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Infant-Toddler Checklist identifies 18-month-old children with communication difficulties in the Swedish child
Anna Fäldt1, Helena Fabian2, Anton Dahlberg2
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Insights
The Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (ITC) effectively screens 18-month-olds for communication delays. Combining the ITC with nurse assessments improves accuracy for early intervention in child health care.
Area of Science:
- Pediatric communication development
- Early childhood screening tools
- Psychometric validation in healthcare
Background:
- Reliable screening for 18-month-old communication difficulties is lacking in Swedish child health care.
- Early identification is crucial for timely intervention and improved developmental outcomes.
Purpose of the Study:
- To evaluate the psychometric properties of the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (ITC).
- To assess the ITC's utility for screening communication difficulties at the 18-month child health visit.
Main Methods:
- The study screened 679 children aged 16-20 months using the ITC.
- Children were referred based on positive ITC screens or parental/nurse concerns.
- Analysis included ITC results alone and combined with nurses' clinical assessments.
Main Results:
- The ITC demonstrated good psychometric properties, with AUCs ranging from 0.68 to 0.84.
- Sensitivity was 0.85 and specificity 0.59 for the ITC alone.
- Combining ITC with nurse input improved sensitivity to 0.88 and specificity to 0.63.
Conclusions:
- The ITC is a viable tool for identifying children needing communication interventions at 18 months.
- Integrating the ITC with nurses' clinical judgment enhances screening accuracy.
- This approach supports early identification and intervention for communication delays.
Aim:
At present, there is no reliable method to screen for communication difficulties at age 18-months in the Swedish child health care. This study examined the psychometric properties of the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (ITC) when used at the 18-month visit in the child healthcare setting.
Methods:
Children aged 16-20 months (n = 679) were screened. Children were referred for an assessment if they screened positive screen or if the parent or nurse was concerned about the child's communicative development. Two groups of positive screens were used in the analysis (n = 78 children), one based on the ITC result, and one combining the ITC with contradicting information from the nurses' informal clinical assessment.
Results:
The AUC ranged from 0.68 to 0.84. The sensitivity was 0.85, and the specificity was 0.59. When the ITC result was combined with the nurses' information, sensitivity increased to 0.88 and specificity to 0.63. The internal consistency was moderate to high, and fit indices were satisfactory.
Conclusion:
The results suggest that the ITC can be used to identify children in need of interventions to enhance communication at 18 months of age, especially in combination with the nurse's assessment.
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