Screening for pickiness - a validation study

Picky eating is prevalent in childhood and is associated with negative health outcomes. Therefore early detection of pickiness is pertinent. Because no psychometric measure of picky/fussy eating has been validated, we aimed to examine the screening efficiency of the 6-item ‘Food Fussiness’ (FF) scale from the Children’s Eating Behavior Questionnaire using structured psychiatric interviews (the Preschool Age Psychiatric Interview), providing meaningful cut-off values based on a large, representative sample of Norwegian 6 year olds (n = 752). Screening efficiency was evaluated using receiver operating characteristic curve analysis, revealing excellent discrimination. The cut-point maximizing the sum of sensitivity and specificity for the scale was found at a score of 3.33 for severe cases and 3.00 when both moderate and severe pickiness were included. The results suggest that the FF scale may provide a tool for identification of clinically significant picky eating, although further assessment may be needed to separate moderate from severe cases

Screening for persistent psychopathology in 4-year-old children

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Detecting Psychiatric Disorders in Preschoolers: Screening With the Strengths and Difficulties Questionnaire

Objective: To examine screening efficiency for preschool psychopathology by comparing the Strengths and Difficulties Questionnaire findings against diagnostic information, and to determine the added value of impact scores and teacher information. Method: Using a 2-phase sampling design, a population-based sample of 845 children 4 years of age was recruited from community health check-ups in Trondheim, Norway, screen score stratified and oversampled for high screening scores. Blinded to screen ratings, DSM-IV diagnoses were assigned using the Preschool Age Psychiatric Assessment interview, against which the Strengths and Difficulties Questionnaire scores were compared through receiver operating characteristic analysis. Results: Emotional and behavioral disorders were identified through parent ratings with a specificity of 88.8% (range, 87.0%–90.6%) and a sensitivity of 65.1% (range, 51.6–78.6%). The negative predictive value was 97.9% (range, 96.8%–98.9%), whereas the positive predictive value was 24.2% (range, 18.0%–30.3%) at a prevalence of 5.2%. Parental ratings identified more behavioral disorders (79.3%) than emotional disorders (59.2%). Screening for any disorder was somewhat less efficient: specificity, 88.9% (range, 87.0%–90.7%); sensitivity, 54.2% (range, 41.8%–66.6%); negative predictive value, 96.4% (range, 95.0%–97.8%); and positive predictive value, 25.9% (range, 19.6%–32.2%) at a prevalence of 6.7%. The area under the curve (AUC) value was 0.83 (range, 0.76–0.90) for emotional and behavioral disorders and 0.76 (range, 0.68–0.83) for any disorder. The prediction accuracy was not improved by impact scores or teacher information. Conclusions: The results indicate that preschoolers' emotional and behavioral disorders can be screened with the same efficiency as those of older children and adults. Other disorders were identified to a lesser extent. Further research should explore the potential of preschool screening to improve early detection and subsequent intervention.acceptedVersio

Detecting Psychiatric Disorders in Preschoolers: Screening With the Strengths and Difficulties Questionnaire

Objective: To examine screening efficiency for preschool psychopathology by comparing the Strengths and Difficulties Questionnaire findings against diagnostic information, and to determine the added value of impact scores and teacher information. Method: Using a 2-phase sampling design, a population-based sample of 845 children 4 years of age was recruited from community health check-ups in Trondheim, Norway, screen score stratified and oversampled for high screening scores. Blinded to screen ratings, DSM-IV diagnoses were assigned using the Preschool Age Psychiatric Assessment interview, against which the Strengths and Difficulties Questionnaire scores were compared through receiver operating characteristic analysis. Results: Emotional and behavioral disorders were identified through parent ratings with a specificity of 88.8% (range, 87.0%–90.6%) and a sensitivity of 65.1% (range, 51.6–78.6%). The negative predictive value was 97.9% (range, 96.8%–98.9%), whereas the positive predictive value was 24.2% (range, 18.0%–30.3%) at a prevalence of 5.2%. Parental ratings identified more behavioral disorders (79.3%) than emotional disorders (59.2%). Screening for any disorder was somewhat less efficient: specificity, 88.9% (range, 87.0%–90.7%); sensitivity, 54.2% (range, 41.8%–66.6%); negative predictive value, 96.4% (range, 95.0%–97.8%); and positive predictive value, 25.9% (range, 19.6%–32.2%) at a prevalence of 6.7%. The area under the curve (AUC) value was 0.83 (range, 0.76–0.90) for emotional and behavioral disorders and 0.76 (range, 0.68–0.83) for any disorder. The prediction accuracy was not improved by impact scores or teacher information. Conclusions: The results indicate that preschoolers' emotional and behavioral disorders can be screened with the same efficiency as those of older children and adults. Other disorders were identified to a lesser extent. Further research should explore the potential of preschool screening to improve early detection and subsequent intervention

Prevalence of psychiatric disorders in preschoolers

Background:  Many disorders in childhood and adolescence were already present in the preschool years. However, there is little empirical research on the prevalence of psychiatric disorders in young children. A true community study using structured diagnostic tools has yet to be published. Methods:  All children born in 2003 or 2004 in the city of Trondheim, Norway, who attended the regular community health check-up for 4-year-olds (97.2% of eligible children) whose parents consented to take part in the study (N = 2,475, 82.0%) were screened for behavioral and emotional problems with the Strengths and Difficulties Questionnaire (SDQ). A screen-stratified subsample of 1,250 children took part in a furthermore comprehensive study including a structured diagnostic interview (the Preschool Age Psychiatric Assessment, PAPA), which 995 parents (79.6%) completed. Results:  The estimated population rate for any psychiatric disorder (excluding encopresis – 6.4%) was 7.1%. The most common disorders were attention deficit hyperactivity disorder (1.9%), oppositional defiant disorder (1.8%), conduct disorder (0.7%), anxiety disorders (1.5%), and depressive disorders (2.0%). Comorbidity among disorders was common. More emotional and behavioral disorders were seen in children whose parents did not live together and in those of low socioeconomic status. Boys more often had attention-deficit/hyperactivity disorder (ADHD) and depressive disorders than girls. Conclusions:  The prevalence of disorders among preschoolers was lower than in previous studies from the USA. Comorbidity was frequent and there was a male preponderance in ADHD and depression at this early age. These results underscore the fact that the most common disorders of childhood can already be diagnosed in preschoolers. However, rates of disorder in Norway may be lower than in the USA