Systematic Review: Classification Accuracy of Behavioral Screening Measures for Use in Integrated Primary Care Settings

J Pediatr Psychol. 2016 Nov;41(10):1091-1109. doi: 10.1093/jpepsy/jsw049. Epub 2016 Jun 11.


OBJECTIVE : To examine the classification accuracy of measures of overall psychopathology recommended for pediatric primary care screening. METHOD : A systematic review identified relevant instruments described in the literature. Subsequent systematic reviews identified studies of sensitivity (SE) and specificity (SP) of each measure for various cutoffs and different criteria for disorder (e.g., caseness determined by structured interview, exceeding a cutoff score, referral for psychiatric evaluation). RESULTS : Measures include the Child Behavior Checklist (CBCL), Pediatric Symptom Checklist (PSC), Strengths and Difficulties Questionnaire (SDQ), Brief Infant-Toddler Social Emotional Assessment (BITSEA), and the Ages and Stages Questionnaire: Social-Emotional scale (ASQ:SE). For three measures (CBCL, PSC, and SDQ) studied extensively, achieving relatively high SE and SP values (≥ .70) simultaneously occurred in only 30-55% of the studies reviewed. There are relatively few studies of the ASQ:SE and BITSEA, or of relatively new measures. DISCUSSION : Documented utility of these measures as screening instruments is limited.

Keywords: pediatrics; psychometrics; screening; sensitivity; specificity.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Child
  • Child Health Services* / organization & administration
  • Community Mental Health Services / methods*
  • Community Mental Health Services / organization & administration
  • Delivery of Health Care, Integrated / methods*
  • Humans
  • Mass Screening / methods*
  • Mental Disorders / diagnosis*
  • Primary Health Care / methods*
  • Primary Health Care / organization & administration
  • Psychiatric Status Rating Scales*
  • Psychometrics
  • Sensitivity and Specificity
  • United States