Allergy tests in children under 2 years of age. Diagnostic material "proofreading test"

The “Corrective Test” method for studying attention was first proposed by B. Bourdon in 1895. Corrective test proposed by Bourdon consists of several tests of different nature. There is only one option offered to your attention here. The technique is designed to assess the volume, concentration and stability of attention. P When using the test for adults, it is necessary to conduct a preliminary conversation with the test subject - many diseases of the cardiovascular, respiratory systems etc., reduce the ability to concentrate.

The form developed by Bourdon consisted of rows of letters of the Russian alphabet. The subject, looking through the form, row by row, looks for the letters “k” and “p” and must cross them out. The task must be completed quickly and accurately.

The technique can be used for adults and children.

However, in the case of working with children, a variation of the “Landolt Ring” technique is more suitable, since it is easier for preschoolers to work with drawings than with letters.

Equipment:

• standard test form “Corrective test”;

Some letters of the Russian alphabet are printed in random order on the form, including the letters “k” and “r”. There are 2000 characters in total, 50 letters in each line.

• stopwatch.

Procedure:

The study must be carried out individually. You need to start only after making sure that the subject is ready to begin the study. The atmosphere of the study should be friendly and comfortable so that the subject does not get the impression that he is being examined. The subject begins to work at the experimenter's command. When after some time the experimenter says: “Damn!” - he must put a vertical line in the place on the line where the team found him. The last letter is considered to be the one crossed out before (or with) the last words “Devil”. The procedure takes 10 minutes.

As a rule, during this time, normally, a common person makes 10-15 mistakes.

Instructions:“Looking at the lines one by one, cross out the letters “k” and “p.” When I say: “Damn!”, you must draw a vertical line in the place on the form where you are at that moment.

Processing and interpretation of test results proofreading test:

When processing the received data, the psychologist checks the results in the subject’s proofreading forms with the key to the test and fills in the corresponding columns in the protocol.

Treatment:

Calculation of attention productivity: the number of letters viewed in 10 minutes, and accuracy, calculated by the formula: K = m:n x 100%, where K is accuracy, n is the number of letters that needed to be crossed out, m is the number of letters crossed out correctly during work.

PROTOCOL OF THE STUDY ASSESSING SUSTAINABILITY OF ATTENTION
Age ______________ Gender __________ Date __________________
Indicators Results

Productivity		Accuracy		Productivity		Accuracy
signs	points	%	points	signs	points	%	points
less than 1010	1	less than 70	1	2660-2825	16	84-85	12
1010-1175	3	70-72	2	2825-2990	17	85-87	13
1175-1340	5	72-73	3	2990-3155	18	87-88	14
1340-1505	7	73-74	4	3155-3320	19	88-90	15
1505-1670	9	74-76	5	3320-3485	20	90-91	16
1670-1835	10	76-77	6	3485-3650	21	91-92	17
1835-2000	11	77-79	7	3650-3815	22	92-94	18
2000-2165	12	79-80	8	3815-3980	23	94-95	20
2165-2330	13	80-81	9	3980-4145	24	95-96	22
2330-2495	14	81-83	10	4145-4310	25	96-98	24
2495-2660	15	83-84	11	more than 4310	26	more than 98	26

To compare data on stability of attention with other properties of the attentional function, it is necessary to again translate the integral indicator of stability of attention into scale ratings according to the following table.

Table for converting indicators of attention properties into comparable scale ratings

Scale ratings	Sustainability of attention	Switching attention	Volume of attention	Scale ratings	Sustainability of attention	Switching attention	Volume of attention
19	more than 50	more than 217	less than 115	9	25-27	172-181	216-235
18				8	23-24	158-171	236-265
17	48-49	214-216	116-125	7	20-22	149-157	266-295
16	46-47	211-213	126-135	6	16-19	142-148	296-335
15	44-45	208-210	136-145	5	14-15	132-141	336-375
14	39-43	205-209	146-155	4	12-13	122-131	376-405
13	36-38	201-204	156-165	3	9-11	114-121	406-455
12	34-35	195-200	166-175	2	–	110-113	–
11	31-33	189-194	176-185	1	–	–	–
10	28-30	182-188	186-195	0	less than 9	less than 109	more than 456

The scale rating (SRS) is interpreted as follows:
SHO Characteristics of the level of attention stability
0-3 Low attention span
4-7 Below average attention span
8-11 Average attention span
12-15 Above average attention span
16-19 High stability of attention

Let's briefly summarize the algorithm:

1. Using the formula K = (M/N) x 100%, we evaluate the accuracy of the work performed.
In the formula, M is the number of letters crossed out correctly during work;
N – the number of letters that needed to be crossed out.
2. Using the table, we convert the indicator K into an accuracy score - criterion C.
3. We calculate the integral indicator of attention stability (A) using the formula A=B+C.
Using the table, we convert indicator A into a scale rating.

28.07.2017

– systemic disease. Autoimmune disorders do not affect specific organs, but entire systems. The symptoms of the disease are very diverse. The release of allergy mediators leads to the development of local and systemic reactions from the skin, respiratory system, gastrointestinal tract, central nervous system.

Therefore the diagnosis allergic disease determined, among other things, by the results of testing with the intended stimulus. Specific examination includes:

• taking anamnesis;
• allergy tests on the skin;
• provocative tests;
• laboratory methods.

The diagnosis is prescribed by an allergist, taking into account the indications and contraindications for each individual child.

Skin tests

Allergy tests on the skin - method for diagnosing the specific sensitivity of the body. It is carried out at the first stage of pathology assessment. Indications forskin allergy tests is information from the anamnesis (questionnaires, conversations with parents) indicating the role of a causally significant factor of a particular allergen or group.

Features of the method

Skin tests for allergens in a child

The diagnostic principle is based on the interaction of the causative allergen with skin cells. If there is sensitization, a local reaction develops. The allergist notes its intensity. When choosing allergens introduced children , information obtained from a survey of parents is taken into account.

This type of diagnostics is economical and quite sensitive. However, to avoid erroneous results, it is important Right perform the staging technique. Result tests for allergies the disease is visible almost immediately. The method is safe and has no age restrictions.

How are allergy tests done?

Allergy tests are done only in a medical facility

Diagnostics are carried out using ready-made water-salt extracts of various allergens: epidermal, pollen, food, dust.

When testing using the scarification method, drops of allergens are applied to the child's small scratches on the back of the forearm. The drops are on the skin for 10 minutes. Then they are wiped, wait 10 minutes and see if redness and a blister appear. Conclusion about positive result is done based on the coincidence of stories received from parents with skin reactions + + for children under 3 years of age and +++ for children after 3 years of age.

Decoding samples using the scarification method is as follows:

Types of skin tests

An intradermal test is performed to identify individual allergens

If the results of prick tests are questionable, they are done inside skin tests. When they are carried out, there is a risk of developing a systemic reaction. Therefore, the allergen solution is diluted 100 times or more.

With the prick test technique, allergens are injected into the skin using special disposable lancets. Most often, testing is performed on the palmar surface of the forearm or on the back.

To diagnose contact allergic dermatitis and photoallergic reactions, skin patch tests (path-tests) are performed. Medicines and chemicals are taken as allergens. The solution is used in concentrations that do not cause skin irritation in healthy people.

To do patch tests, you will need to visit the doctor 3-4 times. During the first visit, the allergen is applied to the skin. After two days, the flaps are removed and after 15-20 minutes the doctor looks at the local reaction. The test conclusion is made upon examination after 72 hours.

Rules for skin testing

Diagnosis of allergies in children is carried out subject to the rules

Skin allergy testsare held only in medical institution, where there is medical equipment, qualified personnel and medications in case of possible development anaphylactic shock. However, such a diagnostic outcome is very rare.

For children under 3 years of age, the examination is carried out incompletely: no more than 5 tests with non-infectious allergens can be performed at a time. No more than 10 tests are performed in older children.

Preparing for allergy testsexcludes taking antihistamines medicines 2-3 days before testing, mast cell stabilizers (ketotifen) 14 days. It is not advisable to carry out the test while taking antibiotics.

If fungal sensitization is detected, it is necessary to exclude from the diet 2 days before the test foods containing microscopic fungi: moldy cheeses, kefir, cottage cheese. These products should not be consumed on the day of diagnosis or the next day, as local reactions may be activated within 24 hours.

Skin testing is rarely performed to diagnose drug allergies in children, since sensitization is usually caused not by the drug itself, but by its breakdown products. They are difficult to define.

Skin tests for allergens in childrenhave contraindications. Diagnosis is not carried out during the period of exacerbation of the disease and immediately after an acute allergic reaction, when a secondary infection occurs, if the child has experienced anaphylactic shock or suffers from nervous disorders.

Allergy tests in childrenhave a high reliability (95%) in the case negative result. Allergen introduction skin Without local reaction excludes the presence of sensitization to it. If the reaction is positive, in some cases the test gives false result. They may be caused by decreased skin reactivity in children. early age(up to 5 years), improper storage of allergens or violation of techniqueallergy tests for children.

Provocative tests

The principle of provocative tests is to evaluate the patient's reactions when introducing a gradually increasing amount of causative allergens. This is the most accurate diagnostic method, but also dangerous. It is carried out under strict indications during the period of disappearance of symptoms of the disease.

Depending on the method of allergen administration, provocative tests can be nasal, conjunctival, or inhalation. For children with food allergies, the intended product is given by mouth.

The disadvantages of provocative tests are as follows:

• You can test only one allergen at a time;
• The results of the study are difficult to quantify, especially when allergic rhinitis or conjunctivitis;
• the method is associated with a high risk of developing severe allergic reactions.

Tests are contraindicated if there is a history of immediate development of urticaria, angioedema, asthma attacks or anaphylactic shock upon contact with this allergen.

Laboratory diagnosis of allergies is safe for children

The examination includes only those studies that help determine the spectrum of sensitivity and changes in the organs and systems involved in the pathological process.

Methods laboratory diagnostics are used quite widely, as they have a number of advantages:

• carried out in early childhood;
• can be prescribed during exacerbation of the disease and when taking antiallergic drugs;
• safe;
• can be carried out in cases where the patient is at a great distance from the allergist and only the patient’s serum can be delivered.

General blood analysis

To identify an allergic disease, a child needs to donate blood

Donate blood to a child will be needed to determine the number of eosinophils. Fine transcript the number of eosinophils is as follows:

• in newborns – 20-50 µl –1,
• in children from 1 year to 3 years – 50-700 µl–1 ,
• in adults – 0-450 µl –1.

A slight increase in the number of eosinophils up to 5-15% is not a pathology for atopic diseases, but presupposes this diagnosis.

Increased eosinophils in blood 15-40% of the total number of leukocytes may be a sign of an allergic disease.

Blood serum testing to detect specific antibodies and antigens

The main methods are to determine increased general level Serum IgE blood - Shelley's reaction and linked immunosorbent assay(ELISA).

The mechanism of the Shelley test is determined by the ability of basophilic leukocytes to release (degranulate) under the influence of a fixed stimulus. The allergen is applied to a suspension of leukocytes of the person being examined. The sample is considered positive if the percentage of degranulated forms exceeds 10%.

Enzyme-linked immunosorbent assay (ELISA)– method for the qualitative or quantitative determination of low molecular weight compounds. It is based on specific reaction"antigen-antibody". In response to a foreign agent, a plasma protein compound is formed blood . The analysis makes it possible to determine even low concentrations of IgE immunoglobulin.

Decoding analysis is as follows:

Skin tests only reveal the presence of sensitivity and indicate that a person has been in contact with this allergen. The tests listed do not provide clear evidence that a reaction will develop to the allergen being tested. For its occurrence, the presence of sensitization and the presence of an allergen are not enough. A number of external and internal factors are also needed.

Laboratory diagnostic methods– This additional measures, helping to clarify questionable test results.

Perseverance and attentiveness are important qualities for the successful acquisition of knowledge. They are of particular importance for junior schoolchildren just starting to get an education. The task of teachers and parents is to help the child learn to concentrate, for which adults need to know how developed the child’s ability to concentrate is. A proof test (Bourdon test) will help determine this.

The essence of the diagnostic technique

Attention is the basis for successful learning in primary school

The 18th century English literary figure Samuel Johnson said: “He who knows how to pay attention knows how to remember.”

A convenient way to study concentration was proposed by the French psychologist Benjamin Bourdon at the end of the 19th century. The correction test is very convenient for testing schoolchildren, as it allows diagnosing the attention of several students at the same time. The subjects are asked to cross out given elements within a certain time on special forms with letters, numbers or figures depicted on them, while the teacher every 60 seconds gives the command “Damn!”, on which the children draw a vertical line in the place where they stopped. Time to work with the form is 10 minutes. During this period, the teacher has the opportunity to analyze how concentration changes and how quickly the child gets tired.

Based on the test results, we can also conclude:

• the student’s ability to concentrate on one task for a long time;
• stability of the subject's attention;
• the ability to switch from one task to another.

Conducting a proofreading test among junior schoolchildren

During the test, you need to ensure that children are not distracted from working with the form.

Instructions:

1. The teacher (or psychologist) distributes forms with pictures and explains the rules for performing the test: the adult names the objects, and the children cross out the corresponding elements in each line, moving from left to right, at the command “Dash!” subjects draw a straight line separating the completed block from those not yet examined.
2. Children take pencils in their hands (it is better not to use pens, as unexpectedly running out of ink will confuse the child and distract them from the test) and, at the teacher’s signal, begin to work.
3. After 10 minutes, students put down their writing objects and the teacher collects their answer sheets.

For younger schoolchildren, it is recommended to carry out the Bourdon diagnosis on forms with little people depicted (the child will need to cross out all the girls (boys), faces with dark hair or with sad faces) or geometric shapes. Children may become confused about letters of the alphabet or numbers, so the results will not be entirely objective.

If the stimulus material consists of letters, then to complicate the task you can cross out entire combinations (for example, “ko”, “la” and so on).

Photo gallery: Samples of stimulus material (forms with letters, geometric shapes, etc.)

Initially, the test had only a letter design. For very small children, a form with simple shapes was developed. Leaves and houses are the most understandable stimulus material for primary schoolchildren. Children enjoy working with the form on which girls are depicted.

Processing and interpretation of Bourdon test results

Students' work is assessed based on the number of elements missed per unit of time and the total number of characters analyzed. The teacher can also draw conclusions about the quality and pace of task completion based on the sum of lines worked and the number of errors made in them in 60 seconds.

To assess concentration, the following formula is used:

K = 2C/O (K - concentration, C - viewed lines, O - errors, which include omissions and incorrectly crossed out elements).

The higher the resulting number, the higher the concentration. This indicator does not have established numerical values, since it depends on the specific stimulus material. But in any case, K should not be more than half the value of C (this result means that the subject has a very low concentration and needs special assistance psychologist).

When determining the stability of attention, the formula is used:

A = S/t x 10 (S is the total number of elements viewed, t is the time period (60 seconds)).

Decoding of indicators:

To analyze the switchability of attention, the following formula is used:

С = (So/S) x 100 (So - the number of lines with errors, S - the total number of worked lines).

Please note that to study switchability, the tasks are given in a slightly more complicated form: children need to cross out given elements on different lines - even or odd.

There are special programs for a computer or mobile device that allow you to conduct the test. The developers offer stimulus tables, elements on which need to be crossed out with a mouse click or finger movement. After completing the work, the application calculates points, shows errors and recommends a suitable level for training.

Being one of the most precise research, allergy tests for children allow you to identify the presence of an allergen and determine its qualitative component. The procedure involves conducting a series of tests with the introduction of an irritant to which the patient may become intolerant. Introduction is carried out different ways, after which, after a certain time, the body’s reaction to the stimulus is assessed.

What are allergy tests?

The procedure differs little from the usual one intended for adults. However, there are restrictions: some types of tests are not allowed for children under 3 years of age. Doctors advise undergoing examination after 5 years of age so that the growing body does not give a biased reaction to a particular allergen.

Important! Allergen is a drug made from plant pollen, wool particles, skin animals, household dust, fungal spores, microelements of a chemical, bacterial, food nature.

Technologically, the process involves applying the substance to small scratches made in advance, or introducing it by injection. An allergist may recommend repeated administration of the allergen in various concentrations. Each time the reaction is assessed, all readings are recorded.

Conditions for the procedure

The main thing and mandatory requirement– persistent and long period of remission. Otherwise, the sample will be irrelevant and the tests will have to be repeated. Before the procedure, a number of general examinations are carried out, including an examination by a pediatrician, urine and blood tests. Only after this the doctor writes out a referral and you can do an allergy test in children. Most often, the test is placed on an area of ​​skin on inner surface forearm, approximately 3-4 cm from the wrist. But if a child suffers from allergies, tests are placed on other places on the body, sometimes on the baby’s back.

Fact! During testing, any reaction may occur. Therefore, it is extremely important to do examinations in specialized medical centers, where, if necessary, they can save the child from hurricane pathological manifestations.

Indications for the procedure

Allergy tests are taken from children if it is necessary to determine the type of substances that cause negative reactions. The main indications for taking an allergy test for children are the following factors:

1. Diagnosis bronchial asthma, allergic dermatitis;
2. Hay fever;
3. Constant nasal congestion;
4. Allergic reactions to food: rash, itching;
5. Rhinitis, allergic conjunctivitis;
6. Attacks of difficulty breathing/suffocation, constant hacking cough;
7. Causeless itching of eyes, nose;
8. Year-round rashes on the body, swelling of the skin;
9. Previously observed allergic reactions for insect and animal bites;
10. Skin rashes when interacting with chemicals household use, food.

Sometimes to skin rashes and itching is accompanied by stomach pain, headaches, and drowsiness. Any of the above signs may be an indication for allergy testing. It is extremely important to pay attention to mothers of babies who already have cases of allergies in their family. Even by keeping a food diary and dosing foods, it is often not possible to identify the allergen; in this case, only an allergen test in children will help.

If seasonal symptoms occur, it is also recommended to do tests for specific immunotherapy. The only difference is how allergy tests are taken. In this case, testing is carried out outside the flowering season of plants (for example), the allergen is introduced into the body in small doses, but the amount of substances can be quite large, in order to find out which plant pollen the baby is intolerant to.

What types of samples are there?

Having figured out how allergy tests are done in children, you should understand what tests can be done:

1. Blood test for antibodies. The first test done on the patient. This test does not increase the intolerance reaction and has no contraindications. Recommended for any form of intolerance.
2. Direct skin tests. Allergens are introduced into microscratches on the skin, the number of samples is up to 20 units. The reaction is assessed after 1 or more days. The patient must be in inpatient conditions under the supervision of the attending physician. A positive reaction is local or extensive redness (more than 2 mm), swelling of the point of application of the allergen.
3. Indirect skin tests are administered by injection. In this case, the dose of the irritant is accompanied by a dose of blood serum, which has hypersensitivity to the allergen. The reaction is also assessed after 1 or more days. The result is an assessment of the danger of this particular irritant for the patient’s body.
4. Provocative samples are prescribed if the reaction signs do not coincide with the data on the development of allergies. There are conjunctive, nasal and inhalation tests. The latter should be taken from patients with bronchial asthma.

Decoding the results

After conducting the tests, the doctor monitors the body's reaction to allergens and evaluates the results. If redness or swelling occurs at the site of allergen injection, an allergy is suspected. But in some cases, diagnosis requires identifying the degree of sensitivity, that is, the body’s intolerance to a particular concentration of a substance. In this case, repeat samples should be taken, monitoring the dosage of the drug.

All results are assessed in bright light 1-3 days after the test. A positive reaction is a papule more than 2 mm in diameter. A single study cannot include more than 15-20 test reactions.

As a result of the identified reactions, the method of treating allergies will be determined. If impossible complete healing, is appointed immune therapy. You should be careful about the samples and limit contact with the allergen. The main method of treatment is to eliminate the cause, vaccination is not a panacea, the method does not always help, so patients are warned about possible consequences diseases.

If the doctor recommends vaccination, then get ready - this is a long and continuous process. The body must get used to the introduced allergens, then gradually begin to produce its own antibodies. The first injections of the vaccine are given every other day, then the duration of the intervals increases. After achieving a certain result, injections are given every 30-35 days to maintain a positive result.

Knowing how an allergy test is done for children and what the process is intended for, you should not delay your visit to the doctor. Detecting signs of allergies at the very beginning helps to identify and minimize the body's reaction. It happens that children “outgrow” allergies, but one cannot hope for such an effect without aids, not worth it.

Annex 1"Corrective test"

Diagnosis of attention development in children aged 6 to 10 years.

A table with various signs arranged in random order, in which the child must, according to the instructions, cross out a certain sign

Methodology "Corrective test" (letter version).

The technique is used to determine the amount of attention (by the number of letters viewed) and its concentration - by the number of mistakes made.

The norm for attention span for children 6-7 years old is 400 characters and above, concentration is 10 errors or less; for children 8-10 years old - 600 characters and above, concentration - 5 errors or less.

Operating time - 5 minutes.

Instructions: “On the form with letters, cross out the first row of letters. Your task is to, looking through the rows of letters from left to right, cross out the same letters as the first.
You need to work quickly and accurately. Operating time - 5 minutes."
Example:

Appendix 2

Development of attention. “Fix the bugs” tasks

Exercise No. 1. Read the words. Correct mistakes. Write down in your notebook only those words that denote living objects:

Staly, katenok, malotok, skis, varabey, propka, masty, lesitsa, sava, lesnitsa, carova, loshka, vidro, legushka, girl, salaway.

Exercise No. 2. Read the words. Correct mistakes. Write down in your notebook only those words that denote inanimate objects:

Fanar, ogarot, krakadil, chayka, mashyna, daroga, tray, dog, cover, begimot, horse, tapor, plate, varona, lef, gorot, polto, chilovek.

Exercise No. 3. Correct the mistakes in Dunno's essay about your garden.

Carrots are not eaten raw. When people cut beets, they always cry. Potatoes can be fried. Radishes have a large pit. Cucumber is a juicy fruit. Zucchini is the smallest vegetable. The scarecrow is needed to attract butterflies.

Exercise #4 Listen carefully to each task, and then complete it accurately, but only when you hear the word “REQUEST”.

Request: raise your hands up.
- Hands down.

Request: arms to the sides.

Hands forward.

Sit down.

Request: stand up.

Jump on one leg.

Request: spin around.

Please: clap your hands.

Put your hands down.

Request: stamp your left foot.

Request: take it right hand behind left ear etc.

Exercise #5 Correct errors in the description of fairy-tale characters.

Kolobok climbed a tree.

Carlson put on his coat and flew to the roof.

Little Red Riding Hood took off her white Panama hat.

Cinderella was rude to her stepmother and refused to clean the house.

Pinocchio took a golden key from the fire.

Appendix 3

Exercises for developing all types of memory

Card No. 1 The numbers are read out, after each line is read, write down

5 8

6 4 3

4 2 7 3

6 1 9 4 7

5 9 1 7 4 2

5 8 1 9 2 6 4

2 7 5 8 6 2 5 8

Card No. 2 10 words are read, test takers write down the words after reading.

Book, circle, ruler, ball, pen, hoop, jump rope, car, backpack, suit.

Card No. 3 10 words are read, and the test takers see these words, after which they are written down.

School, library, sentence, wheel, window, figure, bucket, firewood, grass, bird.

Card No. 4 Test takers listen and write down each word in the air; when all the words have been read, they write them down on a piece of paper.

Lilac, birch, poplar, ash, linden, oak, maple, bird cherry, apple tree, cedar.

Card No. 5 Test takers hear, see, write in the air, after reading all the words, write down on a piece of paper

Snow, shop, desk, doors, room, flowers, painting, pencil, pan, borscht.

Appendix 4

Classification

Divide into groups. 2. What is missing in each row?

3.Compare three items: ruler, pencil triangles - and highlight common and distinctive properties. (For example, general signs objects: all made of wood and used for drawing; distinctive properties - shape of objects and size.)

4. For variety, the following tasks: I name the properties of an object, and the children must name the object itself; I highlight the main properties of an object, without which it cannot exist, the children name the object.

5. How are these expressions different and similar?

2+3 7+2 7-3 8-3

6+2 5+2 5-3 9-4

6.Find the result using the solved example:

3+4=7 3+5= 3+6= 3+7= 3+8= 3+9=