Development of the Vanderbilt Assessment for Delirium in Infants and Children to Standardize Pediatric Delirium Assessment By Psychiatrists

Maalobeeka Gangopadhyay, Heidi Smith, Maryland Pao, Gabrielle Silver, Deepmala Deepmala, Claire De Souza, Georgina Garcia, Lisa Giles, Danica Denton, Natalie Jacobowski, Pratik Pandharipande, Catherine Fuchs

Research output: Contribution to journalReview articlepeer-review

Abstract

Background Pediatric delirium assessment is complicated by variations in baseline language and cognitive skills, impairment during illness, and absence of pediatric-specific modifiers within the Diagnostic and Statistical Manual of Mental Disorders delirium criterion. Objective To develop a standardized approach to pediatric delirium assessment by psychiatrists. Methods A multidisciplinary group of clinicians used Diagnostic and Statistical Manual criterion as the foundation for the Vanderbilt Assessment for Delirium in Infants and Children (VADIC). Pediatric-specific modifiers were integrated into the delirium criterion, including key developmental and assessment variations for children. The VADIC was used in clinical practice to prospectively assess critically ill infants and children. The VADIC was assessed for content validity by the American Academy of Child and Adolescent Psychiatry Delirium Special Interest Group. Results The American Academy of Child and Adolescent Psychiatry-Delirium Special Interest Group determined that the VADIC demonstrated high content validity. The VADIC (1) preserved the core Diagnostic and Statistical Manual delirium criterion, (2) appropriately paired interactive assessments with key criterion based on development, and (3) addressed confounders for delirium. A cohort of 300 patients with a median age of 20 months was assessed for delirium using the VADIC. Delirium prevalence was 47%. Conclusion The VADIC provides a comprehensive framework to standardize pediatric delirium assessment by psychiatrists. The need for consistency in both delirium education and diagnosis is highlighted given the high prevalence of pediatric delirium.

Original languageEnglish (US)
Pages (from-to)355-363
Number of pages9
JournalPsychosomatics
Volume58
Issue number4
DOIs
StatePublished - Jul 2017

Keywords

  • assessment
  • delirium
  • education
  • pediatric
  • psychiatry
  • teaching methods

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health

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