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PEDS: developmental milestones--an accurate brief tool for surveillance and screening
Kyle B Brothers1, Frances Page Glascoe, Nicholas S Robertshaw
1Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.
Insights
The PEDS: Developmental Milestones (PEDS:DM) tool accurately identifies developmental delays in children. This validated tool offers a reliable alternative to informal checklists, improving early detection of disabilities.
Area of Science:
- Child Development
- Developmental Pediatrics
- Screening Tools
Background:
- Approximately 16% of children experience developmental-behavioral disabilities.
- Underdetection is common, with less than one-third of affected children identified by healthcare providers.
- Informal milestone checklists contribute to this underdetection.
Purpose of the Study:
- To evaluate the reliability, validity, accuracy, and utility of the PEDS: Developmental Milestones (PEDS:DM) tool.
- To provide a validated screening instrument for early childhood developmental delays.
- To offer an alternative to less effective informal milestone checklists.
Main Methods:
- A nationally representative sample of 1619 children was analyzed.
- Developmental diagnostic measures were used to identify predictive items for each domain.
- Items with sensitivity/specificity ≥ 70% were selected, resulting in 112 included items.
Main Results:
- The PEDS:DM demonstrated high sensitivity (83%) and specificity (84%) for identifying performance at or below the 16th percentile.
- Excellent test-retest reliability (0.98–0.99) and high interrater reliability (0.82–0.96) were observed.
- The tool features a low readability level (1.8 grade), enhancing accessibility.
Conclusions:
- The PEDS:DM is a validated and accurate tool for developmental screening in children aged birth to 8 years.
- It serves as a reliable alternative to informal checklists, potentially reducing underdetection rates.
- Improved detection can lead to earlier intervention for children with developmental delays and disabilities.
Abstract:
About 16% of children have developmental-behavioral disabilities but less than one-third of the children are detected by their health care providers, probably because of the use of informal milestones checklists. The goal of this study is to determine the reliability, validity, accuracy, and utility of a new tool, PEDS: Developmental Milestones (PEDS:DM). Data from a nationally representative sample of 1619 children administered developmental diagnostic measures were mined for items that best predicted performance in each developmental domain. A total of 112 met inclusion criteria, that is, sensitivity/specificity > or = 70%. For each domain/age level (birth to 8 years of age), sensitivity to performance less than or equal to the 16th percentile on diagnostic measures was 83% and specificity was 84%. Reliability was high (test-retest, .98 to .99; interrater, .82 to .96; kappa, .81). The readability level was 1.8 grades (range 1.1 to 2.6). The PEDS:DM appears to be a validated, accurate alternative to informal milestones checklists that are a probable contributor to underdetection of children with delays and disabilities.
