Validation of an instrument to screen for developmental problems in children younger than 5 years old in Uruguay
Abstract
Introduction: early detection of developmental problems in children enables the application of timely interventions that improve prognosis and reduce disabilities. To that end, the application of sensitive, simple and low-cost screening procedures is required, what led to the creation of the “National Guidelines for the Surveillance of Early Childhood Development (under 5 years old children)” (GNVD V2). Use of these guidelines relies on awareness of psychometric properties a well as fixed rates and variables.
Objective: concurrent validation of GNVD V2 with Battelle Developmental Inventory, Fourth Edition.
Method: we conducted a transversal, observational study in a representative sample of children between 1 month and 5 years old from different schools in Montevideo. Subsequently, results from the application of GNVD V2 were compared to the Battelle Developmental Inventory, Fourth Edition. Sensitivity, specificity and predictive positive and negative values of the GNVD V2 were calculated for the different cut-off points. The clinical benefit if its application was estimated by means of likelihood ratios. A psychometric analysis was performed.
Results: validation was done with 341 children. No failure occurring in any of the behaviors to the left of the four areas corresponding to age represents 77% sensitivity, 65% specificity, 42% positive predictive value and 89% negative predictive value. Given such cut-off point, LR+ is 2.2 and LR- is 0.35, and the likelihood of there being a disorder when not passing the test is 1.6 and 0.26 when passing it.
Conclusions: GNVD V2 has the right psychometric properties and fixed rates that are similar to globally validated tests that allow for it to be recommended as the national screening instrument.
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