Preschool Communication: Early Identification of Concerns About Preschool Language Development and Social Participation.

Background: Adverse communication development in preschool children is a risk factor influencing child health and well-being with a negative impact on social participation. Language and social skills develop and maintain human adaptability over the life course. However, the accuracy of detecting language problems in asymptomatic children in primary care needs to be improved. Therefore, it is important to identify concerns about language development as a risk factor for child health. The association between parental and professional caregivers' concerns about language development and the level of preschool social participation was assessed, as well as the possible mediating/moderating effect of the perception of social competence. In addition, validity and predictive value of parental and professional caregivers' concerns about language development were tested. Methods: To identify emerging concerns about development and social participation, a community sample of 341 preschool children was systematically assessed with a comprehensive preventive child health care "toolkit" of instruments, including parent-completed tools like the Parents' Evaluation of Developmental Status (PEDS) and child competence Visual Analog Scales (VAS). At baseline, children were aged 3 years and at follow-up ~4 years. Results: There was a statistically significant association between parental and professional caregivers' concerns about language development and the level of preschool social participation, with a mediating effect of child social competence at the age of 3 years as well as 4 years. Negative predictive value of parental and professional caregiver language concerns at the age of 3 and 4 years were 99 and 97%, respectively. Furthermore, this article showed that while some preschool children grow out of language problems, others may develop them. Conclusion: Short but valid pediatric primary care tools like the PEDS and child competence VAS can support monitoring and early identification of concerns about language development and social competence as a risk factor for preschool social participation. Personalized health care requires continued communication between parents, professional caregivers and preventive child health care about parental and professional caregiver perceptions concerning preschool language development as well as the perception of a child's social competence.

Validation of short instruments assessing parental and caregivers' perceptions on child health and development for personalized prevention.

Systematically exploring parental as well as other caregivers' concerns is a main component in preventive child health care (PCHC) for family-centred practice and personalized health care. To facilitate communication and early identification of emerging mental health problems, a PCHC toolkit based on short instruments was developed. This article investigates the reliability and validity of (1) two visual analogue scales (VAS) to assess parent-reported 'parenting' and 'child behaviour', (2) a professional caregiver-reported VAS to assess 'child competence' and (3) the parents' evaluation of developmental status (PEDS) in Dutch PCHC. Parents as well as child care, kindergarten and preschool teachers completed instruments in a community-based sample of children (N = 346) aged 3 years at baseline. The three VAS and PEDS were associated with standardized questionnaires assessing the same constructs. Overall predictive accuracy showed: good to excellent for 'parenting' VAS, fair to good for 'child behaviour' VAS and poor for 'child competence' VAS. The PEDS, 'parenting' VAS and 'child behaviour' VAS, demonstrated high sensitivity at various cut-off points of index test and reference standard. At follow-up, approximately 1 year later, results were similar. Although the 'child competence' VAS scored lower on one aspect of validity, the PEDS and the different VAS are reliable, valid and useful as brief monitoring tools in daily Dutch PCHC practice.