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Pre-school screening for developmental and emotional health: Comparison with neurodevelopmental assessment
Nataliia Burakevych1, Christopher Joel Dorman McKinlay1,2, Jane Marie Alsweiler1,2
1Liggins Institute, The University of Auckland, Auckland, New Zealand.
Insights
The New Zealand Before School Check (B4SC) identified more children needing developmental and emotional support than a comprehensive assessment. Children not screened showed higher rates of cognitive and behavioral issues.
Area of Science:
- Child Development
- Developmental Pediatrics
- Public Health Screening
Background:
- Early detection of developmental and emotional problems is crucial for intervention.
- School readiness programs aim to identify children needing support before formal schooling.
- Comparing screening tools with comprehensive assessments is vital for optimizing early identification pathways.
Purpose of the Study:
- To compare the detection and referral rates for developmental and emotional issues between the New Zealand Before School Check (B4SC) and a comprehensive neurodevelopmental assessment.
- To evaluate the effectiveness of the B4SC in identifying children at risk for developmental and emotional problems.
Main Methods:
- A prospective cohort study of 274 children at risk of neonatal hypoglycemia was conducted.
- Children were assessed at 4.5 years using the B4SC and a comprehensive neurodevelopmental assessment (CHYLD Study).
- Parent-completed Strengths and Difficulties Questionnaire scores were compared between the two assessment methods.
Main Results:
- The B4SC identified more children meeting referral criteria (19%) compared to the comprehensive assessment (9%).
- Children who did not undergo B4SC screening exhibited higher rates of cognitive delay (19% vs. 8%) and behavioral difficulties.
- A significant proportion of children (17%) changed their developmental/emotional category between assessments.
Conclusions:
- The B4SC screening program identified a greater number of children requiring referral for developmental and emotional concerns than a comprehensive assessment.
- Children not participating in the B4SC screening were found to have a higher incidence of cognitive and behavioral problems.
- The findings highlight the importance of early screening programs like the B4SC for timely identification and intervention.
Aim:
The study aim was to compare detection of and referral for developmental and emotional problems in a school readiness screening programme (New Zealand Before School Check, B4SC) with that of a comprehensive neurodevelopmental assessment.
Methods:
This is a prospective cohort study of children (n = 274) born at risk of neonatal hypoglycaemia and recruited to a follow-up study of neurodevelopmental outcomes at 4.5 years (Children with Hypoglycaemia and their Later Development (CHYLD) Study). Children identified as of significant concern for developmental and emotional problems, and referrals made, were compared in the B4SC and CHYLD Study. Scores of the parent-completed Strengths and Difficulties Questionnaire used in both assessments were compared.
Results:
Of the 274 children who underwent clinical neurodevelopmental assessment at a mean (standard deviation) age of 53.3 (1.8) months, 237 had the B4SC developmental and emotional health screening. Of these, 44 (19%) children met B4SC referral criteria, and 15 (6%) were referred, but only 21 (9%) children met CHYLD referral criteria, and 10 (4%) were referred. Twelve children (5%) met both the B4SC and CHYLD referral criteria, and two were referred by both. When assessed twice, 39 (17%) children changed parent-completed Strengths and Difficulties Questionnaire category. Children who did not have B4SC screening had higher mean total difficulties score (10.5 vs. 8.2, P = 0.009) and were more likely to have cognitive delay than those who were screened (19% vs. 8%, P = 0.04).
Conclusion:
More children met referral criteria for the B4SC screening programme than for a more comprehensive neurodevelopmental assessment. Children who did not have screening had a higher incidence of cognitive and behaviour problems than those who did.
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