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Designing and Validation of a Hindi-language Parent Self-report Developmental Screening Tool
Rahul Jain1, Anshita Arora, Rohit Anand
1Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, Geeta Colony; and *Child Development Center, Maulana Azad Medical College and associated Lok Nayak Hospital, Bahadur Shah Zafar Marg; New Delhi, India. Correspondence: Dr. Rahul Jain, 61-A, DDA Flats, Phase 1, Qutab Enclave, New Delhi 110 016, India. drrahuljain1980@gmail.com.
Insights
Hindi-language developmental screening questionnaires for 9-month and 18-month-old Indian children show promise. These tools can aid in early detection of developmental delays during routine immunizations.
Area of Science:
- Pediatric developmental screening
- Child development research
- Public health interventions
Background:
- Early detection of developmental delays is crucial for timely intervention in children.
- Existing developmental screening tools may not be culturally or linguistically appropriate for all populations.
- Parental self-report questionnaires offer a feasible method for developmental surveillance.
Purpose of the Study:
- To design and validate Hindi-language parent self-report developmental screening questionnaires.
- To create tools for 9-month-old and 18-month-old Indian children.
- To assess the accuracy of these questionnaires in identifying developmental delays.
Main Methods:
- Cross-sectional study conducted at a tertiary-care pediatric hospital.
- Questionnaires designed based on parental observations and expert consensus, then pre-tested.
- Validation against the gold standard Developmental Assessment Scale for Indian Infants (DASII).
Main Results:
- The 9-month tool showed an Area Under the Curve (AUC) of 0.988, with 100% sensitivity and 87.2% specificity for developmental delay.
- The 18-month tool had an AUC of 0.953, with 91.4% sensitivity and 88.7% specificity.
- Both tools demonstrated high accuracy in detecting developmental delays.
Conclusions:
- The developed Hindi-language questionnaires are effective tools for developmental screening in young Indian children.
- These questionnaires have a promising role in identifying developmental delays during routine immunizations.
- The tools can facilitate early intervention and improve developmental outcomes.
Aim:
To design and validate Hindi-language parent self-report developmental screening questionnaires for 9-month and 18-month-old Indian children.
Design:
Cross-sectional study.
Setting:
Tertiary-care pediatric hospital from April 2014 to March 2016.
Participants:
In each age group (9-month and 18-month), 45 children were enrolled for designing of questionnaires (30 for obtaining parental observations of current development and 15 for pre-testing). For validation of tool, 100 children (60 low risk and 40 high risk) were enrolled in each age group.
Methods:
For designing, observations regarding current developmental milestones were obtained from parents and a list of all enumerated milestones was prepared. After detailed discussion by a team of developmental pediatricians, pediatric resident, clinical psychologist and language specialist, milestones were chosen for drafting of questionnaires. In each age group, drafts were pre-tested and required modifications were done. The final questionnaires contained 20 items each to be scored on a Likert scale (total score ranging from 20 to 60, a lower score indicating a higher risk of developmental delay). These questionnaires were validated against Developmental Assessment Scale for Indian Infants (DASII), a gold standard instrument.
Results:
On ROC analysis, the 9-month and 18-month screening tool had area under curve of 0.988 and 0.953, respectively, for detecting developmental delay. Score ≤50 on the 9-months questionnaire had sensitivity of 100% and specificity of 87.2%. Score ≤49 on the 18-months questionnaire had sensitivity of 91.4% and specificity of 88.7%.
Conclusion:
The new questionnaires have a promising role in developmental screening of children at the time of routine immunizations in our country.
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