Mother-father differences in screening for developmental delay in infants and toddlers

In most cases, caregiver questionnaires are completed by mothers and seldom by fathers. Although parents tend to have moderate to high congruence, some studies suggest that differences between the mothers' and the fathers' answers can complicate diagnostic decision-making. The aim of this study was to determine mother-father response differences on a widely used screening checklist and to describe possible clinical implications of the observed differences.

The Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist, a screening and evaluation tool, is commonly used in many countries to identify developmental delays in infants and toddlers. A Croatian version of the CSBS-DP checklist was completed by 422 parents (211 mothers and 211 fathers). The mean age of children was 15.4 months (6-24 months). Inter-rater reliability and mother-father differences were calculated. An item-by-item analysis was performed, and the relationship between the parental concern and the score a child achieved was also examined.

Mothers and fathers did not differ in Total Scores (p=.165). Item-by-item analysis showed that the level of congruence between mothers' and fathers' scores was, on average, 78%. However, in 10-15% of cases, the parent scores placed a child in different clinical categories (above vs. below the cut-off score). In cases of discordance, fathers placed a child below criterion level more often than mothers, and this trend was more pronounced for girls than boys. The level of parental concern was found to be relatively low and not well balanced with the scores children achieved.

Our findings suggest that the level of parental concern is not a very reliable indicator of delayed or deviant childhood development. Furthermore, in 10-15% of cases, parents differ in the extent to which their responses place a child in different clinical groups.

The reader will: (1) recognize the importance of early communication skills assessment in infants and toddlers; (2) identify the possible limitations of relying on a single parent report in screening infants and toddlers; (3) describe the factors that might affect screening results when caregiver questionnaires are used; (4) be able to better assess parental concern.