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Title: Comparison of the validity of direct pediatric developmental evaluation versus developmental screening by parent report

Author
item VOIGHT, ROBERT - Mayo Clinic
item LLORENTE, ANTOLIN - University Of Maryland
item JENSEN, CRAIG - Children'S Nutrition Research Center (CNRC)
item FRALEY, J - Children'S Nutrition Research Center (CNRC)
item BARBARESI, WILLIAM - Mayo Clinic
item HEIRD, WILLIAM - Children'S Nutrition Research Center (CNRC)

Submitted to: Journal of Clinical Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/24/2007
Publication Date: 7/1/2007
Citation: Voight, R.G., Llorente, A.M., Jensen, C., Fraley, J.K., Barbaresi, W.J., Heird, W.C. 2007. Comparison of the validity of direct pediatric developmental evaluation versus developmental screening by parent report. Journal of Clinical Pediatrics. 46(6):523-529.

Interpretive Summary: Methods available to assess childhood mental development in a typical setting include reports done by the child's parents and direct assessments done by a pediatrician. It is important to know how reliable each of these methods is for measuring childhood development. In this study, assessment of children's mental development by their parents using a developmental screen was compared with a direct evaluation of development by a pediatrician. The results of the direct evaluation by the pediatrician more closely matched the results of an extensive evaluation of development done by a psychologist than did the results from the parental report. Because the direct pediatric evaluation more reliably predicted childhood mental development compared to parent report, the results of this study support the concept that emphasis should be placed on training of pediatric health care providers in direct developmental evaluation to ensure that children with developmental difficulties are properly identified. Parental assessments need to be reevaluated to further strengthen the questions asked in assessing the child.

Technical Abstract: To compare the validity of direct pediatric developmental evaluation with developmental screening by parent report, parents completed a developmental screen (the Child Development Review), a pediatrician performed a direct developmental evaluation (Capute Scales), and a psychologist administered the Bayley Scales of Infant. Development to a group of 30-month-old children. The agreement between these instruments was tested. All developmental quotient scores derived from the Capute Scales were more highly correlated with concurrent Bayley Mental Development Index scores than developmental quotient scores derived from the Child Development Review. Differences between developmental quotient scores derived from the Capute Scales and corresponding Bayley Mental Development Index scores were significantly smaller than those derived from the Child Development Review. Thus, direct pediatric developmental evaluation more reliably predicted concurrent Mental Development Index scores at 30 months of age than developmental screening by parent report. Increased emphasis on training of pediatric health care providers in direct developmental evaluation should be considered.