title: Delirium screening anchored in child development: The Cornell Assessment for Pediatric Delirium.
abstract: OBJECTIVE
  The recently validated Cornell Assessment for Pediatric Delirium (CAPD) is a new rapid bedside nursing screen for delirium in hospitalized children of all ages. The present manuscript provides a "developmental anchor points" reference chart, which helps ground clinicians' assessment of CAPD symptom domains in a developmental understanding of the presentation of delirium.
  
  
  METHODS
  During the development of this CAPD screening tool, it became clear that clinicians need specific guidance and training to help them draw on their expertise in child development and pediatrics to improve the interpretative reliability of the tool and its accuracy in diagnosing delirium. The developmental anchor points chart was formulated and reviewed by a multidisciplinary panel of experts to evaluate content validity and include consideration of sick behaviors within a hospital setting.
  
  
  RESULTS
  The CAPD developmental anchor points for the key ages of newborn, 4 weeks, 6 weeks, 8 weeks, 28 weeks, 1 year, and 2 years served as the basis for training bedside nurses in scoring the CAPD for the validation trial and as a multifaceted bedside reference chart to be implemented within a clinical setting. In the current paper, we discuss the lessons learned during implementation, with particular emphasis on the importance of collaboration with the bedside nurse, the challenges of establishing a developmental baseline, and further questions about delirium diagnosis in children.
  
  
  CONCLUSIONS
  The CAPD with developmental anchor points provides a validated, structured, and developmentally informed approach to screening and assessment of delirium in children. With minimal training on the use of the tool, bedside nurses and other pediatric practitioners can reliably identify children at risk for delirium.
authors.affiliation: Weill Cornell Medical College/New York Presbyterian Hospital,New York,New York.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Silver
authors.affiliation: Memorial Sloan Kettering Cancer Center,New York,New York.
authors.forename: Julia
authors.initials: J
authors.lastname: Kearney
authors.affiliation: Weill Cornell Medical College/New York Presbyterian Hospital,New York,New York.
authors.forename: Chani
authors.initials: C
authors.lastname: Traube
authors.affiliation: Weill Cornell Medical College/New York Presbyterian Hospital,New York,New York.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hertzig
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods* / Q000523:psychology; D003693:Delirium / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008403:Mass Screening / Q000379:methods* / Q000523:psychology; D015203:Reproducibility of Results
keywords: Child psychiatry; Delirium; Developmental anchor points; Pediatric critical care