Developing a Screening Tool for Young Children Using an Ecological Framework.
Carmela J DeCandia, Katherine T Volk, George J Unick and 1 others
PMID 34211253WHAT IT FOUND
A new screening tool for homeless children was tested with 60 families.
Most questions worked well, but items about daily skills and parenting did not fit and were replaced. The tool is feasible for staff to use, but it is not yet proven to accurately identify developmental delays.
Key findings
01Fifty-eight of the 72 initial questions demonstrated strong reliability, while 13 were eliminated for poor fit.
02Items measuring activities of daily living and parenting competence showed low reliability and were removed or reworked for the next phase.
03Program staff reported the tool fit their workflow and took only 15 minutes to complete.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (60 participants) and limited to one geographic area, so the results may not apply to other populations. The study relied entirely on parent self-report, which can be biased. The confirmatory factor analysis models were underpowered, meaning the statistical checks on the tool's structure are not fully reliable. This is a pilot study for tool development, not a validation study proving the tool accurately identifies developmental delays.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not use NEST in clinical practice yet. This was a pilot study to see which questions worked, not a test of whether the tool accurately identifies children with developmental delays. The tool is still being revised and validated in a larger study.