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HEADS-ED Under 6: A clinician-administered mental health and developmental screening and triage tool
Christine Polihronis1,2,3, Paula Cloutier2,4, Scott Robson1,2
1Knowledge Institute on Child and Youth Mental Health and Addictions, CHEO, Ottawa, Ontario, Canada.
Insights
The HEADS-ED Under 6 tool effectively screens mental health and developmental needs in young children. A score of 6 or higher accurately identifies those needing moderate to higher levels of intervention.
Area of Science:
- Child mental health
- Developmental screening
- Healthcare access and navigation
Background:
- Communimetric screening tools are vital for identifying functional impairment and guiding clinical actions.
- The HEADS-ED Under 6 is a communimetric tool for mental health (MH) and developmental screening in children under 6.
Purpose of the Study:
- To assess the feasibility and utility validity of the HEADS-ED Under 6 within a coordinated access program.
- To determine how intake workers use the tool for screening and decision-making regarding intervention levels.
Main Methods:
- A prospective cohort study screened 589 children under 6 using the HEADS-ED Under 6.
- Statistical analyses, including correlation, ANOVA, and ROC analysis, were used to evaluate the tool's performance.
Main Results:
- Utility validity was confirmed through significant associations between HEADS-ED Under 6 scores and the level of need.
- A total score of ≥6 demonstrated high accuracy (AUC = 0.807) in identifying children requiring moderate to higher levels of intervention.
Conclusions:
- The HEADS-ED Under 6 is a brief, valid, and user-friendly screening tool for clinicians.
- It effectively identifies the level of impairment, communicates severity of MH and developmental needs, and guides service allocation.
Objectives:
Communimetric screening tools convey functional impairment and action required, helping clinicians identify and communicate patient's needs and actions within a measurement framework. We examined the feasibility of using the HEADS-ED Under 6, a communimetric mental health (MH) and developmental screening and triage tool for children under 6, within 1Call1Click.ca, a regional coordinated access and navigation program in Eastern Ontario. We explored utility validity to understand how the HEADS-ED Under 6 is used to help intake workers screen, inform their level of need decision, and establish a cut-off for recommending interventions targeting moderate levels of need or higher.
Methods:
Using a prospective cohort design, intake workers at 1Call1Click.ca screened all children under 6 using the HEADS-ED Under 6 from June 2021 to August 2023. Correlations and an Analysis of variance examined how total scores were associated with the level of need, and Receiver Operator Curve analysis examined sensitivity and specificity for identifying moderate levels of need or higher.
Results:
In total, 589 children under 6 were screened with the HEADS-ED Under 6. Utility validity was demonstrated by significant associations between level of need and HEADS-ED Under 6 domains and total scores. A total score of ≥6 supported decision-making for moderate levels of need or higher (Area Under Curve = 0.807).
Conclusions:
The HEADS-ED Under 6 is a brief, easy, and valid screening tool, that can be used by clinicians to identify the level of action/impairment, communicate the severity of MH and developmental needs, and determine the level of need for services.
