The development and testing of a module on child functioning for identifying children with disabilities on surveys. III: Field testing.
Claudia Cappa, Daniel Mont, Mitchell Loeb and 4 others
PMID 30049638WHAT IT FOUND
Caregiver reports on the Child Functioning Module can flag children with functional difficulties.
Stricter severity thresholds, especially for behaviour and daily anxiety or depression, give more consistent estimates and fewer false positives than counting any difficulty.
Key findings
01For children aged 2–4, the recommended module cut-off identifies children with 'a lot more' difficulty controlling behaviour and at least 'a lot' difficulty in other domains, reducing false positives.
02For children aged 5–17, the recommended module cut-off identifies children with daily episodes of anxiety and depression and at least 'a lot' difficulty in other domains.
03In Serbia, the TQSI identified 16% of children aged 2–4, compared with 3.8% using the module's Cut-off 2; the WG-SS identified 1.3% of children aged 5–17, compared with 4.5% using the module's Cut-off 2.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Differences in survey administration, training and questions across countries may have influenced prevalence estimates. Variation across countries may reflect cultural understanding or accommodation levels, not only true differences in child functioning. The fine motor question was not included in Samoa because it was added after the field test, limiting cross-country comparability. Samoa used different response options for behaviour, so behaviour prevalence is not directly comparable with Mexico and Serbia. The analysis relies on caregiver report and survey cut-offs, not clinical diagnosis or medical assessment. Prevalence changes with the severity cut-off, so a child flagged under one threshold may not be flagged under another.
Declared interests
No listed author declared a conflict of interest.
The easy way to misread this
Do not read the module as a clinical diagnosis or proof that a flagged child needs treatment. The study is a survey field test, and the proportion of children identified changes with the severity cut-off.