Related Experiment Video
Updated: Aug 22, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
The ESSENCE-Questionnaire in Medical Records Screening for Neurodevelopmental Symptoms/Problems: Utility and Clinical
Valdemar Landgren1,2, Zohar Raanan Soltis1, Emma Svensson3
1Department of Psychiatry, Skaraborg Hospital, Skövde, Sweden.
Insights
Neurodevelopmental problems (NDPs) are common in medical records and can be reliably identified using the ESSENCE-Q tool. This screening method shows promise for identifying children needing further clinical assessment for NDPs.
Area of Science:
- Pediatric neurology
- Child psychiatry
- Developmental psychology
Background:
- Neurodevelopmental problems (NDPs) are a significant concern in child health.
- Accurate and efficient screening methods are crucial for early identification and intervention.
- Current methods for identifying NDPs in medical records can be inconsistent.
Purpose of the Study:
- To determine the prevalence of neurodevelopmental problems (NDPs) in fourth-grade students' medical records.
- To assess the interrater agreement and validity of a semi-structured review using the ESSENCE-Q.
- To compare the ESSENCE-Q's findings with clinical assessments.
Main Methods:
- A school-based sample of 11-year-old children's medical records (CHC and SHC) were reviewed.
- A pediatric neurologist, child psychiatrist, and adult psychiatrist scored records using the ESSENCE-Q (12 items, 0-24 score).
- Interrater agreement was measured using kappa and ICC; validity was assessed against a multidisciplinary clinical assessment (CGI-S).
Main Results:
- Moderate to strong agreement (kappa ~0.8) was found for 7 out of 12 ESSENCE-Q items.
- Good to excellent concordance (ICC ~0.8-0.9) was observed for the summary score.
- The ESSENCE-Q demonstrated good predictive validity (AUC ~80%) for identifying clinical-level NDPs.
Conclusions:
- The ESSENCE-Q is a reliable tool for identifying potential neurodevelopmental problems in medical records.
- Medical record screening using ESSENCE-Q can aid in structured work-ups for NDPs.
- Further calibration is needed to establish a universal cutoff for ESSENCE-Q medical record screening.
Purpose:
Determine the prevalence of symptoms of neurodevelopmental problems (NDPs) with a semi-structured review of fourth grade students' medical records, its interrater agreement and validity as compared with clinical assessment.
Methods:
A school-based sample of 11-year-old children provided child health care (CHC) records and school health care (SHC) records. A pediatric neurologist, child psychiatrist and an adult psychiatrist scored the records, with the "Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire" (ESSENCE-Q, 12 items scored 0-2, summary score range 0-24). Agreement was measured with model-based kappa and intraclass correlation coefficient (ICC). Ratings were validated against a multidisciplinary assessment involving a physician, psychologist, teacher- and parental behavioral rating scales rendering a clinical global impression severity rating (CGI-S, range 1-7) of NDPs.
Results:
Out of 223 participants, medical charts were available from 201, of whom 169 were rated by all three raters. Kappa agreement was moderate/strong (~0.8) for 7 of the 12 questionnaire items. Measured with the ICC, concordance in the summary score was good for agreement (~0.8) and excellent (~0.9) for consistency. Test-retest reliability was excellent (ICC = ~0.9). Area under the curve for the ESSENCE-Q in predicting clinical-level problems (CGI ≥4) was ~80% for all three raters, albeit with differing optimal cutoffs.
Conclusion:
Using the ESSENCE-Q as a template, NDPs appear to be common in medical records, are identified reliably, and predict clinical-level concern. Medical records screening may facilitate a structured review of medical records in work-ups or be applied in conjunction with other screening measures for neurodevelopmental disorders. However, differences in calibration currently preclude defining a universal cutoff for using the ESSENCE-Q for medical records screening.
