Validity of the ESSENCE-Q neurodevelopmental screening tool in Japan

Area of Science:

• Developmental Pediatrics
• Child Psychology
• Public Health Screening

Background:

• Early identification of neurodevelopmental disorders (NDDs) is crucial for timely intervention and improved outcomes.
• Validated screening tools are essential for efficient population-level assessment.
• The Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire (ESSENCE-Q) is a potential screening tool for NDDs.

Purpose of the Study:

• To evaluate the diagnostic accuracy and clinical utility of the ESSENCE-Q in a large Japanese birth cohort.
• To determine the effectiveness of the ESSENCE-Q in screening for neurodevelopmental problems in 2.5-year-old children.
• To assess the ESSENCE-Q's performance in identifying children with and without neurodevelopmental disorders.

Main Methods:

• A national birth cohort study included 77,612 children aged 2 years 6 months.
• Parents/caregivers completed the 11-item ESSENCE-Q.
• Neurodevelopmental disorders (NDDs) were assessed at age 3 years; ESSENCE-Q scores were analyzed using receiver operating characteristic (ROC) curve analysis.

Main Results:

• The ESSENCE-Q demonstrated strong screening performance with an Area Under the Curve (AUC) of 0.91 (cut-off ≥3).
• Sensitivity was 84.9%, specificity 84.8%, and negative predictive value 99.8%, indicating high accuracy in identifying children without NDDs.
• Parental concerns regarding communication and general development significantly differed between children with and without NDDs.

Conclusions:

• The parent-completed ESSENCE-Q is a valuable tool for screening out neurotypical children at an early age in Japan.
• The tool shows promise for early identification of potential neurodevelopmental issues.
• Further research will explore the ESSENCE-Q's long-term predictive validity as more NDD diagnoses emerge.