Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item REACh for the preschoolers; a developmental assessment tool for 2-5 year old children in Sri Lanka(BioMed Central, 2023) Caldera, A.V.; Wickremasinghe, A.R.; Muttiah, N.; Godamunne, P.K.S.; Jayasena, B.N.; Chathurika, L.K.E.; Perera, K.M.N.; Mendis, M.; Tilakarathne, D.; Peiris, M.K.R.R.; Wijesinghe, T.; Senarathna, N.E.; Saubhagya, W.D.L.; Chandraratne, M.; Sumanasena, S.P.BACKGROUND: Preschool children in low resource settings are at higher risk of missing developmental potential due to the lack of standardized and validated methods for the timely detection of children with developmental delays or neurodevelopmental disorders. The preschool teacher is a non-specialist resourceful link within the community to detect and offer interventions early. This paper discusses the preliminary iteration of designing and testing the psychometric properties of a developmental assessment for children aged 24 to 60 months in Sri Lanka. This assessment is designed to be conducted by preschool teachers in their preschool setting. METHODS: Three processes followed: 1. Designing and development of the Ragama Early Assessment for Children (REACh) complete preschool developmental assessment and a tool kit 2. Testing and training teachers on conducting the REACh assessment 3. Preliminary assessment of the psychometric properties including content validity, internal consistency, interrater reliability and concurrent validity. RESULTS: A literature search identified 11 assessments and 542 items representing cognitive, social-emotional and adaptive, language and motor domains. Content validity was assessed to select and adapt items. A complete assessment tool was designed to be administered in four settings within the preschool. This was further improved during pre and pilot testing and teacher training. Cronbach's alpha measuring internal consistency was > 0.70 for cognitive, language, social-emotional and adaptive domains across all three age groups in 1809 children. Interrater reliability was > 65% for age groups 36-47 and 47- 60 months. Concurrent validity using a clinical gold standard demonstrated sensitivity of more than 0.75 for all age groups with variable specificities (24-35 months: 0.71, 36- 47 months: 0.43 and 48-60 months: 0.67) assessed in 75 children. CONCLUSIONS: This culturally and linguistically adapted tool was tested nationally in Sri Lanka. The inte-rrater reliability between teachers and research assistants was higher than 65% for all domains in children more than 36 months. The preliminary iteration confirms it as an acceptable screening assessment for all age groups but with significantly lower specificity in the 36-47 month age group. Further improvement in certain domains together with intense teacher training is likely to enhance the validity and reliability of the assessment.Item Designing a tool to monitor development of 2-5 year old children by preschool teachers in Sri Lanka: A preliminary report(Sri Lanka Medical Association, 2018) Caldera, A.; Mendis, M.; Muttiah, N.; Wijesinghe, T.M.; Godamunne, P.K.S.; Chathurika, L.K.E.; Jayasena, B.N.; Wickremasinghe, A.R.; Perera, K.M.N.; Tilakarathne, N.; Peiris, M.K.R.R.; Sumanasena, S.P.INTRODUCTION AND OBJECTIVES: Identifying neurodevelopmental impairments and providing early intervention positively impacts later academic and functional outcomes of children. Globally available child development screening tools are not readily accessible or validated for Sri Lanka. As a large proportion of Sri Lankan children aged 2-5 years attend preschools, teachers can complement developmental monitoring. The aim of this study was to design a tool to monitor the development of 2-5 year old children by preschool teachers. METHODS: Twelve local and global tools including the tool developed by Plan International and the Child Health Development Record (CHOR) were reviewed. All tools were mapped according to the domains and subdomains in the National Early Childhood Developmental Standards for Sri Lankan Children. A Delphi process was carried out by a panel of experts to include culture specific activities that assess all domains and subdomains across age groups. RESULTS: The existing tool developed by Plan International lacked indicators for health, daily living and social and emotional development. The CHOR was deficient in cognitive, receptive language, social and emotional indices. Several activities in some instruments were common to more than one age group. The domains incorporated into the proposed tool included motor, cognitive, language, social and emotional and self- help skills. Approximately 50 items per each age group were included in this tool CONCLUSION: A preliminary play-based tool for monitoring development of children 2-5 years of age across five main domains in natural settings for preschool children was developed. A pilot study is required to assess the validity of the tool.Item Developing the Kelaniya Monosyllabic – Trochee – Polysyllabic test (MTP) and Glendonald Auditory Screening Procedure (GASP) for Sinhala-speaking children(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Chathurika, L.K.E.Several test protocols are used in evaluating the auditory development in children following cochlear implantation. However, in Sri Lanka there are no such tests available in Sinhala. In order to assess the performance scores of Sinhala speaking normative hearing children on the a) Translated Glendonald Auditory Screening Procedure (GASP) and b) Kelaniya Monosyllabic – Trochee – Polysyllabic test (MTP), the Kelaniya MTP test (12 words) was developed and the GASP was (10 questions) translated into Sinhala. Two randomly selected samples of 212 participants (101 male, 111 female) aged 4.1- 8.0 years and 200 participants (105 male, 95 female) aged 2.1 – 8.0 years were included in the assessment of the MTP test and GASP, respectively. Children with normal hearing were recruited using their medical history, Pure Tone Audiometry and immittance audiometric results. All children with normal hearing were administered the tests. With the exception of the word /kesel/ in the 2.1 – 3.0 year age group, all the other words were correctly repeated by more than 80% of the children in the MTP test. The average GASP scores were significantly low (p<0.001) in the youngest age group, which increased with age. The Kelaniya MTP test and GASP can be used with children aged above 3.0 years and above 5.0 years respectively.Item Knowledge, Attitudes and Practices on Noise Induced Hearing Loss among Factory Workers of Two Dairy Product Manufacturing Factories in Gampaha District, Sri Lanka(Faculty of Medicine, University of Kelaniya, 2014) Hansajie, S.T.K.; Jayasena, B.N.; Chathurika, L.K.E.The main purpose of this study was to describe dairy product manufacturing factory workers’ knowledge, attitudes and practices on Noise Induced Hearing Loss. A cross-sectional study was conducted involving 187 factory workers in two factories in the Gamapaha District. A self-administered questionnaire was used to obtain information pertaining to knowledge, attitudes and practices related to Noise Induced Hearing Loss. In the study, it was found out that knowledge on risk factors of NIHL (23.5%) and symptoms of NIHL (38%) was weak. Even though most of the workers (76.5%) perceive noise as a usual phenomenon in the working area, 77% of the workers were willing to seek medical attention if the hearing starts to deteriorate. The overall practice level was not satisfactory. 80.2% of the workers have never used hearing protection devices (HPD) while working. 98.9% of the workers have never undergone a hearing evaluation and 99.5% of the workers have never attended to a hearing conservation program. 95% of the workers reported that the occurrence of hearing deterioration due to high level of noise was worrying. Only 0.5% of the workers reported wearing HPD while working. 80.2% of the workers never used HPD during work. There was a significant association between aspects of work experience and HPD usage (2= 5.193, p= 0.02). In conclusion, it was discovered that there is a need to have a hearing conservation program that stresses on the use of hearing protective devices to prevent the occupational noise induced hearing loss in the particular setting.