the survey of well-being of young children (swyc) ellen c. perrin, m.d. r. christopher sheldrick,...
TRANSCRIPT
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The Survey of Well-being of Young Children
(SWYC)
Ellen C. Perrin, M.D.R. Christopher Sheldrick, Ph.D.
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We have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in this CME activity.
We do not intend to discuss an unapproved/investigative use of a commercial product/device in this presentation.
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Historical perspective
• Rosie D. lawsuit• CBHI• Available Instruments
– Lengthy– Proprietary– Scoring complex– Fragmented
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Our goals
• Surveillance Instrument (birth to 5)– First level screening– Integrate “behavior” and “development”– Include family context/risks– Quick to fill out, score & interpret– “Developmental growth curve”
• Free and in public domain• Amenable to electronic format
– Computer– Telephone– Internet
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DevelopmentBehavior
Family Context
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DevelopmentBehavior•Internalizing•Externalizing
Family Risk
Baby Pediatric Symptom
Checklist (BPSC)
Preschool Pediatric Symptom Checklist
(PPSC)
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Development•Delays•Autism
Behavior•Internalizing•Externalizing
Family Risk
Baby Pediatric Symptom
Checklist (BPSC)
Preschool Pediatric Symptom Checklist
(PPSC)
Milestones
Parent’s Observations of
Social Interactions (POSI)
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DevelopmentBehavior
FAMILY RISK FACTORS
Family Risk
FAMILY RISK FACTORSDepressionPHQ-2Substance AbuseAlcoholTobacco Other drugsParental DiscordHunger
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Four Domains
• Social-emotional-behavioral– BPSC (Birth to 18 months) – 12 items– PPSC (18 months to 5 years) – 18 items
• Cognitive, Language and Motor– Milestones (each WCV) – 10 items
• Autism– POSI (18 to 36 months) – 7 items
• Family Risks– Each WCV - 11 items
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SWYCPsychometrics!
• Latent variable modeling• Comparative effectiveness
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Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8
Item 9
Item 10
Item 11
Item 12
Item 13
Item 14
Item 15
Item 16
Item 17
Item 18
Social/emotional problems
f1
f2
f3
Latent variable modelingPPSC bifactor model
general factor
item clusters
•Reliability
•Differential Item Functioning
SES ?
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PPSC
ASQ-SE
PPSC
ASQ-SE
PRIMARY CARE SAMPLESensitivity Specificity
Total Internalizing Externalizing
CBCL 1.5-5
Total Internalizing Externalizing
CBCL 1.5-5
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
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PPSC
ASQ-SE
Sensitivity Specificity
PPSC
ASQ-SE
Total Internalizing Externalizing
CBCL 1.5-5
Total Internalizing Externalizing
CBCL 1.5-5
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
CLINIC SAMPLE
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Sensitivity Specificity
ADHD Anxiety Behavior or Conduct Any diagnosis
Parent report of existing diagnosisSpecificity
PPSC
ASQ-SE
CBCL 1.5-5
0.0
0.2
0.4
0.6
0.8
1.0
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Other SWYC studies
• POSI v MCHAT• Milestones v ASQ-3• BPSC v ???
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Example SWYC Forms
12-Month 24-MonthMilestones
Social/ Emotional Behavior
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Page 2 (on the back)
12-Month 24-MonthAutism
Family RiskQuestions
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Summary• Surveillance/first level screening instrument• Includes
– Cognitive, language, motor, and social-emotional development
– Autism spectrum disorders– Family context/risks
• Compares well with older instruments• Free, public domain• English and Spanish• Convertible to computer platform
– Tailored for child’s age– Link to follow-up questionnaires