Screening Terminology

Understanding screening lingo makes it easier for you to choose the best screening tool for your program

cutoff point

The score that indicates when a child’s development is a concern and referral for further assessment may be appropriate. The cutoff point is empirically derived by standardizing the tool with large numbers of children.

developmental delay

A child who is not developing skills at the expected age (even after consideration for broad differences among individual children) is considered to have a developmental delay. Some children with developmental delays may catch up with their typically developing peers, whereas others may persist in having a developmental disability.

early intervention

Services for infants and toddlers that are designed to identify and treat a problem or delay as early as possible. The services may be offered in a variety of settings—home, clinic, doctor’s office, center—and involve a variety of professionals.

medical home

In a medical home approach to care, the pediatrician partners with the child's family to meet the medical (and non-medical) needs of the child. The pediatrician helps families use and coordinate specialty care and services that are important to the health and well-being of the child.

monitoring

Periodic developmental screening of young children to catch delays that may not be evident in a single screening.

overreferral (or overidentification)

The proportion of children incorrectly identified by a screening tool as in need of further assessment. (This proportion is determined by the results of subsequent in-depth assessments of referred children.)

positive predictive value

The proportion of children identified by a screening tool as needing further assessment who will, in fact, have intervention needs.

psychometrics

The validity, reliability, and utility of a screening tool (or other assessment instrument) determined through research on the tool (definitions of key psychometrics).

screening

A brief assessment designed to identify children who may have delays and should be referred for more in-depth assessment. Screening does not lead to a diagnosis; it simply identifies children who may not be developing typically and may need extra attention.

surveillance

An ongoing process of monitoring a child's development. Professionals conducting surveillance typically gather information about the child’s development and behavior from multiple sources, including direct observation.

underreferral (or underidentification)

The proportion of children incorrectly identified as developing typically by the screening tool.

	Understanding Psychometrics In order to be a high quality screening tool, the tool must be highly accurate. These are the measures commonly used to determine a tool's accuracy: reliability The ability of a screening tool to produce stable and consistent results (regardless of who administers it) when it is repeated under identical conditions. interrater reliability The consistency of results when the tool or test is administered by different people to the same child. High agreement indicates that the tool or test items are concise and able to be interpreted objectively. intrarater reliability The consistency of results when the tool or test is repeatedly administered by the same person. test-retest reliability The consistency of results when the tool or test is administered at different times by the same person using the same testing methods. This measure indicates a test’s consistency over time, and the degree of consistency is often dependent on the amount of time between assessments, with shorter periods having better results. internal consistency The consistency of items within a tool or test, which demonstrates the degree to which all test items measure the same trait or dimension. split-half reliability This measure is calculated by dividing the questionnaire into two equal halves and correlating the two regarding their measurement accuracy. sensitivity The probability that a screening tool will correctly identify children who have developmental delays or disorders. specificity The probability that a screening tool will correctly identify children who are developing typically. validity The extent to which a screening tools measures the actual quality or trait that it says it measures. content validity The extent to which a screening tool actually measures all aspects of the quality or trait. construct validity The extent to which a screening tool measures the construct that it was designed to measure. Construct validity can be verified by comparing it with another test with the same goal or by evaluating the test’s ability to differentiate between two groups known to differ on the particular characteristic of interest. criterion validity How well the test performs in relation to an established “gold standard” used to evaluate the same characteristic.

The National Center of Medical Home Initiatives for Children with Special Needs. Retrieved January 2, 2006 from http://www.medicalhomeinfo.org/

National Dissemination Center for Children with Disabilities. Finding Help for Young Children with Disabilities (Birth–5). Retrieved February 13, 2006 from http://www.nichcy.org/pubs/parent/pa2txt.htm 

Rydz, D., Shevell, M. I., Majnemer, A., & Oskoui, M. (2005). Developmental screening. Journal of Child Neurology, 20(1), 4–21.