Screening Instrument review process and criteria

Criteria:
The Task Force evaluates the purpose of the instrument to ensure that it is focused on screening, rather than assessment or diagnostic evaluation and determines whether it is designed to screen for developmental and social-emotional health rather than predict the child's future academic success.

Criteria:
The following domains must be included in developmental screening: fine and gross motor, communication, cognitive, and social-emotional.

The social-emotional domains embedded within developmental screening instruments do not demonstrate adequate reliability and validity to determine if a child needs further assessment. Therefore, the Task Force also reviews and recommends separate instruments specifically for the social-emotional domain.

Reliability indicates of whether consistent results can be obtained with the same screening instrument across different circumstances. A reliable instrument is one in which differences in test results are attributable less to chance and more to systematic factors such as lasting and general characteristics of the child (Moodie et al., 2014).

Criteria:

• The Task Force expects reliability scores of approximately 0.70 or above.
• Each instrument is evaluated on the actual reliability scores and the methods used to obtain these scores, such as scores by age, test-retest, inter-rater, and intra-rater reliability.

Validity indicates how accurately a screening instrument distinguishes between children at risk and those not at risk for developmental or social delays or concerns. There are various measures of validity. The following are the key measures of validity for screening instruments:

• Sensitivity: Accuracy of the instrument in identifying children at risk for delayed development.
• Specificity: Accuracy of the instrument in identifying children not at risk for delayed development.

Other validity measures include:

• Content validity: How well the measures represent all aspects of a given domain and skills of interest.
• Construct validity: How well the instrument measures what it is supposed to measure.
• Concurrent validity: How well the instrument under study compares to reference-standard (gold standard) measures or valid diagnostic assessment, usually performed 7-10 days after the screening test. The validity coefficient reports the agreement between the two tests (Moodie et al., 2014).
• Positive predictive value: The probability that an instrument can accurately identify delayed development.

Criteria:

• The Task Force expects sensitivity and specificity scores of approximately 0.70 or above (Glascoe & Cairney, 2018).
• Each instrument is evaluated on the actual validity scores, sufficient sample size representative of the US population, and the methods used to obtain these scores.

Expectations for child development change over time as new research emerges and changes occur in population demographics, technology, and curriculum. According to national standards, screening instrument normative data should be updated every 10-15 years to account for these changes (Emmons and Alfonso, 2005; Glascoe & Cairney, 2018).

Criteria:

• The Task Force recommends instruments that have been developed or re-normed within the last 15 years unless no equivalent instrument is available to better meet the population's screening needs.
• Other considerations may include whether the instrument has had recent or ongoing research demonstrating its effectiveness in identifying children needing further evaluation for developmental or social-emotional concerns.

Practicality refers to the ease of administration of the screening instrument, and the amount of time needed to administer and score the screening instrument. It should typically take 30 minutes or less to administer.

The Task Force considers both the target group for whom the instrument was designed and standardized and the age of the child the instrument is designed to screen. The developer or publisher should state this information.

The Task Force considers:

• The instrument's availability in languages other than English, and whether the instrument has been validated in those languages.
• The instrument's ability to accurately screen children from diverse cultures.
• Normative scores, or scores used to establish appropriate cutoff points for referral for the population for which the test is developed (Moodie et al., 2014).

The minimum level of expertise required to administer the tool, score, and interpret the results are instrument-specific and can range from paraprofessional to doctoral-prepared professionals. Some instruments administration by a paraprofessional but need to be scored or evaluated by a professional to determine if the child should be referred for further assessment. The Task Force considers an instrument that requires administration by a psychologist or similar professional to be an assessment rather than a screening instrument.

The Task Force also reviews the availability of training materials or workshops for screeners to receive training on proper administration.

The Task Force understands that school districts and organizations responsible for screening programs consider cost when selecting a developmental screening instrument. For this reason, the Task Force provides cost information on each developmental screening instrument, as available from the publisher.

Emmons, M.R. & Alfonso, V.C. (2005). A critical review of the technical characteristics of current preschool screening batteries. Journal of Psychoeducational Assessment, 23(11).

Glascoe, F.P., Cairney, J. (2018). Best Practices in Test Construction for Developmental-Behavioral Measures: Quality Standards for Reviewers and Researchers. In: Needelman, H., Jackson, B. (eds) Follow-Up for NICU Graduates. Springer, Cham. https://doi.org/10.1007/978-3-319-73275-6_15

Moodie, S., Daneri, P., Goldhagen, S., Halle, T., Green, K., & LaMonte, L. (2014). Early Childhood Developmental Screening: A Compendium of Measures for Children Ages Birth to Five. OPRE Report 2014-11. US Department of Health and Human Services.