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Evaluation of the revised Nipissing District Developmental Screening (NDDS) tool for use in general population
John Cairney1,2,3,4, Jean Clinton5,6, Scott Veldhuizen7
1Department of Family Medicine, McMaster University, 175 Longwood Road South, Suite 109A, Hamilton, ON, L8P 0A1, Canada. cairnej@mcmaster.ca.
Insights
The Nipissing District Developmental Screening (NDDS) tool shows poor agreement with criterion measures for identifying developmental delay. Its modest reliability suggests it should not be used alone in community settings.
Area of Science:
- Child Development
- Developmental Pediatrics
- Screening Tools
Background:
- Early identification of developmental delay is crucial for children under six.
- The Nipissing District Developmental Screening (NDDS) tool is used in Ontario for developmental screening.
- Psychometric properties of the NDDS tool require thorough investigation.
Purpose of the Study:
- To evaluate the psychometric properties of the Nipissing District Developmental Screening (NDDS) tool.
- To assess the reliability and validity of the NDDS for identifying developmental delay.
- To determine the effectiveness of the NDDS in community and population-based settings.
Main Methods:
- 812 children and families participated in the study.
- Test-retest reliability was assessed using a subsample of 111 parents.
- Criterion measures included the Bayley Scales of Infant Development, 3rd edition, and other standardized assessments.
Main Results:
- The NDDS demonstrated modest test-retest reliability (Spearman's rho = .62).
- Sensitivities ranged from 29% to 68%, and specificities ranged from 58% to 88%.
- Agreement between the NDDS and criterion measures was poor to moderate across different definitions of delay.
Conclusions:
- The NDDS tool exhibits modest test-retest reliability.
- Poor agreement with criterion measures indicates limitations for identifying developmental delay.
- The NDDS should not be used as a standalone tool for developmental delay screening in community settings.
Background:
There is widespread interest in identification of developmental delay in the first six years of life. This requires, however, a reliable and valid measure for screening. In Ontario, the 18-month enhanced well-baby visit includes province-wide administration of a parent-reported survey, the Nipissing District Developmental Screening (NDDS) tool, to facilitate early identification of delay. Yet, at present the psychometric properties of the NDDS are largely unknown.
Method:
812 children and their families were recruited from the community. Parents (most often mothers) completed the NDDS. A sub-sample (n = 111) of parents completed the NDDS again within a two-week period to assess test-retest reliability. For children 3 or younger, the criterion measure was the Bayley Scales of Infant Development, 3rd edition; for older children, a battery of other measures was used. All criterion measures were administered by trained assessors. Mild and severe delays were identified based on both published cut-points and on the distribution of raw scores. Sensitivity, specificity, positive and negative predictive values were calculated to assess agreement between tests.
Results:
Test-retest reliability was modest (Spearman's rho = .62, p < 001). Regardless of the age of the child, the definition of delay (mild versus severe), or the cut-point used on the NDDS, sensitivities (from 29 to 68 %) and specificities (from 58 to 88 %) were poor to moderate.
Conclusion:
The modest test-retest results, coupled with the generally poor observed agreement with criterion measures, suggests the NDDS should not be used on its own for identification of developmental delay in community or population-based settings.
