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Development and validation of Egyptian developmental screening chart for children from birth up to 30 months
Ali M El Shafie1, Zein A L Omar1, Mai M Bashir2
1Department of Pediatrics, Menoufia Faculty of Medicine, Menoufia University, Shebin el-Kom, Menoufia, Egypt.
Insights
This study developed the Egyptian Developmental Screening Chart (EDSC) for early detection of developmental delay in children under three. The EDSC is a culturally appropriate, rapid tool for identifying developmental delays and enabling early intervention in Egypt.
Area of Science:
- Pediatric Development
- Public Health Screening
- Cross-Cultural Adaptation of Tools
Background:
- Early detection of developmental delay in children under three is crucial globally.
- Culturally appropriate screening tools are essential for accurate assessment.
- Existing Western tools are often unsuitable for the Egyptian context.
Purpose of the Study:
- To develop and validate an easy, rapid, and culturally appropriate screening chart for Egyptian children (birth to 30 months).
- To create a Z-score chart for monitoring motor and mental development in Egyptian children.
- To address the lack of a specific developmental screening tool in Egypt.
Main Methods:
- A cross-sectional study of 1503 Egyptian children (birth to 30 months) was conducted.
- The Baroda Development Screening Test (BDST) was culturally adapted and applied.
- The Egyptian Developmental Screening Chart (EDSC) was validated against the Ages and Stages Questionnaires (ASQ-3).
Main Results:
- The EDSC, featuring 50% and 97% pass level curves, identified children below the 97% threshold as delayed.
- The EDSC demonstrated high accuracy, sensitivity (84.38%), and specificity (98.36%) compared to ASQ-3 (kappa=0.827).
- A Z-score chart for motor and mental development follow-up was successfully designed.
Conclusions:
- The study successfully created and validated the Egyptian Developmental Screening Chart (EDSC), the first of its kind for Egypt.
- The EDSC is a rapid, easy-to-use, and culturally appropriate tool for early detection of developmental delay.
- The developed Z-score curve provides a reliable method for tracking motor and mental development in Egyptian children.
Background:
Detecting developmental delay in children is an ongoing world commitment, especially for those below three years. To accurately assess the development of children; a culturally appropriate screening tool must be used. Egypt lacks such tool and multiple studies have shown that western tools are not suitable in other cultures.
Objectives:
To develop and validate an easy, rapid, culturally appropriate and applicable screening chart for early detection of developmental delay among Egyptian children from birth up to 30 months and develop a Z-score chart for motor and mental development follow up based on our Egyptian screening chart.
Methods:
A cross sectional randomized study was carried out on 1503 Egyptian children of both genders aged from birth up to 30 months assumed to have normal development according to the inclusion and exclusion criteria. They were selected from vaccination centers and well-baby clinics. Developmental milestones from Baroda development screening test (BDST) were applied on them after items were translated and adapted to Egyptian culture. Egyptian children developmental milestones scores were analyzed and carefully prepared in tables and charts. A 97% pass level of developmental achievements represents the threshold below which children are considered delayed. A Z-score chart for motor and mental development follow up was designed by calculating each age group achievement. The developed Egyptian developmental screening chart (EDSC) was validated against Ages and Stages Questionnaires (ASQ-3) as a reference standard in another different sample of 337 children in different age groups.
Results:
The developed EDSC is represented in a chart format with two curves 50% and 97% pass level. Children considered delayed when the score below 97% pass level. Results revealed a statistically significant difference between EDSC and BDST at 50% and 97% pass levels. A Z-score chart for motor and mental development follow up was designed by calculating each age group achievement. EDSC sensitivity and specificity were calculated 84.38 (95% CI [67.21%-94.72%]) and 98.36 (95% CI [96.22%-99.47%]) respectively with an overall test accuracy 97.03 (95% CI [94.61%-98.57%]) (p ≤ .001). Agreement between EDSC and ASQ-3 was high (kappa score was 0.827) with negative and positive agreement 98.36 and 84.38, respectively.
Conclusions:
Extensive revision of the BDST was needed in order to create and validate a more culturally appropriate Egyptian screening chart. This is the first study to create and validate an Egyptian-specific screening tool, to be rapid and easy to use in Egypt for early detection of developmental delay and enabling early intervention practices. A Z-score curve is reliable for follow up motor and mental development by calculating each age group achievement.
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