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World journal of pediatrics : WJP
Feb, 2025;21 (2): 183-191.

Development and validation of the Parent-Reported Indicator of Developmental Evaluation for Chinese Children (PRIDE) tool.

Sai-Shuang Wu, Hao Pan, Radley Christopher Sheldrick, Jie Shao, Xiu-Mei Liu, Shuang-Shuang Zheng, Sergio Miguel Pereira Soares, Lan Zhang, Jin Sun, Ping Xu, Shao-Hong Chen, Tao Sun, Jin-Wen Pang, Ning Wu, Yuan-Cong Feng, Na-Ren Chen, Yun-Ting Zhang, Fan Jiang
Author Information
  1. Sai-Shuang Wu: Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
  2. Hao Pan: Department of Developmental and Behavioral Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
  3. Radley Christopher Sheldrick: Radley Christopher Sheldrick, University of Massachusetts, Shrewsbury, MA, USA.
  4. Jie Shao: Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
  5. Xiu-Mei Liu: Developmental and Behavior Pediatrics Department, Fujian Branch of Shanghai Children's Medical Center), Fujian Children's Hospital, Fuzhou, China.
  6. Shuang-Shuang Zheng: Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
  7. Sergio Miguel Pereira Soares: Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands.
  8. Lan Zhang: School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China.
  9. Jin Sun: Dalian Women and Children's Medical Group, Dalian, China.
  10. Ping Xu: Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, China.
  11. Shao-Hong Chen: Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, China.
  12. Tao Sun: Shanghai Children's Medical Center, Hainan Branch, Sanya, China.
  13. Jin-Wen Pang: School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
  14. Ning Wu: Shenzhen Xinzhi Institute of Psychological Assessment Technology, Shenzhen, China.
  15. Yuan-Cong Feng: Shenzhen Xinzhi Institute of Psychological Assessment Technology, Shenzhen, China.
  16. Na-Ren Chen: Shenzhen Xinzhi Institute of Psychological Assessment Technology, Shenzhen, China.
  17. Yun-Ting Zhang: Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Rd, Shanghai, 200127, China. edwinazhang@hotmail.com.
  18. Fan Jiang: Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Key Laboratory of Child Brain and Development, National Children's Medical Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Rd, Shanghai, 200127, China. fanjiang@shsmu.edu.cn.
PMID: 39988643 DOI: 10.1007/s12519-025-00878-7

Abstract

BACKGROUND: Developmental delay (DD) poses challenges to children's overall development, necessitating early detection and intervention. Existing screening tools in China focus mainly on children with developmental issues in two or more domains, diagnosed as global developmental delay (GDD). However, the recent rise of early childhood development (ECD) concepts has expanded the focus to include not only those with severe brain development impairments but also children who lag in specific domains due to various social-environmental factors, with the aim of promoting positive development through active intervention. To support this approach, corresponding screening tools need to be developed.
METHODS: The current study used a two-phase design to develop and validate the Parent-Reported Indicator of Developmental Evaluation for Chinese Children (PRIDE) tool. In Phase 1, age-specific milestone forms for PRIDE were created through a survey conducted in urban and rural primary care clinics across four economic regions in China. In Phase 2, PRIDE was validated in a community-based sample. Sensitivity and specificity of both PRIDE and Ages and Stages Questionnaires (ASQ)-3 were estimated using inverse probability weights (IPW) and multiple imputation (MI) to address planned and unplanned missing data.
RESULTS: In Phase 1 involving a total of 1160 participants aged 1 to 48 months, 63 items were selected from the initial item pool to create 10 age-specific PRIDE forms. Our Phase 2 study included 777 children within the same age range. PRIDE demonstrated an estimated sensitivity and specificity of 83.3% [95% confidence interval (CI): 56.8%-100.0%] and 84.9% (95% CI: 82.8%-86.9%) in the identification of DD.
CONCLUSION: The findings suggest that PRIDE holds promise as a sensitive tool for detecting DD in community settings.

Keywords

Community sample Development and validation Developmental delay Early childhood development Screening tool

References

  1. Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, et al. Early childhood development coming of age: science through the life course. Lancet. 2017;389:77���90. [DOI: 10.1016/S0140-6736(16)31389-7]
  2. Cavallera V, Lancaster G, Gladstone M, Black MM, McCray G, Nizar A, et al. Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries. BMJ Open. 2023;13:e062562. [DOI: 10.1136/bmjopen-2022-062562]
  3. Scherzer AL, Chhagan M, Kauchali S, Susser E. Global perspective on early diagnosis and intervention for children with developmental delays and disabilities. Dev Med Child Neurol. 2012;54:1079���84. [DOI: 10.1111/j.1469-8749.2012.04348.x]
  4. Bellman M, Byrne O, Sege R. Developmental assessment of children. BMJ. 2013;346:e8687. [DOI: 10.1136/bmj.e8687]
  5. Choo YY, Agarwal P, How CH, Yeleswarapu SP. Developmental delay: identification and management at primary care level. Singap Med J. 2019;60:119���23. [DOI: 10.11622/smedj.2019025]
  6. Horowitz S, Rawe J, Whittaker M. The state of learning disabilities: understanding the 1 in 5. New York: National Center for Learning Disabilities. 2017;3:211���9. https://assets.ctfassets.net/p0qf7j048i0q/2Q2TsAzUSM9TXq22LPxQwY/658d54ed0529acddf70f89d367db7915/2017_State_of_LD_-_Executive_Summary_Final_Accessible.pdf . Accessed Dec 28, 2024
  7. Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, et al. Nurturing care: promoting early childhood development. The Lancet. 2017;389:91���102. [DOI: 10.1016/S0140-6736(16)31390-3]
  8. Frankenburg WK, Dodds J, Archer P, Shapiro H, Bresnick B. The Denver II: A major revision and restandardization of the denver developmental screening test. Pediatrics. 1992;89:91���7. [DOI: 10.1542/peds.89.1.91]
  9. Chen J, Wei M, Chen S, He L, Jiang L, Shi J, et al. Standardization of Denver II Developmental Screening Test in Shanghai and its relative factors. Zhongguo Ertong Baojian Zazhi. 2007;5:76-77.
  10. Veldhuizen S, Clinton J, Rodriguez C, Wade TJ, Cairney J. Concurrent validity of the ages and stages questionnaires and bayley developmental scales in a general population sample. Acad Pediatr. 2015;15:231���7. [DOI: 10.1016/j.acap.2014.08.002]
  11. Wei M, Bian X, Squires J, Yao G, Wang X, Xie H, et al. Studies of the norm and psychometrical properties of the ages and stages questionnaires, third edition, with a Chinese national sample. Zhonghua Er Ke Za Zhi. 2015;53:913���8. [PMID: 26887546]
  12. Leonard LB. Specific language impairment across languages. Child Development Perspectives. 2014;8:1���5. [DOI: 10.1111/cdep.12053]
  13. Wang D, Zheng L, Lin Y, Zhang Y, Sheng L. Sentence repetition as a clinical marker for mandarin-speaking preschoolers with developmental language disorder. J Speech Lang Hear Res. 2022;65:1543���60. [DOI: 10.1044/2021_JSLHR-21-00401]
  14. Saishuang W, Jin Z, Haiwa W, Hao P, Yunting Z, Fan J. Language development milestones in Chinese children aged 0 to 5.5 years in China: A cross-sectional survey. Chinese J Evidence-Based Pediatr. 2023;18:325.
  15. Dai S, Vo TT, Kehinde OJ, He H, Xue Y, Demir C, et al. Performance of Polytomous IRT Models With Rating Scale Data: An Investigation Over Sample Size, Instrument Length, and Missing Data. Front Education. 2021;6:721963. [DOI: 10.3389/feduc.2021.721963]
  16. Jiang S, Wang C, Weiss DJ. Sample Size Requirements for Estimation of Item Parameters in the Multidimensional Graded Response Model. Front Psychol. 2016;7:109. [DOI: 10.3389/fpsyg.2016.00109]
  17. Sheldrick RC, Perrin EC. Evidence-Based Milestones for Surveillance of Cognitive, Language, and Motor Development. Acad Pediatr. 2013;13:577���86. [DOI: 10.1016/j.acap.2013.07.001]
  18. Zubler JM, Wiggins LD, Macias MM, Whitaker TM, Shaw JS, Squires JK, et al. Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics. 2022;149:e2021052138. [DOI: 10.1542/peds.2021-052138]
  19. Wallace IF, Berkman ND, Watson LR, Coyne-Beasley T, Wood CT, Cullen K, et al. Screening for speech and language delay in children 5 years old and younger: A systematic review. Pediatrics. 2015;136:e448���62. [DOI: 10.1542/peds.2014-3889]
  20. Drachler MDL, Marshall T, De Carvalho Leite JC. A continuous-scale measure of child development for population-based epidemiological surveys: a preliminary study using Item Response Theory for the Denver Test. Paediatr Perinat Ep. 2007;21:138���53. [DOI: 10.1111/j.1365-3016.2007.00787.x]
  21. Sheldrick RC, Marakovitz S, Garfinkel D, Carter AS, Perrin EC. Comparative accuracy of developmental screening questionnaires. JAMA Pediatr. 2020;174:366���74. [DOI: 10.1001/jamapediatrics.2019.6000]
  22. Tso W, Wong V, Xia X, Faragher B, Li M, Xu X, et al. The Griffiths Development Scales-Chinese (GDS-C): A cross-cultural comparison of developmental trajectories between Chinese and British children. Child: Care, Health Development. 2018;44:378���83. [DOI: 10.1111/cch.12548]
  23. Sheldrick RC, Hooker JL, Carter AS, Feinberg E, Croen LA, Kuhn J, et al. The influence of loss to follow-up in autism screening research: Taking stock and moving forward. J Child Psychol Psychiatry. 2024;65:656���67. [DOI: 10.1111/jcpp.13867]
  24. Muth��n LK, Muth��n BO. Mplus. Los Angeles, CA; 2019.
  25. R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2021.
  26. StataCorp. Stata/MP. College Station, TX: StataCorp LLC; 2021.
  27. Rah SS, Jung M, Lee K, Kang H, Jang S, Park J, et al. Systematic review and meta-analysis: real-world accuracy of children���s developmental screening tests. J Am Acad Child Adolesc Psychiatry. 2023;62:1095���109. [DOI: 10.1016/j.jaac.2022.12.014]
  28. Yan K, Tang LK, Xiao FF, Zhang P, Cheng GQ, Wang LS, et al. Brain development in newborns and infants after ECMO. World J Pediatr. 2024;20:556���68. [DOI: 10.1007/s12519-023-00768-w]
  29. Sheldrick RC, Breuer DJ, Hassan R, Chan K, Polk DE, Benneyan J. A system dynamics model of clinical decision thresholds for the detection of developmental-behavioral disorders. Implement Sci. 2016;11:156. [DOI: 10.1186/s13012-016-0517-0]
  30. Sheldrick RC, Garfinkel D. Is a positive developmental-behavioral screening score sufficient to justify referral? A review of evidence and theory. Acad Pediatr. 2017;17:464���70. [DOI: 10.1016/j.acap.2017.01.016]
  31. Xu M, Zhang H, Liu A, Zhao C, Huang X, Berman S, et al. Effectiveness and cost-effectiveness of a group-based intervention to improve social-emotional development of young children in poverty-stricken areas: A cluster randomized controlled trial. J Glob Health. 2023;13:04017. [DOI: 10.7189/jogh.13.04017]

Grants

  1. 823B2087/National Natural Science Foundation of China
  2. U23A20170/National Natural Science Foundation of China
  3. GWVI-11.2-XD16/Shanghai Municipal Health Commission
  4. Child Neurological/Shanghai Municipal Health Commission
  5. Psychological Development Screening/Shanghai Municipal Health Commission
  6. Intervention Project/Shanghai Municipal Health Commission
  7. 24dz2260100/Shanghai Key Laboratory of Child Brain and Development

MeSH Term

Humans
Child, Preschool
China
Male
Female
Developmental Disabilities
Infant
Parents
Child Development
Surveys and Questionnaires
Sensitivity and Specificity
East Asian People
Journal Article Validation Study
Article has an altmetric score of 3

Word Cloud

Created with Highcharts 10.0.0PRIDEdevelopmentDevelopmentaltoolPhasedelayDDchildren1earlyinterventionscreeningtoolsChinafocusdevelopmentaldomainschildhoodstudyParent-ReportedIndicatorEvaluationChineseChildrenage-specificforms2samplespecificityestimated9%DevelopmentvalidationBACKGROUND:poseschallengeschildren'soverallnecessitatingdetectionExistingmainlyissuestwodiagnosedglobalGDDHoweverrecentriseECDconceptsexpandedincludeseverebrainimpairmentsalsolagspecificduevarioussocial-environmentalfactorsaimpromotingpositiveactivesupportapproachcorrespondingneeddevelopedMETHODS:currentusedtwo-phasedesigndevelopvalidatemilestonecreatedsurveyconductedurbanruralprimarycareclinicsacrossfoureconomicregionsvalidatedcommunity-basedSensitivityAgesStagesQuestionnairesASQ-3usinginverseprobabilityweightsIPWmultipleimputationMIaddressplannedunplannedmissingdataRESULTS:involvingtotal1160participantsaged48 months63itemsselectedinitialitempoolcreate10included777withinagerangedemonstratedsensitivity833%[95%confidenceintervalCI:568%-1000%]8495%CI:828%-86identificationCONCLUSION:findingssuggestholdspromisesensitivedetectingcommunitysettingsCommunityEarlyScreening

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