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Developing a brief cross-culturally validated screening tool for externalizing disorders in children.

Barbara W C Zwirs1, Huibert Burger2, Tom W J Schulpen2

  • 1Dr. Zwirs is with the Faculty of Law, Erasmus University of Rotterdam; Dr. Schulpen is with the Department of Pediatrics, University Medical Center Utrecht; Dr. Burger is with the Departments of Epidemiology and Psychiatry, University Medical Center Groningen; and Dr. Buitelaar is with the Department of Psychiatry and the Academic Center for Child and Adolescent Psychiatry, Radboud University Nijmegen Medical Center..

Journal of the American Academy of Child and Adolescent Psychiatry
|January 25, 2008
PubMed
Summary

A new screening tool effectively predicts externalizing disorders in children using teacher-reported data. This brief instrument shows good accuracy for both native Dutch and immigrant children, requiring further validation.

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Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Psychology
  • Behavioral Science

Background:

  • Existing screening tools for externalizing disorders are primarily developed for Western populations.
  • There is a need for culturally sensitive screening instruments applicable to diverse child populations.

Purpose of the Study:

  • To develop and validate a brief teacher-based screening instrument for predicting externalizing disorders in both native Dutch and non-Dutch immigrant children.
  • To assess the predictive accuracy of the instrument across different ethnic groups.

Main Methods:

  • Teachers completed the Strengths and Difficulties Questionnaire for 2,185 children (ages 6-10).
  • A subsample underwent detailed interviews for diagnostic assessment.
  • Logistic regression analysis was used to derive a prediction score from specific questionnaire items.

Main Results:

  • Four items (restless, obeys, lies, concentrates) effectively predicted externalizing disorders.
  • The screening tool demonstrated good discriminatory power (AUC = 0.84).
  • No significant differences in prediction accuracy were found between native Dutch and non-Dutch immigrant children.

Conclusions:

  • A concise, teacher-assessed scoring rule can predict externalizing disorders in diverse child populations.
  • The developed tool shows promise for early identification of externalizing disorders.
  • External validation is required before clinical implementation.