There is no evidence of effect of SSRIs in children and emerging evidence of harm. There is limited evidence of the effectiveness of SSRIs in adults from small studies in which risk of bias is unclear.

This study examines the reliability of the Melbourne Assessment of Unilateral Upper Limb Function: a quantitative test of quality of movement in children with neurological impairment. The assessment was administered to 20 children aged from 5 to 16 years (mean age 9 years 10 months, SD 2 years 10 months) who had various types and degrees of cerebral palsy (CP). The performances of the 20 children during assessment were videotaped for subsequent scoring by 15 occupational therapists. Scores were analyzed for internal consistency of test items, inter- and intrarater reliability of scorings of the same videotapes, and test-retest reliability using repeat videotaping. Results revealed very high internal consistency of test items (alpha=0.96), moderate to high agreement both within and between raters for all test items (intraclass correlations of at least 0.7) apart from item 16 (hand to mouth and down), and high interrater reliability (0.95) and intrarater reliability (0.97) for total test scores. Test-retest results revealed moderate to high intrarater reliability for item totals (mean of 0.83 and 0.79) for each rater and high reliability for test totals (0.98 and 0.97). These findings indicate that the Melbourne Assessment of Unilateral Upper Limb Function is a reliable tool for measuring the quality of unilateral upper-limb movement in children with CP.

This study examines the reliability of the Melbourne Assessment of Unilateral Upper Limb Function: a quantitative test of quality of movement in children with neurological impairment. The assessment was administered to 20 children aged from 5 to 16 years (mean age 9 years 10 months, SD 2 years 10 months) who had various types and degrees of cerebral palsy (CP). The performances of the 20 children during assessment were videotaped for subsequent scoring by 15 occupational therapists. Scores were analyzed for internal consistency of test items, inter-and intrarater reliability of scorings of the same videotapes, and test-retest reliability using repeat videotaping. Results revealed very high internal consistency of test items (α=0.96), moderate to high agreement both within and between raters for all test items (intraclass correlations of at least 0.7) apart from item 16 (hand to mouth and down), and high interrater reliability (0.95) and intrarater reliability (0.97) for total test scores. Test-retest results revealed moderate to high intrarater reliability for item totals (mean of 0.83 and 0.79) for each rater and high reliability for test totals (0.98 and 0.97). These findings indicate that the Melbourne Assessment of Unilateral Upper Limb Function is a reliable tool for measuring the quality of unilateral upper-limb movement in children with CP.

Diagnostic tests for autism spectrum disorder (ASD) in preschool children.

SUMMARY Eleven subjects with cerebral palsy were assessed both with the Melbourne Assessment and by four clinical experts. Comparison of their assessment ratings revealed that the Melbourne Assessment was strongly related to the clinical judgement of the experts. A further 20 subjects were administered the Melbourne Assessment and two occupational therapists scored each subject's performance from videotaped assessments with substantial inter‐rater reliability (0–68); intra‐rater agreement after two weeks was 0–80. The Melbourne Assessment may provide a satisfactory objective measure of the quality of upper‐limb function. RÉSUMÉ Mise en place d'une évaluation clinique de qualité de mouvement dans la fonclion unilatéral du membre supérieur Onze IMC ont étéévalués par le Melbourne Assessement et quatre experts cliniques. La confrontation de leurs évaluations a montré que le Melbourne Assessement était fortement relié au jugement clinique des experts. 20 autres sujets furent évalués à partir de bandes vidéo par le Melbourne Assessement et deux ergothérapeutes, avec une bonne fidélité inter‐examinateur (0–68) et un accord intra‐examinateur de 0–80. Le Melbourne Assessement peut fournir une mesure objective de la qualité de la fonction du membre supérieur. ZUSAMMENFASSUNG Klinische Beurteilung der Bewegungsqualität bei unilateraler Funktion der oberen Extremitat 11 Patienten mit Cerebralparese wurden anhand der Melbourne Assessment, sowie von vier klinischen Experteh untersucht. Der Vergleich ihrer Beurieilungen zeigte, daß die Ergebnisse der Melbourne Assessment klar mit den Befunden der Experten korrelierten. Weitere 20 Patienten wurden mit der Melbourne Assessment getestet und zwei Beschäftigungsthcrapeuten beurteilten die Leistungen jedes Patienten anhand von Videoaufnahmen mit einer erstaunlichen Inter‐Rater Übereinstimmung (0–68); die Inter‐Rater Übereinstimmung nach zwei Wochen betrug 0–80. Die Melbourne Assessment mag eine zufriedenstellende objektive Methode zur Beurteilung der Bewegungsqualitat der oberen Exiremität sein. RESUMEN Desarrollo du una evaluación cli'nica de la calidad de movimiento en la extremidad su perior unilateral Once individuos con parálisis cerebral fueron evaluados por medio de la Evaluación de Melbourne y por cuatro expertos clinicos. La comparación de sus evaluaciones reveló que la Evaluación de Melbourne estaba fuertemente corelacionada con el juicio clinico de los expertos. A otros 20 individuos se les pasó la Evaluación de Melbourne y dos terapeutas ocupacionales puntuaron la realización de cada individuo a partir de cintas de video con una fiabilidad entre los promedios substancial. La coincidencia tras dos semanas era de 0,80. La Evaluación Melbourne puede proporcionar una medición objetiva satisfactoria de la calidad de la función de la extremidad superior.

The prevalence of a parent-reported diagnosis of autism spectrum disorder before age 7 in Australia was higher in the B cohort. Data from future Longitudinal Study of Australian Children waves will clarify whether autism spectrum disorder has been diagnosed earlier in the B cohort or if there is a continued increase in prevalence. Future waves will also provide crucial information about the types and severity of problems experienced during the primary and secondary school years which will assist service planning.

ABBREVIATIONS DIFMETHOD Rasch analysis was used to assess of Melbourne Assessment raw scores for 163 children (94 males, 69 females; mean age 8y, SD 3y 5mo). Analysis was undertaken on the full scale comprising 37 scores and on groups of scores separated into four distinct movement subscales: range of movement, accuracy, dexterity, and fluency. Tests were conducted to evaluate overall model fit, item fit, suitability of the response options, unidimensionality, and differential item functioning (DIF) for sex, child age, and different raters. RESULTSThe results did not support the unidimensionality of the 37-score scale. The four subscales showed adequate model fit after removal of some score items, and rescaling of others. The resulting subscales showed good internal consistency and no DIF for sex or child age.

This pilot study examined the feasibility of a 6-week group-based, task-related training program in children 6 to 14 years-old with spastic diplegia. Eight children were randomized to lower limb training and seven to an upper limb dexterity training program. There were no statistically significant differences in lower limb outcomes between children who received the lower limb training and children who received the upper limb dexterity training after completion of the interventions or at a 6-week follow-up. Children who received the upper limb training demonstrated a greater improvement on measures of manual dexterity compared with children who received the lower limb training program. Children who received the lower limb training demonstrated a trend toward walking a longer distance in 10 minutes immediately following intervention, that was not sustained at the 6-week follow-up. The group setting appeared to motivate the children and enhance their participation in the training programs. The pilot study provides data for the calculation of effect size and sample estimates for future studies.