Development of a triage tool for neurodevelopmental risk in children aged 30 months

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Development of a triage tool for neurodevelopmental risk in children aged 30 months. / Sim, Fiona; Haig, Caroline; O'Dowd, John; Thompson, Lucy; Law, James; McConnachie, Alex; Gillberg, Christopher; Wilson, Philip.

In: Research in Developmental Disabilities, Vol. 45-46, 01.08.2015, p. 69-82.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Sim, F, Haig, C, O'Dowd, J, Thompson, L, Law, J, McConnachie, A, Gillberg, C & Wilson, P 2015, 'Development of a triage tool for neurodevelopmental risk in children aged 30 months', Research in Developmental Disabilities, vol. 45-46, pp. 69-82. https://doi.org/10.1016/j.ridd.2015.07.017

APA

Sim, F., Haig, C., O'Dowd, J., Thompson, L., Law, J., McConnachie, A., ... Wilson, P. (2015). Development of a triage tool for neurodevelopmental risk in children aged 30 months. Research in Developmental Disabilities, 45-46, 69-82. https://doi.org/10.1016/j.ridd.2015.07.017

Vancouver

Sim F, Haig C, O'Dowd J, Thompson L, Law J, McConnachie A et al. Development of a triage tool for neurodevelopmental risk in children aged 30 months. Research in Developmental Disabilities. 2015 Aug 1;45-46:69-82. https://doi.org/10.1016/j.ridd.2015.07.017

Author

Sim, Fiona ; Haig, Caroline ; O'Dowd, John ; Thompson, Lucy ; Law, James ; McConnachie, Alex ; Gillberg, Christopher ; Wilson, Philip. / Development of a triage tool for neurodevelopmental risk in children aged 30 months. In: Research in Developmental Disabilities. 2015 ; Vol. 45-46. pp. 69-82.

Bibtex

@article{7c29cc2636924ce18be71e288248d45c,
title = "Development of a triage tool for neurodevelopmental risk in children aged 30 months",
abstract = "Neurodevelopmental and neuropsychiatric disorders in young children predict educational, health and social problems. Early identification may significantly reduce this burden but relevant tools largely lack validation. We aimed to develop and evaluate the predictive validity of a simple screening tool for neurodevelopmental problems in a community sample of 30 month old children. A sample of children was selected from a community cohort screened at 30 months by health visitors using the Sure Start Language Measure (SSLM) and the Strengths and Difficulties Questionnaire (SDQ) in 2011. Predictive validity was assessed by comparing screening results with detailed psychometric data from the same sample 1-2 years later. Screening performance using different thresholds was explored using Receiver Operating Characteristic (ROC) with ROC area under the curve (AUC) and bootstrapping techniques. The SSLM predicted both language disorder identified by the New Reynell Developmental Language Scales (NRDLS) at follow-up (AUC 0.905) and global developmental delay assessed by the Griffiths Mental Development Scales (AUC 0.983). The SDQ administered at 30 months predicted psychiatric disorders identified by the Development and Wellbeing Assessment (DAWBA) at follow-up (AUC 0.821). Using optimal cut-offs for the SDQ and SSLM at 30 months, both tools together had sensitivity 87{\%}; specificity 64{\%}; positive predictive value 31{\%}; and negative predictive value 97{\%} in the prediction of any kind of neurodevelopmental problem 1-2 years later. The combined measure reported here is not yet sufficient as a stand-alone population screening tool for neurodevelopmental disorders. The SSLM and SDQ did however show promise in identifying preschool children at risk of ongoing language, psychiatric disorders and global developmental delay 1-2 years later but with fairly high false positive rates. Given that current developmental risk prediction in resource-poor settings is little better than random assignment, the SDQ and SSLM may aid clinical judgement when used as interim triage tools for practitioners with no specialist knowledge, in the context of longitudinal follow-up arrangements.",
keywords = "Anxiety, Separation/diagnosis, Area Under Curve, Attention Deficit and Disruptive Behavior Disorders/diagnosis, Autism Spectrum Disorder/diagnosis, Child, Preschool, Developmental Disabilities/diagnosis, Female, Follow-Up Studies, Humans, Hyperkinesis/diagnosis, Language Development Disorders/diagnosis, Male, Mass Screening, Mental Disorders/diagnosis, Predictive Value of Tests, Psychometrics, ROC Curve, Reactive Attachment Disorder/diagnosis, Risk Assessment, Sensitivity and Specificity, Surveys and Questionnaires, Triage/methods",
author = "Fiona Sim and Caroline Haig and John O'Dowd and Lucy Thompson and James Law and Alex McConnachie and Christopher Gillberg and Philip Wilson",
note = "Copyright {\circledC} 2015 Elsevier Ltd. All rights reserved.",
year = "2015",
month = "8",
day = "1",
doi = "10.1016/j.ridd.2015.07.017",
language = "English",
volume = "45-46",
pages = "69--82",
journal = "Research in Developmental Disabilities",
issn = "0891-4222",
publisher = "Pergamon Press",

}

RIS

TY - JOUR

T1 - Development of a triage tool for neurodevelopmental risk in children aged 30 months

AU - Sim, Fiona

AU - Haig, Caroline

AU - O'Dowd, John

AU - Thompson, Lucy

AU - Law, James

AU - McConnachie, Alex

AU - Gillberg, Christopher

AU - Wilson, Philip

N1 - Copyright © 2015 Elsevier Ltd. All rights reserved.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Neurodevelopmental and neuropsychiatric disorders in young children predict educational, health and social problems. Early identification may significantly reduce this burden but relevant tools largely lack validation. We aimed to develop and evaluate the predictive validity of a simple screening tool for neurodevelopmental problems in a community sample of 30 month old children. A sample of children was selected from a community cohort screened at 30 months by health visitors using the Sure Start Language Measure (SSLM) and the Strengths and Difficulties Questionnaire (SDQ) in 2011. Predictive validity was assessed by comparing screening results with detailed psychometric data from the same sample 1-2 years later. Screening performance using different thresholds was explored using Receiver Operating Characteristic (ROC) with ROC area under the curve (AUC) and bootstrapping techniques. The SSLM predicted both language disorder identified by the New Reynell Developmental Language Scales (NRDLS) at follow-up (AUC 0.905) and global developmental delay assessed by the Griffiths Mental Development Scales (AUC 0.983). The SDQ administered at 30 months predicted psychiatric disorders identified by the Development and Wellbeing Assessment (DAWBA) at follow-up (AUC 0.821). Using optimal cut-offs for the SDQ and SSLM at 30 months, both tools together had sensitivity 87%; specificity 64%; positive predictive value 31%; and negative predictive value 97% in the prediction of any kind of neurodevelopmental problem 1-2 years later. The combined measure reported here is not yet sufficient as a stand-alone population screening tool for neurodevelopmental disorders. The SSLM and SDQ did however show promise in identifying preschool children at risk of ongoing language, psychiatric disorders and global developmental delay 1-2 years later but with fairly high false positive rates. Given that current developmental risk prediction in resource-poor settings is little better than random assignment, the SDQ and SSLM may aid clinical judgement when used as interim triage tools for practitioners with no specialist knowledge, in the context of longitudinal follow-up arrangements.

AB - Neurodevelopmental and neuropsychiatric disorders in young children predict educational, health and social problems. Early identification may significantly reduce this burden but relevant tools largely lack validation. We aimed to develop and evaluate the predictive validity of a simple screening tool for neurodevelopmental problems in a community sample of 30 month old children. A sample of children was selected from a community cohort screened at 30 months by health visitors using the Sure Start Language Measure (SSLM) and the Strengths and Difficulties Questionnaire (SDQ) in 2011. Predictive validity was assessed by comparing screening results with detailed psychometric data from the same sample 1-2 years later. Screening performance using different thresholds was explored using Receiver Operating Characteristic (ROC) with ROC area under the curve (AUC) and bootstrapping techniques. The SSLM predicted both language disorder identified by the New Reynell Developmental Language Scales (NRDLS) at follow-up (AUC 0.905) and global developmental delay assessed by the Griffiths Mental Development Scales (AUC 0.983). The SDQ administered at 30 months predicted psychiatric disorders identified by the Development and Wellbeing Assessment (DAWBA) at follow-up (AUC 0.821). Using optimal cut-offs for the SDQ and SSLM at 30 months, both tools together had sensitivity 87%; specificity 64%; positive predictive value 31%; and negative predictive value 97% in the prediction of any kind of neurodevelopmental problem 1-2 years later. The combined measure reported here is not yet sufficient as a stand-alone population screening tool for neurodevelopmental disorders. The SSLM and SDQ did however show promise in identifying preschool children at risk of ongoing language, psychiatric disorders and global developmental delay 1-2 years later but with fairly high false positive rates. Given that current developmental risk prediction in resource-poor settings is little better than random assignment, the SDQ and SSLM may aid clinical judgement when used as interim triage tools for practitioners with no specialist knowledge, in the context of longitudinal follow-up arrangements.

KW - Anxiety, Separation/diagnosis

KW - Area Under Curve

KW - Attention Deficit and Disruptive Behavior Disorders/diagnosis

KW - Autism Spectrum Disorder/diagnosis

KW - Child, Preschool

KW - Developmental Disabilities/diagnosis

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hyperkinesis/diagnosis

KW - Language Development Disorders/diagnosis

KW - Male

KW - Mass Screening

KW - Mental Disorders/diagnosis

KW - Predictive Value of Tests

KW - Psychometrics

KW - ROC Curve

KW - Reactive Attachment Disorder/diagnosis

KW - Risk Assessment

KW - Sensitivity and Specificity

KW - Surveys and Questionnaires

KW - Triage/methods

U2 - 10.1016/j.ridd.2015.07.017

DO - 10.1016/j.ridd.2015.07.017

M3 - Journal article

C2 - 26226112

VL - 45-46

SP - 69

EP - 82

JO - Research in Developmental Disabilities

JF - Research in Developmental Disabilities

SN - 0891-4222

ER -

ID: 217946056