National Framework for Universal Child and Family Health Services

Appendix 3 : Tools to assist in health surveillance and monitoring

Page last updated: 20 May 2013

Tools for assessing child development

Tool Description
Parents’
Evaluation of
Developmental
Status (PEDS)
  • For detecting developmental and behavioural problems in children birth to 8 years via parent report.
  • The 10 item questionnaire facilitates parent and professional communication about development and is designed to be a part of a regular monitoring process [51, 64].
  • When used as a screening tool, PEDS requires the use of a secondary screen e.g. ASQ to reduce the chance of unnecessary referral.
  • The tool covers the following nine domains: global/cognitive; expressive language and articulation; receptive language; fine motor; gross motor; behaviour; socialemotional; self-help and school readiness.
Ages and Stages
Questionnaire
(ASQ)
  • For identifying developmental delays in children aged three months to five years.
  • The tool is completed by parents and is specifically designed to be incorporated into a child health monitoring program [51].
  • The ASQ is also used as a monitoring tool to gauge the development for children at risk of developmental disabilities or delay.
  • The tool comprises a series of 19 separate questionnaires for different ages grouped by months of age, with 30 items per questionnaire. Each questionnaire includes clear drawings and simple directions to help parents to identify their child’s skills[51].
  • The ASQ provides developmental information in five key domains: communication; gross motor skills; fine motor skills; problem solving and personal/social skills.
  • The Ages and Stages Social Emotional Questionnaires (ASQ:SE) can be used as an additional screening tool if a delay is noted in the personal/social skills domain of the ASQ.
Brigance
Screens
  • For measuring development for children aged birth to seven years of age with a greater focus on academic ability than other screening tests, identifying both gifted children and children with delays [51].
  • Brigance Screens use both direct elicitation and observation. Parents can also report on their children’s skills [51].
  • The Screens consist of seven separate forms, one for each 12-month age range.
  • The infant version (birth to 11 months) contains 85 items and the toddler version (12 to 23 months) contains 83 items. Children point to pictures upon request and display specified skills.
  • The infant and toddler Screens cover six domains: fine motor skills; gross motor skills; receptive language; expressive language and self-help skills.
Child
Development
Inventory (CDI)
  • The CDI is a set of three parent-reporting instruments, each with 60 yes/no items and additionally, a General Development Scale.
  • Appropriate for children and toddlers aged between three and 72 months.
  • The tool can indicate school readiness and placement in early childhood special education.
  • The tool provides a report of child observation in eight domains: social; self-help; gross motor; fine motor; expressive language; language comprehension; letter and numbers [65].

Tools for assessing preschool visual acuity screening

Tool Description
LEA paediatric
vision tests
  • LEA Symbols are appropriate for vision screening in children older than 3.5 years of age [53].
  • There are 8 LEA Paediatric vision tests: visual acuity for near and distance; grating acuity; contrast sensitivity; visual field; colour vision; visual adaptation; oculomotor functions and accommodation; and tests for visual perception [124].
Sheridan
Gardiner
  • A well-established vision screen designed for children. The Sheridan-Gardiner Test contains near vision, distance and reduced Snellen tests [53].

Tools for assessing child socioemotional wellbeing

Tool Description
Ages and
Stages Social
and Emotional
Questionnaires
(ASQ:SE)
  • A tool for monitoring social emotional development for children aged between 3 to 66 months. It complements the original ASQ with a more specific focus on the personal-social skills domain. The tool identifies whether a child is in need of further assessment.
  • Eight age-specific parent completed questionnaires, each with between 22 and 36 social emotional development items.
  • Seven characteristics items identified in the ASQ:SE are: self-regulation; compliance; communication; adaptive functioning; autonomy; affect and interaction with people.
Neonatal
Behavioural
Assessment
Scale (NBAS or
the Brazelton)
  • A neuro-behavioural assessment of infants from birth to two months of age,premature babies from about 35 weeks gestation and with infants who are developmentally delayed.
  • Designed to identify the newborn’s contribution to the parent/infant relationship, the competencies and individual differences of the newborn and any difficulties [68].
  • The first scale to assess infant competencies in a social context. The tool emphasises how the infant’s individual differences affect parental caregiving and infant development [125].
  • Consists of 28 behavioural items each scored on a 9-point scale, which assess the infant’s behavioural response to positive and negative stimuli. There are a total of 53 features that can be scored, some of which are administered and some observed during the assessment, like startles, tremors, skin colour and other signs of stress or withdrawal, approach signals and smiles.
  • Seven supplementary items capture the range and quality of the behaviour of frail, high-risk infants.
  • The materials used for the assessment are a torch, bell, rattle, and a red ball to look at habituation and orientation. The examiner’s face and voice are also used for orientation. There are 18 reflex items, each scored on a 4-point scale, which assess the infant’s neurological status, although it is a screening tool and is not diagnostic.
  • It is recommended that to better understand the infant behaviour and adaptation over time, the infant should be assessed more than once within the first four weeks of birth. For use as in intervention, the NBAS should be done three times within the first four weeks of birth [68].
Strengths and
Difficulties
Questionnaire
(SDQ)
  • A tool that determines psychological attributes and screens for behavioural disorders in children aged three to 16 years.
  • Completed by parents or teachers.
  • There are six versions of the SDQ currently specified under the National Outcomes and Casemix Collection [69] (Australian Mental Health Outcomes and Classification network). Two of these are relevant to the birth to 8 years age group: - PC1: Parent Report Measure for Children aged four to 10 years, baseline version. - PC2: Parent Report Measure for Children and Adolescents aged four to 10, follow-up version.
  • The tool consists of either three or (all) four of the following components
1. 25 items and five clinical scales measuring: hyperactivity / inattention; emotional symptoms; conduct problems; peer relationship problems; pro-social behaviour;
2. an impact supplement;
3. cross informant information; and
4. follow-up questions.
Paediatric
Symptom
Checklist
  • A psychological screen used to identify and refer psychological problems
  • Two versions of the Checklist – one for parents to complete if their child is under 11 years of age (PSC), and the other for children to complete if they are aged 11 years and above (Y-PSC) [126].
  • Facilitate the identification of problems in the cognitive, emotional and behavioural domains.
  • Contains 35 scored items. It has separate cut-off scores for children aged four to five years and six to 16 years.
Nursing Child
Assessment
Satellite
Training
(NCAST) —
Parent-Child
  • The Parent Child Interaction (PCI) Scales (for feeding and teaching) are widely used scales for measuring parent/child interaction.
  • Two scales – the Feeding Scale (for infants aged birth to 12 months) and the Teaching Scale (for infants and children aged birth 36 months).
  • Both scales include a set of observable behaviours that can describe parent/child interaction during the respective situation for standardised age-appropriate tasks.
  • The tools describe the behaviour, response patterns and overall interaction between a parent and infant and provide two conceptually parallel observations of parent/child interaction.
  • The scales build upon caregiver and child strengths in the relationship and identify areas that may benefit from intervention [70].
Modified
Checklist
for Autism
in Toddlers
(M-CHAT)
The M-CHAT is validated for screening toddlers between 16 and 30 months of age, to assess risk for autism spectrum disorders (ASD). The M-CHAT can be administered and scored by universal child and family health services as part of the well-child check-up, and also can be used by specialists or other professionals to assess risk for ASD.

A good overview of the M-CHAT is provided at Royal Children's Hospital website