Abstract
BackgroundThe Brief Infant-Toddler Social and Emotional Assessment (BITSEA) is a promising questionnaire for the early detection of psychosocial problems in toddlers. The screening accuracy and clinical application were evaluated.MethodsIn a community sample of 2-year-olds (N = 2060), screening accuracy of the BITSEA Problem scale was examined regarding a clinical CBCL1.5-5 Total Problem score. For the total population and subgroups by child’s gender and ethnicity Receiver Operating Characteristic (ROC) curves were calculated, and across a range of BITSEA Problem scores, sensitivity, specificity, likelihood ratio’s, diagnostic odds ratio and Youden’s index. Clinical application of the BITSEA was examined by evaluating the relation between the scale scores and the clinical decision of the child health professional.ResultsThe area under the ROC curve (95% confidence interval) of the Problem scale was 0.97(0.95–0.98), there were no significant differences between subgroups. The association between clinical decision and BITSEA Problem score (B = 2.5) and Competence score (B = −0.7) was significant (p<0.05).ConclusionsThe results indicate that the BITSEA Problem scale has good discriminative power to differentiate children with and without psychosocial problems. Referred children had less favourable scores compared to children that were not referred. The BITSEA may be helpful in the early detection of psychosocial problems.
Highlights
Preventive child health care has always focused on the detection of physical conditions
We evaluated the clinical application of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) Problem and Competence scale, by comparing BITSEA scores with the clinical decision of the child health professionals
All mean scores differed between boys and girls and native and non-native children (p,0.01), except for the mean CBCL Total Problem score between boys and girls (p = 0.96)
Summary
Preventive child health care has always focused on the detection of physical conditions. In the Netherlands, preventive child health care for young children is delivered through community well-child clinics that are free of charge and provide routine developmental assessment and vaccinations [2]. One approach for facilitating early recognition and identification of psychosocial problems is to use parentcompleted questionnaires as part of routine primary care visits (i.e. well-child visits) [3]. Detection instruments of psychosocial problems, intended for use in preventive child health care, should have adequate psychometric properties (i.e. reliability and validity), and should be short, easy to administer, score, and interpret [4,5]. The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) is a promising questionnaire for the early detection of psychosocial problems in toddlers.
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