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A pilot study comparing two developmental screening tools for use with homeless children
Sheau-Huey Chiu1, Marguerite A DiMarco
1Department of Women's, Children's, & Family Nursing, College of Nursing, University of Florida, Gainesville, FL 32610-0187, USA. sheau41@yahoo.com
Insights
Parent-completed developmental screening tools show promise for identifying risks in homeless children. Early detection through tools like the Ages and Stages Questionnaires can aid in timely interventions for vulnerable populations.
Area of Science:
- Child Development
- Pediatric Health
- Social Determinants of Health
Background:
- Homelessness and poverty significantly increase health risks for children, including developmental delays.
- Early identification and intervention are crucial for mitigating risks associated with delayed development in children.
- Parent-completed developmental screening tools offer a potential avenue for early detection, particularly in vulnerable populations like homeless children.
Purpose of the Study:
- To characterize the growth and developmental profiles of children experiencing homelessness.
- To compare the effectiveness of a parent-completed developmental screening measure against professional assessments in this population.
- To evaluate the utility of the Ages and Stages Questionnaires (ASQ) in identifying developmental concerns in homeless children.
Main Methods:
- A prospective, comparative pilot study involving 20 homeless mothers and their 21 children.
- Professional developmental screening using the Denver Developmental Screening Test II (DDST II).
- Parental completion of the Ages and Stages Questionnaires (ASQ) for developmental assessment.
Main Results:
- The DDST II identified nine children with potential language delays.
- Mothers using the ASQ reported concerns in fine motor skills (n=9), communication/language (n=4), and problem-solving (n=4).
- High agreement between ASQ and DDST II was observed in gross motor (95%) and personal-social development (95%), with lower agreement in language development (67%).
Conclusions:
- Developmental screening is critically important for homeless children due to heightened risks associated with poverty and housing instability.
- Parent-completed tools like the ASQ can be valuable complements to professional screenings for early detection of developmental issues in this population.
- Nurses and nurse practitioners play a vital role in assessing and implementing interventions for developmental concerns in homeless children.
Abstract:
Homelessness and poverty can present serious health issues for children, including those associated with developmental delays. Early identification and intervention may decrease risk associated with delayed development. Parent-completed measures have been used to help screen for children's development, but little is known about how they may enhance early detection with homeless children. The primary aims of this pilot study were to describe growth and developmental characteristics of homeless children and to compare a parent-completed measure with professionally-conducted developmental screening results. A prospective, comparative study was conducted with 20 homeless mothers and their 21 children. Health professionals used the Denver Developmental Screening Test II, identifying nine children with possible language delay. Mothers completed the Ages and Stages Questionnaires and identified three areas of concern: fine motor (n = 9), communication/language (n = 4), and problem solving (n = 4). The percentage agreement between these two tools was strongest in gross motor (95%) and personal social development (95%) but weakest in language development (67%). While it is essential for all children, developmental screening is particularly crucial for homeless children because of increased risks related to poverty and homelessness. Nurses and nurse practitioners are in a unique position to assess applicability of such instruments and to provide critically needed interventions for these children.
