Construction and validation of ShaMaq developmental screening tool.

Abstract

The diagnosis of developmental delay and early intervention ameliorates long-term sequelae. There is a need for an appropriate, regionally adapted and reliable developmental screening tool to be used in low and middle-income countries with scarce resources. The aim of this research is to construct and validate a screening tool for identifying developmental delay in Pakistani children. ShaMaq developmental screening tool (SDST) was developed consisting of five proformas to be administered at different age groups: 6-8weeks (Group 1), 6-10months (Group 2), 18-24 months (Group 3), 3-3.5years (Group 4), and 4.5-5.5years (Group 5). On an average, Groups 1-3 took 10-15 min, whereas Groups 4 and 5 took 20-25 min. We sampled children between the ages of 6weeks to 5.5years and tested them all within their designated age groups. Internal consistency was assessed by Cronbach's alpha. Interobserver testing was done for reliability and concurrent validity was undertaken by using the senior consultant developmental paediatrician's final diagnosis as the gold standard. Out of 550 healthy children, 8-19% in the five groups were found to have some form of developmental delay using SDST. Approximately 50% of the families were in the low-to-moderate income bracket, and nearly 93% lived in a joint family system. Internal consistency of items in the five groups ranged from 0.784 to 0.940, whereas both interobserver reliability and concurrent validity ranged from 0.737 to 1.0. SDST showed 94.4% sensitivity and 92.9% specificity. SDST is an effective tool for identifying delay in healthy children with good internal consistency, reliability, and validity.