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Updated: May 12, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
BEEC psychosocial screening at Royal Manchester Children's Hospital
Samuel Gittins1, Ruth Hurrell2, Catherine Fullwood2
1The University of Manchester, United Kingdom.
Insights
Psychosocial difficulties in children with Bladder Exstrophy and Epispadias Complex (BEEC) are increasing. Early screening and psychological assessment are crucial for timely intervention and improved care for these patients.
Area of Science:
- Pediatric Urology
- Developmental Psychology
- Clinical Psychology
Background:
- Bladder Exstrophy and Epispadias Complex (BEEC) is associated with significant psychosocial challenges.
- Screening questionnaires and psychological consultations are vital for early identification and management of these difficulties.
- Tracking trends in psychosocial well-being can enhance service delivery for children with BEEC.
Purpose of the Study:
- To screen pediatric patients with BEEC for general psychosocial difficulties.
- To compare current screening results with previous studies and established norms.
- To evaluate psychosocial challenges in a multi-disciplinary outpatient clinic setting.
Main Methods:
- Service evaluation of BEEC patients from 2016-2022.
- Utilized Paediatric Quality of Life Inventory (PedsQL) and Strengths and Difficulties Questionnaires (SDQ).
- Collected data from children (aged 4-5, 10-11, 14-15) and their parents/proxies.
Main Results:
- Increased 'At Risk' scores on PedsQL in the 2016-2022 sample compared to 2015.
- Parent/proxy and child/youth (CYP) responses differed, with CYP reporting fewer difficulties.
- Age, gender, and diagnosis influenced responses; emotional domain differences noted in older adolescents; lower physical health scores for cloacal exstrophy; higher parent/proxy SDQ scores for boys.
Conclusions:
- Results confirm the necessity of psychosocial screening and provide benchmarks for BEEC patients.
- Recent years show a higher prevalence of psychosocial difficulties among patients accessing the clinic.
- Integrating questionnaire data with clinical information can refine service evaluations; children meeting thresholds receive further psychological assessment.
Introduction:
Bladder Exstrophy and Epispadias Complex (BEEC) is associated with psychosocial difficulties. Screening questionnaires, alongside consultation with a clinical psychologist, can help identify children/young people for further assessment and track trends over time to improve service delivery.
Objective:
To screen paediatric BEEC patients for a range of general psychosocial difficulties in a multi-disciplinary out-patient clinic setting and compare these results with our previous study and against published norms.
Study Design:
The current service evaluation collected data at outpatient BEEC clinic appointments between 2016 and 2022 (2016-2022 sample). Children aged 4-5, 10-11 and 14-15 years and their parents/proxy were asked to complete two standardised psychosocial questionnaires: Paediatric Quality of Life Inventory (PedsQL 4.0 Generic Core and Family Impact Module) and the Strengths and Difficulties Questionnaires (SDQ). 79 children (CYP) and 93 parent/proxy (P/P) responses were recorded. The sample included paired CYP and P/P responses for the PedsQL (n = 67) and SDQ (n = 35). The mean age for CYP was 9.9 years (SD 3.99, range 2-17), 69.8% (n = 120) of responses for male children.
Results:
The percentage of total CYP scores falling within the 'At Risk' category on the PedsQL increased in the 2016-2022 sample compared to our 2015 sample, indicating the prevalence of greater difficulties. Differences between P/P and CYP responses on both the PedsQL and SDQ favoured CYP. Age, gender, and diagnosis appeared to influence certain questionnaire responses, depending on respondent (CYP or P/P). A significant difference between P/P and CYP in the emotional domain of the PedsQL for those aged 13-18 was observed (p = 0.020), with P/P reporting greater difficulties, but this was not seen in the younger age ranges. Physical Health on the PedsQL were significantly lower for children with a cloacal exstrophy diagnosis, in comparison to bladder exstrophy and epispadias. P/P SDQ scores for boys were significantly higher in several domains.
Conclusions:
The results demonstrate the need for psychosocial screening, providing benchmarking for psychosocial difficulties within this patient group. Results indicate that patients accessing our clinic are reporting a higher level of challenge across psychosocial domains in recent years reflected by the percentage within the 'At Risk' category for psychosocial difficulty. Linked questionnaire data with condition specific information and surgical history would improve service evaluations. CYP reaching clinical thresholds are offered further psychological assessment within the service.
