Commonly used screening tools

Description

Brief descriptions of commonly used screening tools

Here are a number of screening tools which have been recommended by a variety of organizations. The tools are divided into three categories:

Developmental Screening Tools Using Information From Parents
Developmental Screens Requiring Direct Elicitation of Children's Skills
Behavioral/Emotional Screening Tools

Developmental Screening Tools Using Information From Parents

Ages & Stages Questionnaires (ASQ) - Second Edition

Source: Paul H. Brookes Publishing Co., PO Box 10624, Baltimore, Maryland 21285 (1-800-638-3775). ($199 per available language) http://www.brookespublishing.com

Age Range: 0 to 60 months

Description: Clear drawings and simple directions help parents elicit and indicate children's skills in four domains: language, personal-social, motor, and cognition. The ASQ involves separate 5 - 6 page photocopiable forms of approximately 30 items for each age range (tied to well-child visit schedule). Children who arrive between scheduled visits take two separate forms of the ASQ. The measure can also be used in mass mail-outs for child-find programs. Published in English, Spanish, French and Korean, other translations are available for licensing. A CD-ROM is available for training purposes and for facilitating scoring. To screen for emotional and behavioral problems, the newly developed Ages and Stages Questionnaire: Social Emotional (ASQ:SE) works similarly and is available for children 6 - 60 months.

Scores: Single pass/fail score for each of four domains

Accuracy: Sensitivity ranged from 70% to 90% at all ages except the 4 month level. Specificity ranged from 76% to 91%

Time Frame: About 10-15 minutes, less if parents complete independently

Cost: ~$4.60 including material cost and administration time for the ASQ alone, and ~$9.20 for the ASQ + ASQ:SE

Parents' Evaluations of Developmental Status (PEDS)

Source: Ellsworth & Vandermeer Press, Ltd. 1013 Austin Court, Nolensville, TN 37135 phone: 615.776.4121 fax: 615.776-4119 http://www.pedstest.com (in print $30.00, online ($0.50 - $1.00 per use) email: evpress@pedstest.com

Age Range: Birth to 8 years.

Description: This screening and surveillance tool provides evidence-based decision support and is designed to both detect and address a wide range of developmental issues including behavioral and mental health problems. It promotes parent-provider collaboration and family-centered practice by relying on 10 carefully constructed questions eliciting parents' concerns. PEDS identifies, using substantial evidence, when to refer, screen further or refer for additional screening, counsel, reassure, temporize, or monitor development, behavior, and academic progress. Written at the 4th to 5th grade level, parents can complete the measure while they wait for appointments. A longitudinal score and interpretation form organized by the AAP's well-visit schedule remains in the medical record. Anecdotal evidence suggests that PEDS reduces "oh by the way" concerns and helps focus visit content. Research points to improvements in positive parenting practices and satisfaction with services. Printed in English, Spanish and Vietnamese, aditional translations can be licensed (e.g., Hmung, Somali, Russian, Chinese, Thai, etc.) by emailing the publisher. The website includes a training slide show, downloadable parent handouts, and research updates. The online application offers PEDS plus the Modified Checklist of Autism in Toddlers(optional) automated scoring, generates ICD-9 and procedure codes, a summary report for parents, and when needed, a referral letter to share with other professionals.

Scores: High, moderate, and low risk for developmental and behavioral/mental health problems.

Accuracy: Sensitivity ranging from 74% to 79% and specificity ranging from 70% to 80% across age levels.

Time Frame: About 2 minutes, less if parents complete independently.

Cost: ~$1.19 including material costs and administration time

PEDS: Developmental Milestones (PEDS:DM)

Source: Ellsworth & Vandermeer Press, Ltd. 1013 Austin Court, Nolensville, TN 37135 phone: 615.776.4121 fax: 615.776-4119 $275 http://www.pedstest.com

Age Range: Birth to 8 years.

Description: The PEDS:DM consists of 6 - 8 items per well-visit. Each item taps a different developmental domain: fine motor, gross motor, expressive language, receptive language, self-help, social-emotional, and for older children reading and math. Forms are continuous across the 0 - 8 year age range and thus useful when children are above or below the expected age at each visit. Each colorful form is laminated and parents (or providers) answer questions (written at the high first grade level) about children's skills with a dry erase marker. When completed, parents are encouraged to read a developmentally age-appropriate story focusing on parent-child interactions. A second section of the Family Book (in which the Forms and stories are housed), includes laminated copies of the M-CHAT, Pictorial Pediatric Symptom Checklist-17, Brigance Parent-Child Interactions Scale, Family Psychosocial Screen, Safety Word Inventory and Literacy Screener, and the Vanderbilt ADHD Scale. A longitudinal scoring form serves as a repository for results and illustrates strengths and weaknesses over time. In addition to the well-visit version, there is an assessment level version for NICU follow-up that produces age-equivalent scores and includes a reusable booklet for each child/family. The manual includes sample referral letters, parent information handouts, and a guide to helping residents and other trainees learn about child development through assessment of children and families. The PEDS:DM can be used with or without PEDS but in combination offers better compliance with the AAP's 2006 policy statement on early detection. Published in English; Spanish available by May, 2007.

Scores: Pass/fail score for each of 8 developmental domains

Accuracy: Sensitivity/specificity ranging from 70% to 93% across age levels and developmental domains.

Time Frame: 3 - 5 minutes for parents to answer items, about 1 minute to score

Cost: ~$0.02 per visit for reusable longitudinal score form with total cost for materials and administration time of ~$1.15

Infant-Toddler Checklist for Language and Communication

Source: (1998). Paul H. Brookes, Publishing, Inc., P.O. Box 10624, Baltimore, MD, 21285 (phone: 800-638-3775). http://www.pbrookes.com/ ($99.95 w/ CD-ROM)

Age Range: 6 - 24 months.

Description: Parents complete the Checklist's 24 multiple-choice questions in English. Reading level is 6th grade. The measure focuses on social aspects of language development and produces scores for Social, Speech, and Symbolic composites. The measure does not screen for motor milestones. The Checklist is copyrighted but remains free for use at the Brookes web site. Scoring is complicated but much aided by the CD-ROM that also generates summary letters for parents. Ongoing research on the tool can be found at http://firstwords.fsu.edu

Scores: cut-off scores at 1.25 standard deviations below the mean in each composite.

Accuracy: Sensitivity is 78%; Specificity is 84%

Time Frame: About 5 to 10 minutes

Cost: ~$3.60 for material cost and administration time

Developmental Screens Requiring Direct Elicitation of Children's Skills

Bayley Infant Neurodevelopmental Screener (BINS)

Source: San Antonio, Texas: The Psychological Corporation, 1995. 555 Academic Court, San Antonio, TX 78204 (1-800-228-0752) ( $325) http://www.psychcorp.com

Age Range: 3 - 24 months.

Description: The BINS uses 10 - 13 directly elicited items per 3 - 6 month age range assess neurological processes (reflexes, and tone); neurodevelopmental skills (movement, and symmetry) and developmental accomplishments (object permanence, imitation, and language). A single form covers all age ranges and a carrying case of needed materials is provided. A videotape is also available to facilitate learning to administer the measure. Training with a Physical therapist, developmental-behavioral pediatrician, neurologist is helpful for detecting abnormal reflexes and tone. The BINS is published in English only. A parent report version is in development.

Scores: Cut scores of low, moderate or high risk for each of the three domains .

Accuracy: 75% to 86% across ages

Time Frame: About 10 to 15 minutes.

Cost: ~$10.45 for materials and administration time

Brigance Screens-II

Source: Brigance A. N. Billerica, MA: Curriculum Associates, Inc. (1985) 153 Rangeway Road, PO Box 2001, North Billerica, MA 01862-090 (1-800-225-0248) http://www.curriculumassociates.com/ Includes: the Brigance Infant and Toddler Screen for children 0 - 23 months ($248), Early Preschool Screen for children 2- 0 to 2 - 8 ($248), Preschool Screen for children 2 - 9 to 4 - 8 ($268); K & 1 Screen for children 4-9 through the end of first grade ($258).

Age Range: 0 - ~ 90 months.

Description: Nine separate forms, approximately one for each 12 month age range, the Brigance Screens tap speech-language, motor, readiness and general knowledge, and for the youngest age group, social-emotional skills. The K & 1 Screen also measures reading and math skills. The Infant & Toddler Screens comes with a small box of materials while the remaining screens require only blocks and crayons. All Screens use direct elicitation and observation except the Infant and Toddler Screen which can be administered by parent report. Widely used in educational settings and often administered by paraprofessionals, a video is available to facilitate learning the test . Scoring software is useful for generating the wide range of scores produced by the Screens. Online scoring is available and can be used to aggregate results across widely spread settings and for program evaluation. All Brigance Screens are available in English or Spanish and the K & 1 Screen is also available in Laotian, Vietnamese, Cambodian, and Tagalog. The website provides helpful training on administration of the tools.

Scores: Cutoff, age equivalents, percentiles, and quotients in motor, language, and readiness at all age levels except Infant and Toddler which provide scores for nonverbal and communication. Overall scores are generated at all age levels. In addition, there are cutoffs indicating potential giftedness and/or psychosocial risk. Growth indicator scores plot progress over time.

Accuracy: sensitivity and specificity to giftedness and to developmental and academic problems are 70% to 82% across ages.

Time Frame: About 10 minutes.

Cost: ~$11.68 including materials and administration time.

Battelle Developmental Inventory Screening Test (BDIST), 2nd Edition

Source: Riverside Publishing Company, 8420 Bryn Mawr Avenue, Chicago, Illinois 60631 (1-800-767-8378) ($308.50) http://www.riverpub.com/

Age Range: 0 - 8 years

Description: Items use a combination of direct assessment, observation, and parental interview. The BDIST taps a range of discrete domains include receptive and expressive language, fine and gross motor, adaptive, personal-social, and cognitive/academic. The test is challenging to administer and score but an instructional video and scoring software are available. The BDIST is published in English and Spanish.

Scores: Cutoffs at 1.0, 1.5, and 2.0 standard deviations below the mean with 1.5 providing optimal sensitivity and specificity. The BDIST also produces age equivalents but these appear deflated and thus are best used only when cutoffs fall at or below 1.5.

Accuracy: 72% to 88% sensitivity and specificity across age ranges and domains

Time Frame: About 15 minutes - 35 minutes

Cost: ~$20.55 for materials and administration time

Behavioral/Emotional/Mental Health Screening Tools

Eyberg Child Behavior Inventory (ECBI)/Sutter Eyberg Student Behavior Inventory Revised (SESBI-R)

Source: Psychological Assessment Resources, P.O. Box 998 Odessa Florida: 33556 (1-800-331-8378) ($170.00) http://www.parinc.com/

Age Range: 2 to 16 years of age

Description: The ECBI consists of 36 short statements of common acting out behaviors. Parents rate each item for frequency of occurence (referred to as intensity) on a 1 - 7 scale and then indicate whether the behavior is a problem for them. Scores are then totaled to produce a single cutoff score suggesting the presence of disruptive, externalizing behavior problem (e.g., disorders of attention, conduct, oppositional-defiance, etc.). The SESBI-R works in much the same way but uses teachers as the informant. Both tests are available in English only.

Scores: Refer/nonrefer score for intensity and presence of problem

Accuracy: Sensitivity 80%, specificity 86%.

Time Frame: About 5 minutes, less if parents complete independently.

Cost: ~$2.68 for materials and administration time

Pediatric Symptom Checklist

Source: Jellinek MS, Murphy JM, Robinson J, et al. Pediatric Symptom Checklist: Screening school age children for psychosocial dysfunction. Journal of Pediatrics, 1988; 112:201-209. The PSC is one of only a few public domain measures and can be freely downloaded in English or Spanish at: http://psc.partners.org/

Age Range: 4 - 18 years.

Description: The PSC consists of 35 short statements of problem behaviors including both externalizing (conduct, attention, etc.) and internalizing (depression, anxiety, adjustment, etc.) Ratings of never, sometimes or often are assigned a value of 0,1,or 2. Scores totaling 28 or more suggest referrals. For children 4 - 5 years of age, several items referring to academic performance are omitted and a cutoff of 24 is used. Recent research on the PSC illustrates the presence of discrete factors for attention, externalizing, internalizing, and school dysfunction. The PSC-17 enables factor scoring for internalizing, externalizing and attentional problems. The Pictorial PSC adds pictograms for each item and is known to ensure that the measure adequately identifies children in Spanish speaking families. Both the PSC-17 and the PPSC are downloadable at www.dbpeds.org or www.pedstest.com A Chinese version is available by e-mailing mmurphy6@partners.org

Costs: ~$1.19 including materials and administration time

Strengths and Difficulties Questionnaire

Source: http://www.sdqinfo.com/. The measure is available for a free download in a multiplicity of languages

Age Range: 3 - 16 years

Description: the SDQ consists of 25 items presented on a single page to which respondants indicate whether the statements are "certainly true, somewhat true or not true". Values of 0,1, and 2 are assigned and then results divided between 5 scales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. The SDQ can be completed by parent report. Teacher-report and adolescent self-report versions are also available, The website houses a wealth of research and scoring assistance (manual scoring overlays, online scoring, SPSS syntax, database, etc.). Several studies suggests that two informants (teacher and parent) are more likely to sensitively and specifically identify children with difficulties.

Scores: cutoff scores for each of the 5 subscales

Accuracy: Sensitivity 70%, for conduct, hyperactivity, depressive and some anxiety disorders, but ~50% for specific phobias, separation anxiety and eating disorders, specificity 94%. These indices are much lower when only a single informant is used.

Time Frame: about 10 minutes

Costs: ~$1.19 including materials and administration time