Simultaneous Screening for Child Health and Development: A Study of Visual/Developmental Screening of Preschool Children

摘要

This study was designed to explore the feasibility of using observations made during pediatric health examinations to obtain clinically useful developmental information without prolonging the health procedure itself. Standard preschool vision-screening procedures were modified so that adjustments in approach could be made for developmental capability as it unfolded and so that behavioral responses could be systematically recorded and quantified. There were 440 children (aged 52 to 64 months) screened by trained lay people who demonstrated high inter-tester reliability (95% agreement; r = .99). The average time required to complete each screening was eight minutes. In order to estimate the clinical efficiency of the developmental aspects of the experimental observation system, a stratified sample of 129 of these children was administered the McCarthy Scale for Infants and Children. Utilizing a weighted function of the sample to approximate the population distribution, the sum of the experimental vision/development test items was found to correlate .71 with the General Cognitive Index (GCI) score of the McCarthy test. A multiple correlation of .84 was obtained between items of the experimental test and the GCI scores. Discriminant analyses revealed that the overall agreement between the experimental test and the McCarthy criterion test was 93.3%, with a 5.4% over-referral rate and a 1.4% underreferral rate. Co-positivity was .84; co-negativity was .94. These results are comparable or better than results reported by others comparing extensive and time-consuming developmental tests with the McCarthy test.