Primary care physicians (PCPs) frequently serve pediatric patients with developmental delays and disorders (DD/D). Although the most widely used primary care behavioral health screener, the Pediatric Symptom Checklist-17 (PSC-17), is validated for use with children without DD/D, it is unclear whether this measure accurately identifies behavioral health symptoms in youth with DD/D. Thus, the purpose of this study was to assess the psychometric properties of the PSC-17 for children with DD/D. Medical record data from 3596 pediatric patients at a primary care clinic were analyzed. Descriptive analyses, measurement invariance testing, and internal consistency evaluations were conducted to assess the psychometric properties of the PSC-17. The results of these analyses support the use of the PSC-17 for behavioral health screening for children with DD/D. Behavioral health screening in this population is critical, because the timely identification of behavioral health concerns can facilitate early intervention, which may enhance long-term functioning.
ZablotskyBBlackLIMaennerMJ, et al. Prevalence and trends of developmental disabilities among children in the United States: 2009–2017. Pediatrics. 2019;144(4):e20190811.
2.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. Washington, D.C: American Psychiatric Association; 2022.
3.
EvansSWOwensJSBunfordN.Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. J Clin Child Adolesc Psychol. 2014;43(4):527-551. doi:10.1080/15374416.2013.850700.
4.
HolmbeckGNDevineKABrunoEF. Developmental issues and considerations in research and practice. In: JRWeiszAEKazdin, eds. Evidence-based Psychotherapies for Children and Adolescents. New York, NY: Guilford; 2010:28-39.
5.
JonesKDaleyDHutchingsJBywaterTEamesC.Efficacy of the incredible years programme as an early intervention for children with conduct problems and ADHD: long-term follow-up. Child Care Health Dev. 2008;34(3):380-390. doi:10.1111/j.1365-2214.2008.00817.x.
6.
MazurekMOKanneSMWodkaEL.Physical aggression in children and adolescents with autism spectrum disorders. Res Autism Spectr Disord. 2013;7(3):455-465. doi:10.1016/j.rasd.2012.11.004.
7.
ZablotskyBKalbLGFreedmanBVasaRStuartEA.Health care experiences and perceived financial impact among families of children with an autism spectrum disorder. Psychiatr Serv. 2014;65(3):395-398. doi:10.1176/appi.ps.20120055.
8.
PerrinJMCouryDLJonesNLajonchereC.The autism treatment network and autism intervention research network on physical health: future directions. Pediatrics. 2012;130(suppl 2):S198-S201. doi:10.1542/peds.2012-0900S.
9.
ShellmanABMeinertACCurtisDF.Physician utilization of a universal psychosocial screening protocol in pediatric primary care. Clin Pediatr (Phila). 2019;58(9):957-969. doi:10.1177/0009922819845878.
10.
Centers for Disease Control and Prevention. Percentage of children aged <18 years who received a well-child checkup in the past 12 months, by age group and year—national health interview survey, United States, 2008 and 2018. MMWR Morb Mortal Wkly Rep. 2020;69:222. doi:10.15585/mmwr.mm6908a5.
11.
KozlowskiAMMatsonJLHorovitzMWorleyJANealD.Parents’ first concerns of their child’s development in toddlers with autism spectrum disorders. Dev Neurorehabil. 2011;14(2):72-78. doi:10.3109/17518423.2010.539193.
12.
American Academy of Pediatrics. The case for routine mental health screening. Pediatrics. 2010;125(suppl 3):s133-s139. doi:10.1542/peds.2010-0788J.
13.
HymanSLLevySEMyersSM.Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):e20193447. doi:10.1542/peds.2019-3447.
14.
VolkmarFSiegelMWoodbury-SmithM, et al. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2014;53(2):237-257. doi:10.1016/j.jaac.2013.10.013.
15.
MannionALeaderG.Comorbidity in autism spectrum disorder: a literature review. Res Autism Spectr Disord. 2013;7(12):1595-1616. doi:10.1016/j.rasd.2013.09.006.
16.
Van CleaveJHolifieldCNeumeyerAM, et al. Expanding the capacity of primary care to treat co-morbidities in children with autism spectrum disorder. J Autism Dev Disord. 2018;48(12):4222-4230. doi:10.1007/s10803-018-3630-x.
17.
GardnerWMurphyMChildsG, et al. The PSC-17: a brief pediatric symptom checklist with psychosocial problem subscales. Ambul Child Health. 1999;5:225-225.
18.
MurphyJMBergmannPChiangC, et al. The PSC-17: subscale scores, reliability, and factor structure in a new national sample. Pediatrics. 2016;138(3):e20160038. doi:10.1542/peds.2016-0038.
19.
DiStefanoCLiuJBurgessY.Investigating the structure of the pediatric symptom checklist in the preschool setting. J Psychoeduc Assess. 2017;35(5):494-505. doi:10.1177/0734282916647648.
20.
StoppelbeinLGreeningLMollGJordanSSuozziA.Factor analyses of the pediatric symptom checklist-17 with African-American and Caucasian pediatric populations. J Pediatr Psychol. 2012;37(3):348-357. doi:10.1093/jpepsy/jsr103.
21.
LanceCEButtsMMMichelsLC.The sources of four commonly reported cutoff criteria: what did they really say?Organ Res Methods. 2006;9(2):202-220. doi:10.1177/1094428105284919.
22.
ByrneBM.Structural equation modeling with Mplus: basic concepts, applications and programming. New York, NY: Taylor & Francis;2012.
23.
ChenFF.Sensitivity of goodness of fit indexes to lack of measurement invariance. Struct Equ Model. 2007;14(3):464-504. doi:10.1080/10705510701301834.
24.
VandenbergRJLanceCE.A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organ Res Methods. 2000;3(1):4-69. doi:10.1177/109442810031002.
25.
MaennerMJWarrenZWilliamsAR, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2020. CDC Morb Mortal Wkly Rep. 2023;72(2):1-12. doi:10.15585/mmwr.ss7202a1.
26.
BlackLIVahratianAHoffmanHJ.Communication disorders and use of intervention services among children aged 3-17 years: United States, 2012. NCHS Data Brief. 2015(205):1-8.
27.
CaplanPJCosgroveL eds. Bias in Psychiatric Diagnosis. Lanham, Maryland: The Roman and Littlefield Publishing Group, Inc; 2004.
28.
HealyMKidiaK.The power in our words: reducing bias in clinical communication. Am Fam Physician. 2023;107(5):454-455. doi:10.1007/s11606-022-07609-y.
29.
SmedleyASmedleyBD.Race as biology is fiction, racism as a social problem is real: anthropological and historical perspectives on the social construction of race. Am Psychol. 2005;60(1):16-26. doi:10.1037/0003-066X.60.1.16.
30.
YoonEChangCTKimS, et al. A meta-analysis of acculturation/enculturation and mental health. J Couns Psychol. 2013;60(1):15-30. doi:10.1037/a0030652.
31.
WilliamsLWMatsonJLGoldinRLAdamsHL.Children assessed for autism spectrum disorder: developmental delay and change over time in BDI-2 developmental quotients. Res Autism Spectr Disord. 2014;8(11):1500-1507. doi:10.1016/j.rasd.2014.08.001.
