Psychometric properties of the rapid neurodevelopmental assessment in detecting social-emotional problems during routine child developmental monitoring in primary healthcare.

Abstract

The global prevalence of social-emotional problems in children and adolescents is nearly double in First Nations populations compared to non-First Nations populations, highlighting health inequities due to the impact of colonisation. Addressing this requires culturally responsive social-emotional screening in primary healthcare, enhanced by a simple, psychometrically sound tool. The Rapid Neurodevelopmental Assessment (RNDA) is user-friendly, incorporates child observations and parental input, and can be used by primary healthcare providers. This study evaluated the RNDA's performance in screening social-emotional problems during routine health checks with First Nations children. Working with an Aboriginal Community Controlled Health Organisation in Australia, children (60% male, 92% identifying as First Nations) aged 3 to 16 years (M = 8.40, SD = 3.33) and a caregiver participated in this study as part of a health check. The convergence with, and accuracy of, children's scores derived from single-item measures of seven social-emotional problems on the RNDA was compared to their corresponding multi-item scores from the parent-report Behavior Assessment System for Children 3rd Edition (BASC-3). Each of the single-item measures on the RNDA were significantly correlated with the corresponding multi-item construct on the BASC-3, except for anxiety. The total accuracy of the RNDA relative to the BASC-3 was 58 to 81%, with high sensitivity for four of the seven items: hyperactivity (90%), attention problems (87%), externalising problems (82%) and behaviour symptoms index (88%). Sensitivity of the remaining items ranged from 14 to 71% and specificity ranged from 29 to 88%. The measure showed an average positive predictive value of 50% and negative predictive value of 75%. The single-item measures within the RNDA's behaviour domain showed good convergent validity relative to the BASC-3. Most items had acceptable accuracy, comparable with similar screening measures. These findings further support the RNDA's integration into First Nations child health checks, allowing for a rapid, holistic assessment of child development to improve health equity.