Development and validation of the Parent-Reported Indicator of Developmental Evaluation for Chinese Children (PRIDE) tool.

Background: Developmental delay (DD) poses challenges to children's overall development, necessitating early detection and intervention. Existing screening tools in China focus mainly on children with developmental issues in two or more domains, diagnosed as global developmental delay (GDD). However, the recent rise of early childhood development (ECD) concepts has expanded the focus to include not only those with severe brain development impairments but also children who lag in specific domains due to various social-environmental factors, with the aim of promoting positive development through active intervention. To support this approach, corresponding screening tools need to be developed.

Methods: The current study used a two-phase design to develop and validate the Parent-Reported Indicator of Developmental Evaluation for Chinese Children (PRIDE) tool. In Phase 1, age-specific milestone forms for PRIDE were created through a survey conducted in urban and rural primary care clinics across four economic regions in China. In Phase 2, PRIDE was validated in a community-based sample. Sensitivity and specificity of both PRIDE and Ages and Stages Questionnaires (ASQ)-3 were estimated using inverse probability weights (IPW) and multiple imputation (MI) to address planned and unplanned missing data.

Results: In Phase 1 involving a total of 1160 participants aged 1 to 48 months, 63 items were selected from the initial item pool to create 10 age-specific PRIDE forms. Our Phase 2 study included 777 children within the same age range. PRIDE demonstrated an estimated sensitivity and specificity of 83.3% [95% confidence interval (CI): 56.8%-100.0%] and 84.9% (95% CI: 82.8%-86.9%) in the identification of DD.

Conclusion: The findings suggest that PRIDE holds promise as a sensitive tool for detecting DD in community settings.