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Evaluating Caregiver Report of Developmental Delays in Young Children

Evaluating Caregiver Report of Developmental Delays in Young Children 1024 681 Mary Bates, PhD

Caregiver-report measures of cognitive skills correlate with direct assessments by clinicians.

Researchers from Nationwide Children’s Hospital report that a standardized caregiver interview can effectively identify children at risk for cognitive developmental delays. The findings suggest that caregiver-report measures may be useful in assessing young children, particularly when direct clinical assessment is not feasible.

For children with developmental delays, access to appropriate intervention typically requires direct assessment and formal diagnosis obtained through a specialized clinic. However, direct assessment can be a challenge — for instance, during the COVID-19 pandemic or for families in remote locations or with other barriers to access.

Caregiver-report measures offer another way to assess children’s development, says Kevin Stephenson, PhD, a psychologist at Nationwide Children’s and lead author the new study.

“There are structured tools for use by caregivers but limited evidence on how they compare with direct assessments and what kind of weight we should put on them,” he says.

To investigate, Dr. Stephenson and colleagues conducted a retrospective chart review of patients referred for evaluation of developmental delay: 167 children, between 6 and 42 months old, completed both a direct assessment developmental measure, the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4), and a caregiver-report measure, the Developmental Profile 4 (DP-4).

The researchers found that a cutoff of 70 or 69 on the DP-4 was ideal for identifying developmental delay based on the Bayley-4 or a diagnosis of global developmental delay. Overall, there was a moderately strong correlation between Bayley-4 and DP-4 Cognitive scores, even after controlling for confounds such as degree of autism severity, age and sex.

“The biggest implication is that parents are accurate reporters of their children’s cognitive skills,” says Dr. Stephenson. “With this structured interview, which is straightforward and easy to administer, parents can provide reliable, valid information on a child’s development.”

Given the young age of this sample, the researchers say that further work is needed to determine how well these results may generalize to older children. Future research should also explore agreement between the DP-4 and other cognitive measures, such as IQ tests.

While the findings support the reliability of parent-report measures, the authors emphasize the need for multiple sources of information when assessing development in early childhood.

“Ideally, parent-report measures should be one part of a full, comprehensive evaluation,” says Dr. Stephenson. “But when we have to rely on a parent-report, we know that the DP-4 is a helpful tool that can help us determine whether a child has a developmental delay, even in the absence of a direct assessment.

“It’s good news that there are multiple ways we can assess developmental skills accurately in young children.”

 

Reference:

Stephenson KG, Vargo KC, Cacciato NM, Albright CM, Kryszak EM. Developmental Assessment in Children at Higher Likelihood for Developmental Delays – Comparison of Parent Report and Direct Assessment. Journal of Autism and Developmental Disorders. 2024 Jun 14. doi: 10.1007/s10803-024-06420-4.

Image credit: Adobe Stock

About the author

Mary a freelance science writer and blogger based in Boston. Her favorite topics include biology, psychology, neuroscience, ecology, and animal behavior. She has a BA in Biology-Psychology with a minor in English from Skidmore College in Saratoga Springs, NY, and a PhD from Brown University, where she researched bat echolocation and bullfrog chorusing.

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