Cognitive and physical are a substantial problem for infants and children in both developed and developing countries. Developed countries have in place established resources for screening infants to detect at young ages (birth to two years), individuals with likely delays, and to enroll them in appropriate treatment and prevention programs. One particular high risk group of such infants are those born with birth defects. Children with cleft lip and palate, because of its ease of identification and high frequency, can serve as a sentinel for birth defects in general. In disadvantaged regions of South America, there is a disconnect between available services and the ability to recognize and refer children who could benefit. Our currently funded Birth Defects Treatment and Prevention Program (BDTPP) is establishing methodologies to identify children born with clefts who also have developmental delays as co-morbidities and to establish a program at multiple South American sites of using early detection to intervention to improve treatment and provide options for prevention. We are currently incorporating the Bailey Infant Neurodevelopmental Screener (BINS) a well established developmental screening instrument used in English-speaking countries, into the BDTPP. The BINS provides a standard format that can be used to monitor development during the 2 year intervention for a subgroup of children with cleft lip and palate. In this supplement we are requesting funds to create Spanish and Portugese language norms for the use of the BINS to allow us to carry out comparisons using our cleft population already being sampled to a matched-control population. In addition these norms would also serve to establish the BINS as a useful tool for wide-use in Hispanic populations in Latin-America as well as the large Spanish and Portugese speaking populations in the United States. We will make use of an established South American birth defects registry program that is already identifying and characterizing these children, and that has already developed expertise with the use of the BINS to carry this out on an additional group of control children, on whom the norms will be established. ? ?
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