A speech and language assessment procedure was developed to study different aspects of speech and language skills in children 6.5 years old who had needed intensive care in the neonatal period. It was required that the procedure could be carried out at one examination session and that it should characterize a broad spectrum of language skills and permit detection of deviations in language development. The assessment comprises three parts. Part A is an evaluation of the child's spontaneous speech during a 10- to 15-minute conversation between the child and the assessor. Eight different variables are assessed, and an overview of the child's conversational behaviour is obtained. Part B is an assessment of speech and language skills. A set procedure is used to assess auditory discrimination, interaction between auditory and speech motor capacity, different comprehension functions, vocabulary and word fluency. Some motor tasks are included to elucidate the relationship between speech and non-linguistic fine motor activity. Part C is an interview with the parents. A control group of 40 children was tested. The assessment protocol is now being applied for follow-up examination of children who have needed neonatal intensive care at Uppsala University Hospital, Sweden.
This study evaluates the predictability of a new language screening procedure in 3-y-olds. It is used in several Child Health Centres (CHC) in Sweden and has the character of a field study involving more than 60 CHC nurses. The main questions concern the (i) development in 3-y-olds assessed as severely language delayed and (ii) whether there are any earlier unknown severely disabled children identified at 4 y of age. Ninety-six percent of the original study population participated in the follow-up. The calculations are based on results from 2237 children. A well-established screening routine, which has been shown capable of predicting the risk of not being able to follow expected schooling, and case records were used as an acceptable proxy outcome measure, pending a better gold standard. In the group of severely disabled 3-y-olds, sensitivity, specificity and positive predictive values were 86, 99 and 43%, respectively. Finally, three false-negatives were identified. In light of the present results, continued application of the 3-y screening is discussed.
This paper is a provisional report from an ongoing field experiment in Uppsala, Sweden, with the aim to reduce the number of serious childhood accidents. Groups of parents have been systematically trained to function as child-environment supervisors. The experiences have been very positive so far. The child-environment supervisors have proved to possess good knowledge about how to prevent accidents. A large number of hazards have been detected and successfully eliminated. The groups are now taking an active part in the planning of new housing estates. The findings also indicate that the Child Health Organization should be able to play a more active role in the work of environmental improvement for the safety of children. A suggestion for a collective strategy for such activity has been worked out.
In considering health information systems, great hope is attached to the use of child health records as a data source for research and community planning. In order to test the completeness of child health records data and their agreement with other sources, information about living conditions, use of medical services and health problems in preschool children were studied in 707 child health centres' records. The results show a considerable number of deficiencies in the system which could, to a certain extent, be remedied by improved instructions to the staff. Health problems in the area of child care also need to be fully defined.
AIMS: To analyse mothers' self-assessed quality of interaction with their children and their opinions about child difficulty with respect to socio-economic status and subjective factors: postnatal depression, social isolation, sense of coherence and locus of control. METHODS AND MATERIAL: A comprehensive questionnaire was completed by 1039 mothers of 18-mo-old children participating in the baseline measurements of a Swedish multicentre study developing and testing a new psychosocial model for the child health services. RESULTS: All subjective factors, including the number of factors, showed significant associations with perceived interaction and difficultness. Effect sizes of subjective factors ranged from about 0.3 to 1 SD for interaction, and from about 0.2 to 0.8 SD for difficultness. As for difficultness, effect sizes were larger for boys. There were no associations between high socio-economic status and high-quality interaction or low child difficultness: the few significant differences in fact favoured low-status children. CONCLUSION: The results provided some contradictory findings to the well-known association between high socio-economic status and favourable outcome. This result is of practical relevance for interventions: supportive programmes cannot be limited to areas and families of low socio-economic status. Positive effects may ensue if subjective factors like those studied here can be promoted among parents and children through the child health services.