Screening Child Social-emotional and Behavioral Functioning in Low-Income African Country Contexts (original) (raw)
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BMC Public Health
Background The UNICEF/Washington Group Child Functioning Module (CFM) assesses child functioning among children between 5 and 17 years of age. This study adapted and validated the CFM at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Uganda. Methods This cross-sectional study was conducted between September 2018–January 2019 at the IM-HDSS. Respondents were caregivers of children between 5 and 17 years of age who were administered modified Washington Group short set (mWG-SS) and CFM. The responses were recorded on a 4-point Likert scale. Descriptive analysis was conducted on child and caregiver demographic characteristics. Exploratory factor analysis (EFA) assessed underlying factor structure, dimensionality and factor loadings. Cronbach’s alpha was reported as an assessment of internal consistency. Face validity was assessed during the translation process, and concurrent validity of CFM was assessed through comparison with disability short form. Results Out...
BMC Pediatrics
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.
Global Social Welfare, 2018
Little is known about the prevalence of child mental health (MH) problems in sub-Saharan Africa, where poverty, HIV, and family disruption increase risk. One barrier is the lack of MH assessment tools lay staff can validly and reliably administer in settings with few MH professionals. In a South African (SA) peri-urban cohort, we examined psychometric properties of the Strengths and Difficulties Questionnaire (SDQ), a widely used measure of child emotional and behavioral functioning. Data come from a large population-based study (N=1581) of children 4-6 years old. Lay fieldworkers administered the SDQ in isiZulu to caregivers at baseline and two years later. Exploratory factor analysisexamined whether the established SDQ five-factor structure and Total Difficulties score would be replicated. The psychometric model was tailored for ordinal items, and target factor rotation was used. Total Difficulties, Emotional symptoms and Prosocial behavior factors were supported, with partial sup...
Journal of neuroscience methods, 2015
Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS). We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes. Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who...
Child and adolescent psychiatry and mental health, 2016
Behavioural/emotional problems may be common in preschool children living in resource-poor settings, but assessment of these problems in preschool children from poor areas is challenging owing to lack of appropriate behavioural screening tools. The child behaviour checklist (CBCL) is widely known for its reliability in identifying behavioural/emotional problems in preschool children, but it has not been validated for use in sub-Saharan Africa. With permission from developers of CBCL, we translated this tool into Ki-Swahili and adapted the items to make them culturally appropriate and contextually relevant and examined the psychometric properties of the CBCL, particularly reliability, validity and factorial structure in a Kenyan community preschool sample of 301 children. It was also re-administered after 2 weeks to 38 randomly selected respondents, for the purpose of evaluating retest reliability. To evaluate inter-informant reliability, the CBCL was administered to 46 respondents (...
Assessment, 2018
There is a paucity of validated mental health measures for assessing psychological well-being among HIV-affected youth. We sought to explore the psychometric properties and validity of the Achenbach Youth Self-Report and Child Posttraumatic Stress Disorder Symptom Scale among orphans and vulnerable children (OVC) living in Lusaka, Zambia. These scales were administered to 210 OVC aged 13 to 17 years via audio computer-assisted self-interview. Confirmatory factor analysis was used to assess scale structure, Cronbach's alpha for internal consistency, and correlations between scales related to mental or psychosocial health for construct validity. A known-groups validation was conducted using local identifications of youth with and without significant psychosocial problems, and test-retest reliability was assessed. Scales exhibited good internal reliability (α > .80), adequate criterion validity (area under the curve > .70), and moderate test-retest reliability (.62-.68). Find...
Frontiers in Psychiatry
BackgroundChildren in Sub-Saharan Africa are burdened by significant unmet mental health needs. Across the region, high rates of poverty, HIV/AIDS, food insecurity, stigma, and an inadequate health safety net system exacerbate serious child behavioral health needs and impede an effective response. Disruptive behavioral disorders are particularly concerning as they persist through adolescence and adulthood. Hence, addressing the context-specific social influences on child behavioral health is critical given that children in the region comprise more than half of the total regional population. Against this backdrop, this study protocol describes a randomized clinical trial that will examine the mechanisms by which economic empowerment and family strengthening interventions targeting social, familial, and context-specific drivers affect the mental health of children in Uganda.MethodsThe study uses an experimental, longitudinal design across 30 cluster-randomized primary schools to compa...
AIDS and Behavior, 2014
Due to the HIV/AIDS pandemic which has left 12 million children orphaned in Sub-Saharan Africa, children are at increased risk for mental health problems. Currently, no validity data exist for any screening measure of emotional-behavior disorders in pre-adolescent children in Sub-Saharan Africa. The aims of the current study were to evaluate the construct validity of the caregiver-, teacher-, and self-report versions of the one-page Strengths and Difficulties Questionnaire (SDQ) in 466 orphans in South Africa between the ages of 7 and 11 (M age = 9.23 years, SD = 1.33, 51.93 % female) and to provide, for the first time, clinical cutoffs for this population. Findings demonstrated support for the caregiver SDQ, but not the teacher and self-report versions. We provide clinical cutoffs , but caution their use before further research is conducted. There remains a critical need for further psychometric studies of the SDQ in the developing world. Resumen Debido a la pandemia de VIH / SIDA que ha dejado a 12 millones de niños huérfanos en Á frica subsahariana, los niños tienen un riesgo mayor de tener problemas de salud mental. Actualmente, no hay data para validar ningún cuestionario de trastornos emocionales y de comportamiento en los niños pre-adolescentes en el Á frica subsahariana. Los objetivos de este estudio fueron evaluar la validez de constructo de varias versiones (completadas por cuidador, maestro, y autoinforme) de un cuestionario de una página, el Strengths and Difficulties Questionnaire (SDQ), en 466 huérfanos en Sudáfrica entre las edades de 7 y 11 (M = 9.23 años, SD = 1.33, 51.93 % mujeres) y describir, por primera vez, los puntos de estratificación para esta población. Los resultados demuestran apoyo para la versión SDQ completada por el cuidador, pero no la versión completada por el maestro ni por autoinforme. Ofrecemos puntos de estratificación, pero advertimos contra su uso antes de que se realicen más investigaciones. Sigue habiendo una necesidad crítica de estudios psicométricos del SDQ en el mundo subdesarrollado.
Annals of Human Biology, 2008
Background: There is increasing interest in the social determinants of children's developmental outcomes in developing countries because of the links with schooling, behavioral, and employment outcomes. Yet, little is known about the impact of household and caretaker variables in influencing developmental outcomes in rural, developing country settings. Aim: The study examined the relative impact of individual and household variables and caretaker symptoms of common mental disorders on children's personal-social, fine and gross motor, and language development. Subjects and methods: A total of 431 children aged 3-24 months in a rural Ethiopian setting were studied. Children underwent a developmental assessment and parents independently provided information on household characteristics and were administered anxiety and depression symptom inventories. Results: In adjusted multivariable models, maternal symptoms of mental disorders were associated with both global development and most developmental sub-scales ( p 5 0.01) except language developmental; there was no consistent relation between paternal symptoms of mental disorders and child development. Nutritional stunting was generally a risk factor for lower developmental scores but few household-level variables were associated with child development. Conclusion: Child development in this setting is strongly associated with child age and maternal depression. If these findings are replicated elsewhere, they may suggest that interventions aimed at improving maternal depression may have an important role to play in efforts to improve child development and to mitigate the intergenerational transmission of poor health in sub-Saharan Africa.
2021
ObjectiveBehavioural screening tools may be used to identify at-risk children in resource-limited settings in sub-Saharan Africa. The ASEBA forms (Child Behaviour Checklist and Youth Self-Report) are frequently translated and adapted for use in sub-Saharan African populations, but little is known about their measurement properties in these contexts.MethodsWe conducted a systematic review of all published journal articles that used the ASEBA forms with sub-Saharan African samples. We evaluated the reported psychometric properties, as well as the methodological quality of the psychometric evaluations, using COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) guidelines.ResultsFifty-eight studies reported measurement properties of the ASEBA forms. Most studies came from Southern (n = 29, 50%) or East African (n = 25, 43%) countries. Forty-nine studies (84%) used translated versions of the tool, but details regarding the translation process, if availab...