Agreement and Reliability of Parental Reports and Direct Screening of Developmental Outcomes in Toddlers at Risk

Abstract

Developmental screening is a practice that directly benefits vulnerable and low-income families and children when it is regular and frequently applied. A developmental screening tool administered by parents called CARE is tested. CARE contains a compilation of activities to report and enhance development at home. Hundred and fifty-seven families in Bogotá (Colombia) initially responded to a call to participate in developmental screening tools’ validation and reliability study. All children (Average: 42.7 months old; SD: 9.4; Min: 24, Max: 58) were screened directly by trained applicants using a Spanish version of the Denver Developmental Screening test [i.e., the Haizea-Llevant (HLL) screening table]. After a first screening, 61 dyads were positive for follow-up and received a second HLL screening. Fifty-two out of 61 dyads use and returned CARE booklet after 1-month screening at home. The comparative analysis for parent reports using CARE and direct screening observation included (a) the effects of demographic variables on overall and agreement, (b) agreement and congruence between the CARE report classification and direct screening classification (“At risk” or “Not at risk”), (c) receiver operating characteristic analysis, (d) item-Level agreement for specific developmental domains, and (e) acceptability and feasibility analysis. Results and conclusions show the parental report using the CARE booklet as a reliable screening tool that has the potential to activate alerts for an early cognitive delay that reassure clinicians and families to further specialized and controlled developmental evaluations and act as a screen for the presence of such delay in four developmental dimensions.

Efectos en el desarrollo cognitivo de niños y niñas en condición de riesgo y pobreza multidimensional de dos intervenciones con cuidadores principales

“…El DDST es el instrumento de observación de mayor utilización y validación en múltiples y recientes estudios (McCoy, et al, 2018). Un primer piloto en el uso de CARE (Giraldo & Schafer, 2021), indica óptimas propiedades diagnósticas para el monitoreo infantil (Sensibilidad = .95, Especificidad =.85, LR+ =6.17, LR-= .06). Sin embargo, hasta el momento no se ha diseñado una intervención que además de entregar la cartilla CARE permita acompañar el monitoreo parental.…”

Parental developmental screening with CARE: A pilot hybrid assessment and intervention with vulnerable families in Colombia

“…Results of a receiver operating curve (ROC) analysis indicated that parental report using CARE is a satisfactory tool for screening diagnostics (Area Under the Curve—AUC: 0.894, trapezoidal Wilcoxon area). All the reliability, agreement and diagnostic-characteristics analysis results were previously carried and published before the intervention and efficacy study [ 38 ]. However, it is important to note that using CARE solely as a developmental screening tool, without incorporating its intended characteristics as a parental intervention, does not constitute an actual intervention.…”