Development and validation of Egyptian developmental screening chart for children from birth up to 30 months

Abstract

Background Detecting developmental delay in children is an ongoing world commitment, especially for those below three years. To accurately assess the development of children; a culturally appropriate screening tool must be used. Egypt lacks such tool and multiple studies have shown that western tools are not suitable in other cultures. Objectives To develop and validate an easy, rapid, culturally appropriate and applicable screening chart for early detection of developmental delay among Egyptian children from birth up to 30 months and develop a Z-score chart for motor and mental development follow up based on our Egyptian screening chart. Methods A cross sectional randomized study was carried out on 1503 Egyptian children of both genders aged from birth up to 30 months assumed to have normal development according to the inclusion and exclusion criteria. They were selected from vaccination centers and well-baby clinics. Developmental milestones from Baroda development screening test (BDST) were applied on them after items were translated and adapted to Egyptian culture. Egyptian children developmental milestones scores were analyzed and carefully prepared in tables and charts. A 97% pass level of developmental achievements represents the threshold below which children are considered delayed. A Z-score chart for motor and mental development follow up was designed by calculating each age group achievement. The developed Egyptian developmental screening chart (EDSC) was validated against Ages and Stages Questionnaires (ASQ-3) as a reference standard in another different sample of 337 children in different age groups. Results The developed EDSC is represented in a chart format with two curves 50% and 97% pass level. Children considered delayed when the score below 97% pass level. Results revealed a statistically significant difference between EDSC and BDST at 50% and 97% pass levels. A Z-score chart for motor and mental development follow up was designed by calculating each age group achievement. EDSC sensitivity and specificity were calculated 84.38 (95% CI [67.21%–94.72%]) and 98.36 (95% CI [96.22%–99.47%]) respectively with an overall test accuracy 97.03 (95% CI [94.61%–98.57%]) (p ≤ .001). Agreement between EDSC and ASQ-3 was high (kappa score was 0.827) with negative and positive agreement 98.36 and 84.38, respectively. Conclusions Extensive revision of the BDST was needed in order to create and validate a more culturally appropriate Egyptian screening chart. This is the first study to create and validate an Egyptian-specific screening tool, to be rapid and easy to use in Egypt for early detection of developmental delay and enabling early intervention practices. A Z-score curve is reliable for follow up motor and mental development by calculating each age group achievement.

Development and validation of the Ibadan Simplified Developmental Screening chart

“…As part of the efforts at developing tools for routine developmental assessments in children in LMICs, El Shafie and colleagues developed the Egyptian Developmental Screening Chart (EDSC) for children from birth up to 30 months (30). The EDSC has a set of checklists based on the Baroda Developmental Screening Test (BDST) questionnaire (31) which consists of 54 items carefully chosen from the 230 items in the Bayley's Scale of Infant Development.…”

Designing and validating the Dubai Tool for Developmental Screening (DTDS)

“…The EDSC can be applied to children 0–30 months old. Initially a Z-score chart for motor and mental development was created, then the EDSC validity was tested against ASQ3 with an overall sensitivity of 84.38% and specificity of 98.36% ( 27 ). When looking to the methods followed to create different available screening tools, 2 models were identified.…”