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Developmental screening at four years of age. Relation to home situation, perinatal stress, development and behaviour
J O Larsson1, G Aurelius, L Nordberg
1Department of Child and Adolescent Psychiatry, Karolinska Institute, St Göran's Children's Hospital, Stockholm, Sweden.
Insights
This study validated a simple developmental screening tool for four-year-olds. The screening effectively identifies children at risk for abnormal mental and behavioral development, enabling timely intervention.
Area of Science:
- Child Development
- Developmental Pediatrics
- Behavioral Science
Background:
- Early identification of developmental risks is crucial for intervention.
- Existing screening tools may be time-consuming or require specialized personnel.
- A need exists for accessible and efficient developmental screening methods for young children.
Purpose of the Study:
- To evaluate the efficacy of a novel, time-efficient developmental screening program for four-year-old children.
- To assess the correlation between screening results and various developmental, perinatal, and psychosocial factors.
- To determine the utility of the screening tool in identifying children at risk for abnormal development.
Main Methods:
- A prospective, longitudinal study involving 471 children followed from early pregnancy.
- A four-item developmental screening test administered by child welfare centre nurses.
- Comparison of screening scores with Griffiths' developmental scales, family psychosocial data, perinatal factors, and psychopathology assessments.
Main Results:
- The screening test, assessing object naming, drawing, and speech development, yielded lower average scores in boys compared to girls.
- Screening scores correlated significantly with Griffiths' scales, family psychosocial issues, and the child's behavioral and psychiatric symptoms.
- No significant association was found between screening scores and reduced perinatal optimality scores.
Conclusions:
- A simple, nurse-administered developmental screening method demonstrates value in identifying four-year-olds at risk for adverse mental and behavioral outcomes.
- This screening tool can aid in the early detection of children requiring specialized care and attention.
- The findings support the integration of this screening program into routine child welfare services.
Abstract:
A developmental screening programme constructed for the use of Swedish child welfare centres on four-year-old children has been tested on a cohort of 471 children who have been followed up from the stage of early pregnancy. The results of the screening test were compared with data in the project using a multidisciplinary, longitudinal and prospective design. The test, which can be performed by a child welfare centre nurse and which is not time-consuming, includes four items summed up in a four-years-of-age score: the child is asked to name three easily recognizable objects, to draw a cross (according to a model), and to draw a man; in addition, an evaluation is made of speech development. On average, boys were found to have a lower score than girls. The results of the screening test were related to data available in the ongoing project; to the psychosocial conditions of the families, to foetal and perinatal factors (reduced optimality score according to Prechtl), to the presence of psychopathology, and to the results of Griffiths' developmental scales. The developmental screening score, which in most instances was associated with the Griffiths' scales, was found to be related to psychosocial problems in the family and to abnormal behaviour and psychiatric symptoms in the child, but not to reduced optimality scores. The results indicate that a relatively simple screening method is of value for the identification of children who are at risk of abnormal mental and behavioural development, and who may thus be in need of special care and attention.