Development of a screening test for mild developmental disorders (MDDs) in preschool children

Objectives: The symptoms of attention-deficit/hyperactivity disorder (ADHD), pervasive developmental disorder (PDD), mild mental retardation, and learning disorders (LDs) overlap. In Japan, these disorders are considered as mild developmental disorders (MDDs). Although it is difficult to strictly distinguish these disorders, detection of MDDs in pre-school children is important from the public health viewpoint. The purpose of this study was to develop a simple screening questionnaire for detecting of MDDs in pre-school children.

Methods: Thirty-four questions were selected from previous studies. These questions addressed children's social skills, attention, communication, imagination, etc. We conducted a case-control study at several rural pediatric hospitals in Japan. The case subjects were 43 children diagnosed with MDD. The controls were 67 outpatient children without MDD. Parents answered the questionnaire for their children. After discriminant analysis, test-retest reliability and internal consistency were assessed.

Results: Stepwise regression revealed that 13 of the 34 questions were the most discriminant. By factor analysis, these 13 questions were divided into 3 factors. The first factor was characterized by ADHD symptoms and the second and third factors, by PDD symptoms. The test-retest reliability and internal consistency were acceptable. The scores of the case subjects were distributed in lower, while those of the controls were distributed in higher. The lowest score for the case subjects was 11. With this score as the cut-off point, the sensitivity was 1.0 and the specificity, 0.86.

Conclusion: We developed a simple 13-question questionnaire to screen children with MDD. It will soon be assessed in community-based studies.