Abstract
BackgroundThe use of multidomain developmental screening tools is a viable strategy for pediatric professionals to identify children at risk for developmental problems. However, a specialized multidimensional computer adaptive testing (MCAT) tool has not been developed to date.ObjectiveWe developed an app using MCAT, combined with Multidimensional Screening in Child Development (MuSiC) for toddlers, to help patients and their family members or clinicians identify developmental problems at an earlier stage.MethodsWe retrieved 75 item parameters from the MuSiC literature item bank for 1- to 3-year-old children, and simulated 1000 person measures from a normal standard distribution to compare the efficiency and precision of MCAT and nonadaptive testing (NAT) in five domains (ie, cognitive skills, language skills, gross motor skills, fine motor skills, and socioadaptive skills). The number of items saved and the cutoff points for the tool were determined and compared. We then developed an app for a Web-based assessment.ResultsMCAT yielded significantly more precise measurements and was significantly more efficient than NAT, with 46.67% (=(75-40)/75) saving in item length when measurement differences less than 5% were allowed. Person-measure correlation coefficients were highly consistent among the five domains. Significantly fewer items were answered on MCAT than on NAT without compromising the precision of MCAT.ConclusionsDeveloping an app as a tool for parents that can be implemented with their own computers, tablets, or mobile phones for the online screening and prediction of developmental delays in toddlers is useful and not difficult.
Highlights
Preschooler developmental delay has been defined to occur when a child does not reach developmental milestones, including gross motor, fine motor, language, cognitive, and social skills, at the expected times [1] or when a child’s developmental milestones appear more slowly compared to those of typically developing children [2]
We investigated the feasibility of screening toddlers (1- to 3-year olds) using the multidimensional computer adaptive testing (MCAT) combined with Multidimensional Screening in Child Development (MuSiC) for toddlers, including (i) comparisons with MCAT and nonadaptive testing (NAT; responding to all items) in efficiency and precision using a Monte Carlo simulation method, (ii) determining cutoff points for a variety of ages and stages using a parent-completed child monitoring system, and (iii) developing an online MCAT app for mobile phones to efficiently collect data and discriminate developmental delays for preschoolers
Applying the study’s cutoff points in logits for the 137 participants (2-year-old children) [7], the highest skill level was found to be in the cognitive domain and the lowest was in the gross motor domain
Summary
Preschooler developmental delay has been defined to occur when a child does not reach developmental milestones, including gross motor, fine motor, language, cognitive, and social skills, at the expected times [1] or when a child’s developmental milestones appear more slowly compared to those of typically developing children [2]. Objective: We developed an app using MCAT, combined with Multidimensional Screening in Child Development (MuSiC) for toddlers, to help patients and their family members or clinicians identify developmental problems at an earlier stage. Methods: We retrieved 75 item parameters from the MuSiC literature item bank for 1- to 3-year-old children, and simulated 1000 person measures from a normal standard distribution to compare the efficiency and precision of MCAT and nonadaptive testing (NAT) in five domains (ie, cognitive skills, language skills, gross motor skills, fine motor skills, and socioadaptive skills). Conclusions: Developing an app as a tool for parents that can be implemented with their own computers, tablets, or mobile phones for the online screening and prediction of developmental delays in toddlers is useful and not difficult
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