Screening Child Social-emotional and Behavioral Functioning in Low-Income African Country Contexts.

Abstract

Background: children in low-income countries (LICs). Currently, there is little information available on the use of brief screening instruments Increased attention is being paid to identifying and responding to the social-emotional and behavioral needs of in LICs. The lack of psychometrically sound brief assessment tools creates a challenge in determining the population prevalence of child social-emotional and behavioral risk burden in Sub-Saharan African (SSA) country contexts. This study sought to determine the reliability and validity of three brief parent-rated screening tools-the Social Competence Scale (SCS), Pictorial Pediatric Symptom Checklist (PPSC), and the Strengths and Difficulties Questionnaire (SDQ)-in Uganda. These tools consider both strength- and pathology-based dimensions of child outcomes.

Methods: Parents of 154 Ugandan 5-9 year-old children who were enrolled in Nursery to Primary 3 in Kampala (the capital city of Uganda) and part of a school-based mental health intervention trial were recruited and interviewed. About 54% of parents had educational attainment of primary school level or less. One hundred and one of these parents were interviewed a second time, about 5 months after the first/baseline assessment. Data from both time points were utilized to assess reliability and validity.

Results: Inspection of psychometric properties supports the utility of these three brief screening measures to assess children's social-emotional and behavioral functioning as demonstrated by adequate internal consistency, temporal stability, discriminant validity, concurrent validity, and predictive validity. Subscales from three screening measures were inter-related and associated with family characteristics, such as parental depression and food insecurity, in the expected directions.

Conclusion: This study provides evidence supporting the appropriateness of using three tools and applying the developmental and behavioral constructs measured in each assessment in a low-income African setting.