No abstract

No abstract

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. AbstractBackground Developmental problems in children can be alleviated to a great extent with early detection and intervention through periodic screening for developmental delays during pre-school ages. Currently, there is no established system for developmental screening of children in Sri Lanka. Although some developmental norms, which are similar to those of Denver Developmental Screening Test-II (DDST-II), have been introduced into the Sri Lankan Child Health Developmental Record (CHDR), those norms have not been standardized to the Sri Lankan child population. The aim of this research was to establish Sri Lankan norms for DDST-II and to test the universal and regional applicability of developmental screening tests by comparing the Sri Lankan norms with the norms of DDST-II and DDST-Singapore norms, the geographically nearest standardization of DDST-II. The norms were also compared with the milestones already available in the CHDR. Methods DDST-II was adapted and standardized on a sample of 4251 Sri Lankan children aged 0-80 months. Thirteen public health nursing sisters were trained to collect the data as part of their routine work. The 25th, 50th, 75th and 90th percentile ages of acquiring each developmental milestone were then calculated using logistic regression. Results The Denver Developmental Screening Test for Sri Lankan Children (DDST-SL) was created. Most of the established DDST-SL norms were different to the comparable norms in DDST-II, DDST-Singapore and the CHDR. Conclusions In view of the results of the study, it is imperative that developmental screening tests are used in context and are adapted and standardized to the populations in question before utilization.

ObjectiveTo investigate whether men and women who were looked-after (in public care) or adopted as children are at increased risk of adverse psychological and social outcomes in adulthood.Design, settingProspective observational study using the Avon Longitudinal Study of Parents and Children, which recruited pregnant women and their male partners in and around Bristol, UK in the early 1990s.Participants8775 women and 3654 men who completed questionnaires at recruitment (mean age: women 29; men 32) and 5 years later.ExposureChildhood public care status: looked-after; adopted; not looked-after or adopted (reference group).OutcomesSubstance use (alcohol, cannabis, tobacco) prepregnancy and 5 years later; if ever had addiction; anxiety and depression during pregnancy and 5 years later; if ever had mental health problem; social support during pregnancy; criminal conviction.ResultsFor women, 2.7% were adopted and 1.8% had been looked-after; for men, 2.4% and 1.4%, respectively. The looked-after group reported the poorest outcomes overall, but this was not a universal pattern, and there were gender differences. Smoking rates were high for both the looked-after (men 47%, women 58%) and adopted (men 44%, women 40%) groups relative to the reference group (both 28%). The looked-after group were at increased risk of a high depression score (men: 26% vs 11%, OR 2.9 (95% CI 1.5 to 5.6); women: 24% vs 9%, 3.4 (2.2 to 5.0)). A high anxiety score was reported by 10% of the reference women, compared with 26% of those looked-after (3.0 (2.0 to 4.5)) and 17% of those adopted (1.8 (1.2 to 2.6)). Looked-after men and women reported the lowest social support, while criminal convictions and addiction were highest for looked-after men. Adjustment for adult socioeconomic position generally attenuated associations for the looked-after group.ConclusionsThe needs of those who experience public care as children persist into adulthood. Health and social care providers should recognise this.

Purpose: This paper report findings from two research studies that set out to calculate the rate and predictors of post-order adoption disruption in England and Wales. Methods: All available national level administrative data on adopted children in England and Wales were analysed, supplemented by national surveys adoption managers. Complete national datasets were available for 12 years in England and for 11 years in Wales. Results: Of the 36,749 and 2,317 adoptions considered, 565 in England and 35 in Wales had disrupted over the follow up period. Kaplan Meier analyses indicate that cumulative post-order adoption disruption rates were 3.2% and 2.6% respectively for England and Wales. Cox regression models indicate that being older than four years adoptive placement, adoptive parents taking longer than a year to legalise the adoption, being a teenager and previous multiple placements in care were risk factors for post-order adoption disruption. Conclusion: The post order adoption disruption rate is low. Implications for policy and practice are discussed. ➢ Table 1. UK studies of adoption disruption rates (1990-2015)* * Adapted from authors' own publication (Selwyn et al., 2014) ᶧ No differentiation made between pre/post order adoption disruptions Author Country Sample Characteristics Follow up period Pre/post Order disruption rate Post-Order disruption rate