Identification of psychosocial problems among 0-4 years old by the Child Preventive Health care

In the Netherlands, 4-6% of the children aged 0-4 years old have psychosocial
problems. It*s becoming increasingly clear that the older the child, the more
difficult it is to deal with the problems, and that the early treatment of
young children has the greatest effect. As such, it is important to spot the
signs early on that a child (and/or parent) is in need of extra support. The
Youth Healthcare organisation (JGZ) reaches almost all children in the age
range of 0-4 years old in the Netherlands and, as such, it is an important link
in the early detection of psychosocial problems in children. However, less than
half of the young children with problems are identified by the JGZ. An
important reason for this is that, in the Netherlands, there are no proven,
validated and usable short questionnaires for helping to detect these problems
in these children.

A questionnaire for detecting psychosocial problem in the JGZ should include
some criteria, namely:
- Directed at emotional and behavioural problems.
- having a goed validity and reliability.
- useable among persons with a lower education en persons who are not that good
in dutch.
- useable in the practic of the JGZ: meaning, easy to score and provides leads
for the contact with the parents
- Is useables for specific age groups in the age group 0-4 and the items
describe oriblems that are relevant for these specific age groups.

Although there are no validated questionnaires for the identification of
psychosocial problems among young children, the KIPPPI is being used in some
JGZ-organisations. Furthermore there are some promising questionnaires
available in the US and in the UK. These questionnaires will be eligible for
these validation study.
In this study several of these questionnaires will be compared in terms of
validity, reliability, specificity and sensitivity and in terms of utility in
the JGZ. The results of this study will be used to give a recommendation on the
instruments that can best be used for the identification of psychosocial
problems among 0-4 years old in the JGZ.

The aim of the present study is to assess which short questionnaire can play an
important role in the identification of psychosociale problems among children
aged 0-4 by the JGZ . This operationalized by the following questions:


- Which short questionnaires give the best results with respect to psychometric
properties: validity, reliability, specificity and sensitivity?
- Have the screening lists an added value for the JGZ in the sense that they
provide information about the prevention of psychosocial problems, additional
to the information that a JGZ employee gets by taking a standard anamnesis and
doing a check-up?
- Which screening lists are suitable for wide scale use within the JGZ 0-4?

We have decided to include four short questionnaire for the detection of
psychosocial problems in the study: the BITSEA (Briggs-Gowan e.a. 2004), the
SDQ * (Widenfelt e.a., 2003; Vogels e.a., 2005), the ASQ:SE (Squires e.a.
2001), and the KIPPPI (Romijn & Kousemaker, 2001). The KIPPPI is used in
several JGZ-organisations but has not been validated. The SDQ has been
validated for the age group 7-12 years old but not the younger group. The two
other questionnaires are promising for the Dutch situation. They have been
validated in other countries.
The study consists of four phases. Phase 1 involves the translation and
modification of the short questionnaires that are used for screening for
psychosocial problems in young children (such as the ASQ:SE). Phase 2 is the
data collection phase. Parents of children in different age cohorts fill in
these questionnaires and the Child Behaviour Checklist (validation criterion)
and the JGZ records the background characteristics of the family and their own
opinion about the presence of any psychosocial problems.
A year later, the children are assessed again to determine the predictive value
of the short questionnaires. In phase 3 the usefulness of the questionnaires
within the JGZ is investigated and in phase 4 the various outcomes of the
questionnaires are compared with each other, after which a recommendation will
be given as to which instruments are most suitable for screening for
psychosocial problems.

Not applicable