Parent Evaluation of Developmental Status (PEDS) in screening: The Thai experience.

Abstract

Parent Evaluation of Developmental Status (PEDS) is a feasible developmental screening tool but it is not commonly used in Thailand. To examine the potential of PEDS as a screening tool, PEDS was implemented in well-child visits to identify the prevalence of developmental problems, characteristic parental concerns and comments, and to compare it with pediatrician developmental evaluation using Parent Evaluation of Developmental Status: Developmental Milestones, assessment level (PEDS: DM-AL). Participants were 266 children at the 9, 18 and 30 month health checkups as well as their parents. The PEDS questionnaire (Thai version) was first used for parents, and then the children were evaluated by pediatricians using PEDS: DM-AL. Using PEDS, 12% and 34% of children were classified as high and moderate risk for developmental and social-emotion disorders. The most common concerns were behavioral problems, social-emotion problems and expressive language. On PEDS: DM-AL, 24% of children had delay in at least one domain of development. When PEDS screening was compared with PEDS: DM-AL, being in the PEDS high-risk group had 27.7% sensitivity and 93.0% specificity. If being in the moderate or high-risk group was used instead, the sensitivity was enhanced to 67.7%, with 60.7% specificity. Implementation of PEDS in well-child visits could enhance early detection of developmental problems, but many Thai parents were unable to mention their concerns about delayed abilities in the correct PEDS question. Therefore, to ensure higher sensitivity, criteria for referral should be adjusted and a second stage developmental evaluation may be incorporated with PEDS.