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      ECI-4 screening of attention deficit-hyperactivity disorder and co-morbidity in Mexican preschool children: preliminary results Translated title: Tamizaje del trastorno por déficit de atención-hiperactividad y su co-morbilidad en preescolares mexicanos por el ECI-4: resultados preliminares

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          Abstract

          OBJECTIVE: To examine prospectively usefulness of Early Childhood Inventory-4 (ECI-4) in identifying attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). METHOD: A sample of children <6 years of age were evaluated in school settings with ECI-4 and results compared with those of Conners Rating Scales-Revised (CRS-R) 6 months later. Sample consisted of 34 healthy children (20 boys, 14 girls) prospectively followed-up. RESULTS: Frequency of children fulfill DSM-IV AD-HD criteria in ECI-4 parent scale was 17%, and in teacher scale was 32%. Frequency of children fulfill DSM-IV AD-HD criteria in parent CRS-R was 20%, and for teacher questionnaire was 23%. Correlations were significant among teacher ECI-4 and both teacher and parent CRS-R scales. Sensitivity and specificity of teacher and parent ECI-4 scales were not good. Frequency of ODD identified in parent ECI-4 scale was 5%, and for teacher 17%. Frequency of ODD in CRS-R for parents and teachers questionnaires was 17%. CD was not identified by parents in ECI-4 scale, but in teacher scale frequency was 14%. CONCLUSION: These facts support partially the use of ECI-4 screening of ADHD in Spanish-speaking preschool children.

          Translated abstract

          OBJETIVO: Examinar prospectivamente la utilidad del Inventario Temprano de la Niñez-4 (Early Childhood Inventory-4, ECI-4) para identificar el trastorno por déficit de atención-hiperactividad (TDAH), el trastorno desafiante-oposicional (TDO) y el trastorno de conducta (TC). MÉTODO: Una muestra de niños <6 años fue evaluada con el ECI-4 en un ambiente escolar y los resultados comparados con los de las Escalas de Conners (Conners Rating Scales-Revised, CRS-R) 6 meses mas tarde. La muestra consistió de 34 niños (20 niños, 14 niñas) seguidos prospectivamente. RESULTADOS: La frecuencia de niños que llenaron los criterios del DSM-IV para TDAH en la escala para padres del ECI-4 fue 17%, mientras que en la escala para maestros fue 32%. La frecuencia de niños que llenaron los criterios del DSM-IV para TDA-H en la escala para padres CRS-R fue 20%, en la escala para maestros fue 23%. Se hallaron correlaciones significativas entre la escala para maestros del ECI-4 y las escalas para maestros y para padres de CRS-R. La sensibilidad y la especificidad de las escalas para maestros y padres del ECI-4 no fueron alentadoras. La frecuencia del TDO identificada en la escala para padres del ECI-4 fue 5% y en la escala para maestros fue 17%. La frecuencia del TDO en la escala para padres y para maestros CRS-R fue 17%. El TC no fue identificado por los padres con la escala del ECI-4, pero en la escala para maestros, la frecuencia fue de 14%. CONCLUSIÓN: Los resultados obtenidos apoyan parcialmente el uso de las escalas de tamizaje del ECI-4 para encontrar TDAH, TDO y TC en preescolares mexicanos.

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          Most cited references25

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          Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioral, social, and school functioning.

          To examine differences in home, school, and medical functioning between preschool-age children with attentiondeficit/hyperactivity disorder (ADHD) and normal control children. A sample of 94 children (58 with ADHD, 36 normal controls) between 3 and 5 years old participated. Dependent measures included parent and teacher ratings of problem behavior and social skills, parent ratings of stress and family functioning, medical functioning data, observations of parent-child interactions and classroom behavior, and a test of preacademic skills. Young children with ADHD exhibited more problem behavior and were less socially skilled than their normal counterparts according to behavior ratings. Parents of children with ADHD experienced greater stress and were coping less adaptively than parents of non-ADHD children. Children with ADHD exhibited more noncompliant and inappropriate behavior than normal controls, particularly during task situations. Parents of children with ADHD were more likely to display negative behavior toward their children. Children with ADHD exhibited more negative social behavior in preschool settings and scored significantly lower on a test of preacademic skills. No significant differences in injuries or utilization of medical services were found. Preschool-age children with ADHD are at significant risk for behavioral, social, familial, and academic difficulties relative to their normal counterparts.
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            Psychiatric comorbidity and functioning in clinically referred preschool children and school-age youths with ADHD.

            Although the literature documents that attention-deficit/hyperactivity disorder (ADHD) commonly onsets prior to age 6, little is known about the disorder in preschool children. We evaluated the clinical characteristics, psychiatric comorbidity, and functioning of preschool children and school-age youths with ADHD referred to a pediatric psychiatric clinic for evaluation. Structured psychiatric interviews assessing lifetime psychopathology by DSM-III-R criteria were completed with parents about their children. Family, social, and overall functioning were also assessed at intake. We identified 165 children with ADHD aged 4 to 6 years (preschool children) and 381 youths aged 7 to 9 years (school-age) with ADHD. Despite being younger, preschool children had similar rates of comorbid psychopathology compared with school-age youths with ADHD. There was an earlier onset of ADHD and co-occurring psychopathology in the preschool children compared to school-age youths. Both preschool children and school-age youths had substantial impairment in school, social, and overall functioning. The results of this study suggest that despite being significantly younger, clinically referred preschool children with ADHD are reminiscent of school-age youths with ADHD in the quality of ADHD, high rates of comorbid psychopathology, and impaired functioning. Follow-up of these clinically referred preschool children with ADHD to evaluate the stability of their diagnoses, treatment response, and their long-term outcome are necessary.
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              The Child and Adolescent Psychiatric Assessment (CAPA).

              Great advances have been made during the last 20 years in the development of structured and semi-structured interviews for use with psychiatric patients. However, in the field of child and adolescent psychiatry there have been weaknesses in the specification and definition of both symptoms and the psychosocial impairments resulting from psychiatric disorder. Furthermore, most of the available interviews for use with children have been tied to a single diagnostic system (DSM-III, DSM-III-R, or ICD-9). This has meant that symptom coverage has been limited and nosological comparisons have been inhibited. The Child and Adolescent Psychiatric Assessment (CAPA) represents an attempt to remedy some of these shortcomings. This paper outlines the principles adopted in the CAPA to improve the standardization, reliability and meaningfulness of symptom and diagnostic ratings. The CAPA is an interviewer-based diagnostic interview with versions for use with children and their parents, focused on symptoms occurring during the preceding 3 month period, adapted for assessments in both clinical and epidemiological research.
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                Author and article information

                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo, SP, Brazil )
                0004-282X
                1678-4227
                December 2006
                : 64
                : 4
                : 932-936
                Affiliations
                [01] Mexico City orgnameNational Institute of Rehabilitation orgdiv1Department of Language Therapy orgdiv2Laboratory of Cognitive Neurophysiology Mexico
                Article
                S0004-282X2006000600008 S0004-282X(06)06400408
                221cad8b-3278-46ec-bf92-44baa13dc7ce

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 23 February 2006
                : 11 August 2006
                : 10 July 2006
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 5
                Product

                SciELO Brazil


                preescolares,screening,disruptive behavior,hyperactive children,preschool children,tamizaje,trastorno de conducta,trastorno desafiante oposicional,trastorno por déficit de atención-hiperactividad

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