Construction Of Screening Model For Neuropsychological Development In Children Aged 1 To 2 Years

Objective:In order to improve the efficiency of screening of children’s neuropsychological development,to achieve the purpose of early recognition and early intervention,and to promote the healthy development of children’s neuropsychology,in this paper,we build a convenient,effective and comprehensive screening model for neuropsychological development in children aged 1 to 2 years in line with the local cultural background based on the Children Aged 0 to 6 Years Old Neuropsychological Development Diagnosis Scale.Methods:Children aged 1 to 2 years who visited the child health center in provincial hospital from September 2019 to May 2020 were selected as the research subjects,who were randomly sampled and grouped according to the age and the population composition of each city in our province.The Gesell Developmental Schedules,Children Aged 0 to 6 Years Old Neuropsychological Development Diagnosis Scale and Denver Developmental Screening Tests were used to assess the neuropsychological development of children in this study,and the results,the number of items passed and the duration of the assessment were recorded.The result of Gesell Developmental Schedules was used as the gold standard,Children Aged 0 to 6 Years Old Neuropsychological Development Diagnosis Scale was uesd as the blueprint,and Denver Developmental Screening Tests was used as the control to construct the screening model for neuropsychological development in children aged 1 to 2 years.The content of the screening model was adjusted and modified by the Delphi method.In this study,the measurement data were expressed as mean ± standard deviation,and paired t-test,one sample t-test were used to compared the difference in it,while the enumeration data were expressed as constituent ratio and Mc Nemar test was used to compare the difference in it.The difference between the data was considered statistically significant when p<0.05.And ROC curve was also used in this study.Sensitivity,specificity,Youden index were used to evaluate the authenticity of the screening model.Cronbach’s alpha coefficient,split-half reliability,content validity,correlation coefficient and other indicators were used to test the reliability and validity of the screening model in this study.Finally the advantages and application value of the screening model in the work of children health care were discussed.Results:1.The sample composition was representative in this study.A total of 454 children aged 1 to 2 years were enrolled,which including 168 children with normal development and 286 children with abnormal development according to the Gesell Developmental Schedules.The age of the subjects was basically evenly distributed between 1 and 2 years old in each month and the proportion of children was in line with the population composition ratio of all cities and regions in our province.2.The authenticity of the screening model was good due to the sensitivity of which was 96.5%,specificity was 82.1%,Youden index was 0.786 and area under the curve was 0.893.The comparison of area under the curve between DDST and neuropsychological development screening model for children aged 1 to 2 showed that there was no significant difference between the two scales(p=0.327).3.The construction of neuropsychological development screening model for children aged 1 to 2 years old was reliable.The Delphi method was adopted to adjust and modify the content of the screening model.In the two rounds of consultation,the recovery rate of questionnaires reached 100%,and the authority coefficient of experts participating in the letter consultation was 0.965.The statistical results showed that the coefficient of variation(CV)and Kendall’s W coefficient in the two rounds of consultation both reached the standard level.4.The reliability and validity test result of neuropsychological development screening model for children aged 1 to 2 years old was at an ideal level.The Cronbacn’s alpha coefficient of screening items for each group and split-half reliability in the screening model were all greater than 0.6,suggesting that the reliability of the screening model was acceptable.The item of content validity index and scale of content validity index of this screening model were both 1.0,suggesting that it had good content validity.The correlation coefficients between the final result of the screening model and each field in it ranged from 0.510 to0.689(p<0.05),which indicated that the screening model had good contract validity.5.The neuropsychological development screening model for children aged 1to 2 years old was quick,efficient and simple to operate.In the screening model,there were 7 to 8 items for each month of age,which took 13.05±1.43 minutes,16.59± 1.21 minutes,17.79 ± 1.18 minutes,19.11± 0.87 minutes,respectively.While the average number of items in the Gesell Developmental Schedules for each month of age was 33.98±4.20,35.75±5.07,32.13±1.20 and 37.21±1.25,respectively,and it took about 28.23±2.04 minutes,30.45±1.14 minutes,32.13±1.20 minutes and 37.21 ± 1.25 minutes,respectively.In addition,the screening model can be directly connected with the diagnostic model during application,which helped to skip the process of converting the assessment measures,and improve work efficiency,save time and economic cost.Conclusions:1.This screening model has proved to has ideal levels of sensitivity and specificity,and the reliability and validity test have indicated that it is reliable and can screen out children with neuropsychological developmental disorders accurately.2.This screening model has fewer assessment items,requires a short time,and is highly feasible,which is quick,efficient and simple to operate,can help improve the efficiency and coverage rate of assessment for neuropsychological development of children,and has a good application prospect.