Identification of developmentally appropriate screening items for disruptive behavior problems in preschoolers

Screening preschool-aged children for disruptive behavior disorders is a key step in early intervention. The study goal was to identify screening items with excellent measurement properties at sub-clinical to clinical levels of disruptive behavior problems within the developmental context of preschool-aged children. Parents/caregivers of preschool-aged children (N = 900) were recruited from four pediatric primary care settings. Participants (mean age = 31, SD = 8) were predominantly female (87 %), either white (55 %) or African-American (42 %), and biological parents (88 %) of the target children. In this cross-sectional survey, participants completed a sociodemographic questionnaire and two parent-report behavioral rating scales: the PSC-17 and the BPI. Item response theory analyses provided item parameter estimates and information functions for 18 externalizing subscale items, revealing their quality of measurement along the continuum of disruptive behaviors in preschool-aged children. Of 18 investigated items, 5 items measured only low levels of disruptive behaviors among preschool-aged children. The remaining 13 items measured sub-clinical to clinical levels of disruptive behavior problems (i.e., >1.5 SD); however, 5 of these items offered less information, suggesting unreliable measurement. The remaining 8 items had high discrimination and difficulty parameters, offering considerable measurement information at sub-clinical to clinical levels of disruptive behavior problems. Behaviors measured by the 8 selected parent-report items were consistent with those identified in recent efforts to distinguish developmentally typical misbehaviors from clinically concerning behaviors among preschool-aged children. These items may have clinical utility in screening young children for disruptive behavior disorders.