Pub Date : 2020-07-01DOI: 10.1097/IYC.0000000000000169
S. Gavidia-Payne
The National Disability Insurance Scheme (NDIS) was introduced in Australia in 2013 to address the inadequacies of a fragmented and underfunded service system for people with disabilities. For young children with developmental disabilities, NDIS services fall under the early childhood early intervention (ECEI) approach, the impact of which is yet to be documented. Considering the critical role of families in supporting their children with a disability, the aim of the present study was therefore to examine their experiences of the ECEI approach in the State of Victoria. Seventeen parents participated in interviews and focus groups, which generated information clustered around five themes: (1) accessing the NDIS and the ECEI; (2) plan development and implementation; (3) choice and control; (4) family and community life; and (5) parental distress. While highlighting the potential of the NDIS funding and its long-term benefits, participating parents reported numerous challenges in their pursuit of supports under the ECEI. It is concluded that for the NDIS to fulfil its promise and potential, substantive revisions of its systems, policies and practices will be required to be relevant and sensitive to the needs of young children with developmental disabilities and their families.
{"title":"Implementation of Australia's National Disability Insurance Scheme","authors":"S. Gavidia-Payne","doi":"10.1097/IYC.0000000000000169","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000169","url":null,"abstract":"The National Disability Insurance Scheme (NDIS) was introduced in Australia in 2013 to address the inadequacies of a fragmented and underfunded service system for people with disabilities. For young children with developmental disabilities, NDIS services fall under the early childhood early intervention (ECEI) approach, the impact of which is yet to be documented. Considering the critical role of families in supporting their children with a disability, the aim of the present study was therefore to examine their experiences of the ECEI approach in the State of Victoria. Seventeen parents participated in interviews and focus groups, which generated information clustered around five themes: (1) accessing the NDIS and the ECEI; (2) plan development and implementation; (3) choice and control; (4) family and community life; and (5) parental distress. While highlighting the potential of the NDIS funding and its long-term benefits, participating parents reported numerous challenges in their pursuit of supports under the ECEI. It is concluded that for the NDIS to fulfil its promise and potential, substantive revisions of its systems, policies and practices will be required to be relevant and sensitive to the needs of young children with developmental disabilities and their families.","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"2 1","pages":"184 - 194"},"PeriodicalIF":1.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78597830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/IYC.0000000000000171
E. Schaughency, Jessica Riordan, E. Reese, Melissa Derby, G. Gillon
Natural disasters are disruptive to families and communities, particularly when cascading effects continue over time. Such events, and ensuing disruptions to family life, present risks to young children's development, including oral language. Recognition of this potential vulnerability has led to calls for early childhood programming to support parenting and foster children's early learning. Therefore, we developed and trialed a research-informed home literacy preventive intervention for preschool-aged children living in communities adversely affected by devastating earthquakes. In this feasibility case study, 2 community workshops were offered. Both encouraged repeated, interactive shared reading and verbal interactions between parents and their 4- to 5-year-old children. Workshop 1 focused on scaffolding children's comprehension-related language skills through extratextual dialogue and reminiscing about shared experiences related to stories; Workshop 2 focused on promoting children's phonological awareness through playful interactions during reading and wordplay activities outside of reading. Before participation, parent-reported shared reading frequency for this sample (n = 44) was low (mode for shared reading was 1 or 2 days per week). Parent-report data collected after each workshop supported social validity and suggested workshop-specific benefits with medium to large effect sizes. Findings from this process evaluation support proof of concept for efforts to engage families in communities affected by ongoing stressors to support resilience in everyday interactions and promote children's early learning.
{"title":"Developing a Community-Based Oral Language Preventive Intervention","authors":"E. Schaughency, Jessica Riordan, E. Reese, Melissa Derby, G. Gillon","doi":"10.1097/IYC.0000000000000171","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000171","url":null,"abstract":"Natural disasters are disruptive to families and communities, particularly when cascading effects continue over time. Such events, and ensuing disruptions to family life, present risks to young children's development, including oral language. Recognition of this potential vulnerability has led to calls for early childhood programming to support parenting and foster children's early learning. Therefore, we developed and trialed a research-informed home literacy preventive intervention for preschool-aged children living in communities adversely affected by devastating earthquakes. In this feasibility case study, 2 community workshops were offered. Both encouraged repeated, interactive shared reading and verbal interactions between parents and their 4- to 5-year-old children. Workshop 1 focused on scaffolding children's comprehension-related language skills through extratextual dialogue and reminiscing about shared experiences related to stories; Workshop 2 focused on promoting children's phonological awareness through playful interactions during reading and wordplay activities outside of reading. Before participation, parent-reported shared reading frequency for this sample (n = 44) was low (mode for shared reading was 1 or 2 days per week). Parent-report data collected after each workshop supported social validity and suggested workshop-specific benefits with medium to large effect sizes. Findings from this process evaluation support proof of concept for efforts to engage families in communities affected by ongoing stressors to support resilience in everyday interactions and promote children's early learning.","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"28 1","pages":"195 - 218"},"PeriodicalIF":1.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83843857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/IYC.0000000000000168
Coral Kemp
The adoption of interventions for infants and young children with disabilities/delays or at risk of disability/delay is likely to be influenced by sources other than research evidence. Where the available research evidence does influence the choice of intervention, there may be difficulties translating research that has been implemented in a controlled environment to an intervention that can be successfully applied in natural settings. Such settings include the family home as well as early childhood education and care centers. Incentives for the use of evidence-based interventions in early intervention settings include improved outcomes for infants and young children, service credibility, and program accountability. Barriers to using evidence-based practice (EBP) in natural settings include difficulties with identifying EBP and in reliably implementing evidence-based interventions. Lack of quality professional training and absence of support from competent coaches/mentors can also compromise the adoption and effective implementation of EBP. Collaborative partnerships between researchers and practitioners, where the goals of both parties have equal value, may assist with bridging the research-to-practice gap. Incentives, barriers, and opportunities are explored in this article.
{"title":"Research Informing Practice in Early Childhood Intervention","authors":"Coral Kemp","doi":"10.1097/IYC.0000000000000168","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000168","url":null,"abstract":"The adoption of interventions for infants and young children with disabilities/delays or at risk of disability/delay is likely to be influenced by sources other than research evidence. Where the available research evidence does influence the choice of intervention, there may be difficulties translating research that has been implemented in a controlled environment to an intervention that can be successfully applied in natural settings. Such settings include the family home as well as early childhood education and care centers. Incentives for the use of evidence-based interventions in early intervention settings include improved outcomes for infants and young children, service credibility, and program accountability. Barriers to using evidence-based practice (EBP) in natural settings include difficulties with identifying EBP and in reliably implementing evidence-based interventions. Lack of quality professional training and absence of support from competent coaches/mentors can also compromise the adoption and effective implementation of EBP. Collaborative partnerships between researchers and practitioners, where the goals of both parties have equal value, may assist with bridging the research-to-practice gap. Incentives, barriers, and opportunities are explored in this article.","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88812030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/IYC.0000000000000170
T. A. Woodruff, Tara M. Lutz
The pediatric medical home is a model to provide quality health care to a child that is coordinated and overseen by a team of professionals who are grounded in family-centered practice (Cleveland Clinic, 2012; Munoz, Nelson, Bradham, Hoffman, & Houston, 2011). The medical home can be a centralized, consolidated, and comprehensive approach to address concerns for a child and can bolster the early intervention goals of Early Hearing Detection and Intervention ([EHDI]; Buchino et al., 2019; Munoz, Shisler, Moeller, & White, 2009; Munoz et al., 2011). With early access to screening information for children who are D/deaf or hard of hearing, the medical home plays a role in early diagnostic services and follow-up care that are critical to EHDI. This connection allows for discussion of how the medical home can exist and be supported within the context of existing service provision systems as a potential preemptive intervention to address the needs of children and families. By reviewing publicly accessible materials, the state of Connecticut can be used as a case study to look at various methods of medical home engagement with the outcome of supporting EHDI-based benchmarks (Connecticut Department of Public Health, 2014, 2018). At the same time, a novel means of data collection through the medical home is proposed.
儿科医疗之家是一种为儿童提供高质量医疗保健的模式，由以家庭为中心的专业团队协调和监督(克利夫兰诊所，2012;Munoz, Nelson, Bradham, Hoffman， & Houston, 2011)。医疗之家可以是一个集中、统一和全面的方法来解决儿童的问题，并可以促进早期听力检测和干预的早期干预目标([EHDI];Buchino et al.， 2019;Munoz, Shisler, Moeller， & White, 2009;Munoz et al.， 2011)。由于失聪儿童或重听儿童能够及早获得筛查信息，医疗之家在早期诊断服务和后续护理方面发挥了作用，这对EHDI至关重要。这种联系允许讨论如何在现有服务提供系统的背景下存在和支持医疗之家，作为解决儿童和家庭需求的潜在先发制人的干预措施。通过审查可公开获取的材料，康涅狄格州可以作为一个案例研究，研究医疗家庭参与的各种方法，以及支持基于ehdi的基准的结果(康涅狄格州公共卫生部，2014年，2018年)。同时，提出了一种通过医疗之家进行数据采集的新方法。
{"title":"Early Hearing Detection and Intervention (EHDI) Within the Medical Home","authors":"T. A. Woodruff, Tara M. Lutz","doi":"10.1097/IYC.0000000000000170","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000170","url":null,"abstract":"The pediatric medical home is a model to provide quality health care to a child that is coordinated and overseen by a team of professionals who are grounded in family-centered practice (Cleveland Clinic, 2012; Munoz, Nelson, Bradham, Hoffman, & Houston, 2011). The medical home can be a centralized, consolidated, and comprehensive approach to address concerns for a child and can bolster the early intervention goals of Early Hearing Detection and Intervention ([EHDI]; Buchino et al., 2019; Munoz, Shisler, Moeller, & White, 2009; Munoz et al., 2011). With early access to screening information for children who are D/deaf or hard of hearing, the medical home plays a role in early diagnostic services and follow-up care that are critical to EHDI. This connection allows for discussion of how the medical home can exist and be supported within the context of existing service provision systems as a potential preemptive intervention to address the needs of children and families. By reviewing publicly accessible materials, the state of Connecticut can be used as a case study to look at various methods of medical home engagement with the outcome of supporting EHDI-based benchmarks (Connecticut Department of Public Health, 2014, 2018). At the same time, a novel means of data collection through the medical home is proposed.","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"33 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80846163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1097/IYC.0000000000000164
L. Barnard‐Brak, T. Stevens, Zhanxia Yang
The current study examined 2 sets of variables associated with parents prematurely exiting early intervention services for their child. The first set consisted of the variables predictive of premature parent withdrawal, and the second set consisted of variables predictive of a parent and child being dismissed from early intervention services because of failure in being able to contact them. This study represents the first empirical examination of variables associated with parents prematurely exiting early intervention services despite having children who continued to qualify for services.
{"title":"Predictors of Parental Premature Exiting From Early Intervention Services","authors":"L. Barnard‐Brak, T. Stevens, Zhanxia Yang","doi":"10.1097/IYC.0000000000000164","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000164","url":null,"abstract":"The current study examined 2 sets of variables associated with parents prematurely exiting early intervention services for their child. The first set consisted of the variables predictive of premature parent withdrawal, and the second set consisted of variables predictive of a parent and child being dismissed from early intervention services because of failure in being able to contact them. This study represents the first empirical examination of variables associated with parents prematurely exiting early intervention services despite having children who continued to qualify for services.","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"71 1","pages":"132 - 141"},"PeriodicalIF":1.1,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79581466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1097/IYC.0000000000000162
C. Coogle, Allison Parsons, Leslie La Croix, Jennifer R. Ottley
The authors used an alternating treatment, single-case design to determine the effect of dialogic reading, modeling, and dialogic reading plus modeling on the expressive vocabulary identification of 2 preschool children identified with autism spectrum disorder. Their preschool teacher implemented each of the conditions within the daily routines of the classroom. Each condition demonstrated effectiveness; however, the dialogic reading condition had the most robust effect on both of the children's labeling of target vocabulary words.
{"title":"A Comparison of Dialogic Reading, Modeling, and Dialogic Reading Plus Modeling","authors":"C. Coogle, Allison Parsons, Leslie La Croix, Jennifer R. Ottley","doi":"10.1097/IYC.0000000000000162","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000162","url":null,"abstract":"The authors used an alternating treatment, single-case design to determine the effect of dialogic reading, modeling, and dialogic reading plus modeling on the expressive vocabulary identification of 2 preschool children identified with autism spectrum disorder. Their preschool teacher implemented each of the conditions within the daily routines of the classroom. Each condition demonstrated effectiveness; however, the dialogic reading condition had the most robust effect on both of the children's labeling of target vocabulary words.","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"68 1","pages":"119 - 131"},"PeriodicalIF":1.1,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85809513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1097/IYC.0000000000000163
C. Chen, J. Squires, Kathleen Scalise
Supplemental Digital Content is Available in the Text. Social–emotional competence is important for children's lifelong positive developmental outcomes. The dimensionality and psychometric properties of a widely used social–emotional assessment, the Ages & Stages Questionnaires: Social–Emotional Second Edition (ASQ:SE-2), were investigated in this study using item response theory models. A comparison was conducted between a unidimensional model, reflecting a compound construct—social–emotional competence, and a multidimensional model, based on the theoretical framework that posits that social competence and emotional competence are highly related but different constructs. The result indicated that the multidimensional structure presented a better fit for the ASQ:SE-2 sample across most intervals (i.e., 6, 12, 18, 24, 30, 36, 48, and 60 months). The psychometric properties estimated by the multidimensional model reflected congruence between the levels of item difficulty and the design of the ASQ:SE-2 and indicated a high quality of items based on the fit item statistics. However, the expected a posteriori/plausible value reliability estimates for several younger age intervals (i.e., 6, 12, 18, and 24 months) did not meet the 0.70 benchmark. The relationship between the 2 dimensions presented a moderate correlation during infancy (r = .43–.56) and a stronger relationship in older ages (r = .71–.83).
{"title":"Evaluating the Dimensionality and Psychometric Properties of a Social–Emotional Screening Instrument for Young Children","authors":"C. Chen, J. Squires, Kathleen Scalise","doi":"10.1097/IYC.0000000000000163","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000163","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Social–emotional competence is important for children's lifelong positive developmental outcomes. The dimensionality and psychometric properties of a widely used social–emotional assessment, the Ages & Stages Questionnaires: Social–Emotional Second Edition (ASQ:SE-2), were investigated in this study using item response theory models. A comparison was conducted between a unidimensional model, reflecting a compound construct—social–emotional competence, and a multidimensional model, based on the theoretical framework that posits that social competence and emotional competence are highly related but different constructs. The result indicated that the multidimensional structure presented a better fit for the ASQ:SE-2 sample across most intervals (i.e., 6, 12, 18, 24, 30, 36, 48, and 60 months). The psychometric properties estimated by the multidimensional model reflected congruence between the levels of item difficulty and the design of the ASQ:SE-2 and indicated a high quality of items based on the fit item statistics. However, the expected a posteriori/plausible value reliability estimates for several younger age intervals (i.e., 6, 12, 18, and 24 months) did not meet the 0.70 benchmark. The relationship between the 2 dimensions presented a moderate correlation during infancy (r = .43–.56) and a stronger relationship in older ages (r = .71–.83).","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"31 1","pages":"142 - 159"},"PeriodicalIF":1.1,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74991580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/IYC.0000000000000155
B. Elbaum
The purpose of this secondary analysis of state-collected data was to investigate developmental outcomes of preschool special education (PSE) services in a statewide cohort of participating children (n = 17,828). In line with federal performance indicators for Individuals with Disabilities Education Act early childhood programs, the outcome of interest in this study was the percentage of children who demonstrated age-expected functioning in all 5 major domains of development—communication, cognitive, motor, personal–social, and adaptive—at the time they exited the PSE program. The study also investigated the extent to which this outcome varied, depending on the severity and complexity of children's delays when they began PSE services. Overall, 38.2% of children exited the program within age norms in all 5 domains; percentages for subgroups of children ranged from 77% for children with no measured delay on entry to 23% for children demonstrating severe delay in 1 or more developmental areas. Holding delay severity constant, each additional domain of delay on entry was associated with a decrease in the percentage of children exiting within age norms. Findings of the study problematize the application of a single definition of “expected progress” for all participating children and underscore the utility of examining and reporting program outcomes for subgroups of children.
{"title":"Developmental Outcomes of Preschool Special Education","authors":"B. Elbaum","doi":"10.1097/IYC.0000000000000155","DOIUrl":"https://doi.org/10.1097/IYC.0000000000000155","url":null,"abstract":"The purpose of this secondary analysis of state-collected data was to investigate developmental outcomes of preschool special education (PSE) services in a statewide cohort of participating children (n = 17,828). In line with federal performance indicators for Individuals with Disabilities Education Act early childhood programs, the outcome of interest in this study was the percentage of children who demonstrated age-expected functioning in all 5 major domains of development—communication, cognitive, motor, personal–social, and adaptive—at the time they exited the PSE program. The study also investigated the extent to which this outcome varied, depending on the severity and complexity of children's delays when they began PSE services. Overall, 38.2% of children exited the program within age norms in all 5 domains; percentages for subgroups of children ranged from 77% for children with no measured delay on entry to 23% for children demonstrating severe delay in 1 or more developmental areas. Holding delay severity constant, each additional domain of delay on entry was associated with a decrease in the percentage of children exiting within age norms. Findings of the study problematize the application of a single definition of “expected progress” for all participating children and underscore the utility of examining and reporting program outcomes for subgroups of children.","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"234 1","pages":"20 - 3"},"PeriodicalIF":1.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76114833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/IYC.000000000000017210.1097/FCH.0000000000000266
C. Ford
{"title":"From the EditorCommentary: Addressing Inequities in the Era of COVID-19: The Pandemic and the Urgent Need for Critical Race Theory","authors":"C. Ford","doi":"10.1097/IYC.000000000000017210.1097/FCH.0000000000000266","DOIUrl":"https://doi.org/10.1097/IYC.000000000000017210.1097/FCH.0000000000000266","url":null,"abstract":"","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61765311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1097/iyc.000000000000017210.1097/rli.0000000000000689
P. Lyu, Xing Liu, Rui Zhang, Lei Shi, Jianbo Gao
Objectives The aim of this study was to assess the clinical severity of COVID-19 pneumonia using qualitative and/or quantitative chest computed tomography (CT) indicators and identify the CT characteristics of critical cases Materials and Methods Fifty-one patients with COVID-19 pneumonia including ordinary cases (group A, n = 12), severe cases (group B, n = 15), and critical cases (group C, n = 24) were retrospectively enrolled The qualitative and quantitative indicators from chest CT were recorded and compared using Fisher exact test, one-way analysis of variance, Kruskal-Wallis H test, and receiver operating characteristic analysis Results Depending on the severity of the disease, the number of involved lung segments and lobes, the frequencies of consolidation, crazy-paving pattern, and air bronchogram increased in more severe cases Qualitative indicators including total severity score for the whole lung and total score for crazy-paving and consolidation could distinguish groups B and C from A (69% sensitivity, 83% specificity, and 73% accuracy) but were similar between group B and group C Combined qualitative and quantitative indicators could distinguish these 3 groups with high sensitivity (B + C vs A, 90%;C vs B, 92%), specificity (100%, 87%), and accuracy (92%, 90%) Critical cases had higher total severity score (>10) and higher total score for crazy-paving and consolidation (>4) than ordinary cases, and had higher mean lung density (>−779 HU) and full width at half maximum (>128 HU) but lower relative volume of normal lung density (≦50%) than ordinary/severe cases In our critical cases, 8 patients with relative volume of normal lung density smaller than 40% received mechanical ventilation for supportive treatment, and 2 of them had died Conclusions A rapid, accurate severity assessment of COVID-19 pneumonia based on chest CT would be feasible and could provide help for making management decisions, especially for the critical cases
目的采用定性和/或定量胸部计算机断层扫描(CT)指标评估COVID-19肺炎的临床严重程度，确定危重病例的CT特征材料与方法51例COVID-19肺炎患者，包括普通病例(A组，n = 12)、重症病例(B组，n = 15)、危重病例(C组，C组)。采用Fisher精确检验、单因素方差分析、Kruskal-Wallis H检验、受试者工作特征分析等方法，记录胸部CT的定性和定量指标，并进行比较。结果根据疾病的严重程度，累及的肺节段和肺叶数量、实变频率、病理样、定性指标包括全肺严重程度总分、疯狂铺路和夯实总分均能区分B、C组与A组(灵敏度69%、特异性83%、准确率73%)，但B、C组间差异无统计学意义。定性和定量指标结合可区分B、C组与A组具有较高的灵敏度(B + C vs A, 90%;C vs B, 92%)、特异性(100%、87%)、准确性(92%)。危重病例的总严重程度评分(>0)高于普通病例，疯狂铺装和巩固总分(>4)高于普通病例，平均肺密度(>−779 HU)和一半最大全宽(>128 HU)高于普通/重症病例，但正常肺密度相对体积(≦50%)低于正常肺密度。我们的危重病例中，有8例正常肺密度相对体积小于40%的患者接受了机械通气支持治疗。结论基于胸部CT快速、准确地评估COVID-19肺炎的严重程度是可行的，可以为制定管理决策提供帮助，特别是对危重病例
{"title":"From the Editor The Performance of Chest CT in Evaluating the Clinical Severity of COVID-19 Pneumonia: Identifying Critical Cases Based on CT Characteristics","authors":"P. Lyu, Xing Liu, Rui Zhang, Lei Shi, Jianbo Gao","doi":"10.1097/iyc.000000000000017210.1097/rli.0000000000000689","DOIUrl":"https://doi.org/10.1097/iyc.000000000000017210.1097/rli.0000000000000689","url":null,"abstract":"Objectives The aim of this study was to assess the clinical severity of COVID-19 pneumonia using qualitative and/or quantitative chest computed tomography (CT) indicators and identify the CT characteristics of critical cases Materials and Methods Fifty-one patients with COVID-19 pneumonia including ordinary cases (group A, n = 12), severe cases (group B, n = 15), and critical cases (group C, n = 24) were retrospectively enrolled The qualitative and quantitative indicators from chest CT were recorded and compared using Fisher exact test, one-way analysis of variance, Kruskal-Wallis H test, and receiver operating characteristic analysis Results Depending on the severity of the disease, the number of involved lung segments and lobes, the frequencies of consolidation, crazy-paving pattern, and air bronchogram increased in more severe cases Qualitative indicators including total severity score for the whole lung and total score for crazy-paving and consolidation could distinguish groups B and C from A (69% sensitivity, 83% specificity, and 73% accuracy) but were similar between group B and group C Combined qualitative and quantitative indicators could distinguish these 3 groups with high sensitivity (B + C vs A, 90%;C vs B, 92%), specificity (100%, 87%), and accuracy (92%, 90%) Critical cases had higher total severity score (>10) and higher total score for crazy-paving and consolidation (>4) than ordinary cases, and had higher mean lung density (>−779 HU) and full width at half maximum (>128 HU) but lower relative volume of normal lung density (≦50%) than ordinary/severe cases In our critical cases, 8 patients with relative volume of normal lung density smaller than 40% received mechanical ventilation for supportive treatment, and 2 of them had died Conclusions A rapid, accurate severity assessment of COVID-19 pneumonia based on chest CT would be feasible and could provide help for making management decisions, especially for the critical cases","PeriodicalId":47099,"journal":{"name":"Infants & Young Children","volume":"33 1","pages":"161-162"},"PeriodicalIF":1.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61765354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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