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[Evaluation of a tool for developmental disorder screening in 4-year-old children]
P Pouzet1, A Collignon, P F Pouthier
1Mutualité Sociale Agricole (MSA) du Calvados, Caen.
Insights
This study assessed a clinical tool for screening child development difficulties in Mother and Infant Protection Services (PMI). The tool showed good performance for language and adaptation issues but was less reliable for psychomotor disorders.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Early detection of developmental difficulties is crucial for children's long-term outcomes.
- Mother and Infant Protection Services (PMI) play a key role in child health surveillance.
- A reliable screening tool is needed to support PMI physicians.
Purpose of the Study:
- To evaluate the performance of a clinical tool used by PMI physicians for screening developmental difficulties in four-year-old children.
- To assess the tool's accuracy in identifying language, adaptation, and psychomotor disorders.
Main Methods:
- A cohort of four-year-old children in Calvados were independently screened by PMI doctors using the tool and by a specialized service.
- The study compared the results of the PMI screening with those of the specialized service.
Main Results:
- The PMI tool demonstrated significant correlation with specialist evaluations for language disorders (70% sensitivity) and adaptation issues (70% sensitivity).
- Positive predictive values were 28% for language and 57% for adaptation difficulties.
- The tool showed lower reliability for psychomotor disorders, detecting only one-quarter of children needing further investigation.
Conclusions:
- The clinical tool is effective for screening language and adaptation difficulties in preschool children.
- Improvements in the tool, such as refining questionnaire items, are recommended to enhance its efficiency, particularly for psychomotor disorder detection.
Abstract:
With the aim of helping physicians working in a "Mother and Infant Protection Service" (PMI) in their mission of children's development difficulties screening, authors tried to assess performances of a clinical tool including parental informations and standardized tests. The whole four years old children going at school in a canton of Calvados department were independently examined by a PMI doctor using the tool to be estimated and by a specialized service working from a beforehand established protocol. For the language disorders on the one hand and the adaptation on the other hand, this evaluation shows a significant correlation between the PMI screening and the specialists one's: the sensitivity of the PMI examination is about 70% for those two types of difficulties with a positive predictive value respectively 28% and 57%. However the tool appears less reliable for the psychomotor disorders screening: only one quarter of the children who require a specialized investigation about these problems have been detected by the PMI screening. A filing and a selection of the questionnaire items should permit to improve the efficiency of this tool.