Assessing the Validity of the Baby Pediatric Symptom Checklist Using a Nationally Representative Household Survey

Area of Science:

• Pediatric Psychology
• Developmental Pediatrics
• Public Health Surveillance

Background:

• The Baby Pediatric Symptom Checklist (BPSC) is a tool for identifying behavioral and emotional concerns in children under 18 months.
• Previous research has not utilized nationally representative data to validate the BPSC or assess its utility for children aged 18-23 months.

Purpose of the Study:

• To assess the construct and predictive validity of the BPSC using data from the National Health Interview Survey (NHIS).
• To evaluate the BPSC's appropriateness for children aged 18-23 months.
• To establish age-based normative data for BPSC domains.

Main Methods:

• Analysis of the 2019 NHIS data for a nationally representative sample of children aged 2-23 months.
• Confirmatory factor analysis (CFA) and differential item functioning (DIF) to assess validity and item bias.
• Quantile regression to generate age-based normative curves for irritability, inflexibility, and difficulty with routines.

Main Results:

• A 3-factor CFA confirmed the BPSC's structure, yielding results comparable to the original validation study.
• No significant differential item functioning (DIF) was observed across child sex, race/ethnicity, urbanization, family size, or respondent type.
• Importantly, DIF was not detected between younger (2-17 months) and older (18-23 months) age groups, supporting its use across this range.

Conclusions:

• The BPSC demonstrates validity when applied within a nationally representative survey, consistent with prior findings.
• The National Health Interview Survey (NHIS) is a suitable platform for tracking BPSC scores and monitoring pediatric behavioral health at a population level.