. Living in these countries places children at risk for disability due to poverty related health factors, such as anemia and malnutrition. World health organization (WHO) has launched Gap action program on mental health which aims for detection and early intervention to worldwide infant disabilities .The program listed many tests for developmental screening for both high income countries and low income countries.
Developmental screening test is the process of identifying children who may have a developmental problem or a delay in one or more domains of development, or who are at risk of developmental problems in the future. Comprehensive developmental screening should include consideration of the child‘s physical, cognitive, language, and social-emotional development and risk factors in the child‘s background.
The aim of our work is validation of Egyptian screening tool for identifying developmental delay among children from birth up to 30 months of age.
This study is a Cross section study of normal infants in Alexandria from birth up to the age of 30 months. The Egyptian Development Screening chart (EDSC) was validated against Ages and Stages Questionnaires (ASQ-3) as the ’Reference Standard’. The criterion validity was assessed in a community sample of 337 children. The full scales of EDSC have total 54 items; 22 motor and 32 mental, and subsequent ASQ of the same age were applied. Sample included all children with proper consent and willingness to participate in the study. Exclusion included those who are ill and non-testable.
All cases were submitted to complete history taking, complete clinical examination, recording all developmental milestones according to The Egyptian Development Screening chart and Ages And Stages Questionnaires (ASQ-3) as the ’Reference Standard’.
The Egyptian Developmental Screening chart (EDSC), that consists of 54 items (22 motors and 32 mental) was first applied in the questionnaire. The parents were asked and the children were examined. 97% pass level is determined referentially the passing percentage of developmental milestones (figure 6). Hence, any infant failed to pass above the 97% pass level criterion was defined as ‗delayed‘. The items of EDSC were translated into Arabic by Egyptian certified translation center; then explained easily to the parents by their local Egyptian words.
Those items based on Baroda developmental screening test of infants; the items in Baroda were arranged sequentially according to their 97% pass level, it is the level at which 97% of normal infants attain certain skill or milestone. We found that the items are easily applicable and represent our community.
Ages and Stages Questionnaire (ASQ-3) was also applied to the same participants as the (Reference Standard). Each questionnaire for a specific age group contains 30 questions, 6 in each domain. The test was administered by another observer blinded to the results of the previous test. Scores falling in the
Summary
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white area indicate the child is developing typically. Scores falling in the gray area mean the child should be monitored and another screening may be needed later on. Scores falling in the black area mean that the child may be at risk for developmental delay and should be referred for further assessment (2 SD below mean).
In our study, the validity and reliability data show that the Egyptian Developmental Screening chart ―EDSC‖ is a sensitive and reliable screening test for developmental delay in infants and young children. It is not time-consuming, special test equipment is not needed, and developmental milestones need not be strictly memorized by the parents. The chart design is simple and conceptually clear in depicting for physicians and parents the general development of a child, whether normal or delayed. At follow-up, it is useful in portraying a child’s continued progress or lack of progress.
In this study, the EDSC was found to have adequate overall psychometric properties defined as sensitivity (84.38%) and specificity of (98%.36%).EDSC was developed as a screening tool for the developmental delay; as test positive predictive value is 84.37% and negative predictive value is 98.36%. (Table 8)
This research work concluded that EDSC is a simple, valid and convenient, screening tool for identifying children from birth up to 30 months of age with developmental delay in the community. This is a tool that can be accomplished in few minutes by the health worker. It is accurate; time saving does not require special equipment or special training to apply the questionnaire. This helps in community intervention programs and if needed, refers the child for appropriate intervention to a nearby center. This tool can assess the developmental age of the child together with assessing the developmental delay.
This research work encourages a wide utilization of the Egyptian Developmental Screening chart ―EDSC‖ in clinical practices and field studies across Egypt.