A screening tool for psychological difficulties in children aged 6 to 36?months: cross-cultural validation in Kenya, Cambodia and Uganda.

ABSTRACT:

Background

In low-resource settings, the lack of mental health professionals and cross-culturally validated screening instruments complicates mental health care delivery. This is especially the case for very young children. Here, we aimed to develop and cross-culturally validate a simple and rapid tool, the PSYCa 6-36, that can be administered by non-professionals to screen for psychological difficulties among children aged six to 36?months.

Methods

A primary validation of the PSYCa 6-36 was conducted in Kenya (n?=?319 children aged 6 to 36?months; 2014), followed by additional validations in Kenya (n?=?215; 2014) Cambodia (n?=?189; 2015) and Uganda (n?=?182; 2016). After informed consent, trained interviewers administered the PSYCa 6-36 to caregivers participating in the study. We assessed the psychometric properties of the PSYCa 6-36 and external validity was assessed by comparing the results of the PSYCa 6-36 against a clinical global impression severity [CGIS] score rated by an independent psychologist after a structured clinical interview with each participant.

Results

The PSYCa 6-36 showed satisfactory psychometric properties (Cronbach's alpha >?0.60 in Uganda and?>?0.70 in Kenya and Cambodia), temporal stability (intra-class correlation coefficient [ICC] >?0.8), and inter-rater reliability (ICC from 0.6 in Uganda to 0.8 in Kenya). Psychologists identified psychological difficulties (CGIS score?>?1) in 11 children (5.1%) in Kenya, 13 children (8.7%) in Cambodia and 15 (10.5%) in Uganda, with an area under the receiver operating characteristic curve of 0.65 in Uganda and 0.80 in Kenya and Cambodia.

Conclusions

The PSYCa 6-36 allowed for rapid screening of psychological difficulties among children aged 6 to 36?months among the populations studied. Use of the tool also increased awareness of children's psychological difficulties and the importance of early recognition to prevent long-term consequences. The PSYCa 6-36 would benefit from further use and validation studies in popula`tions with higher prevalence of psychological difficulties.

SUBMITTER: Nackers F 

PROVIDER: S-EPMC6460684 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature