CHICAGO — Physicians can screen for academic problems in school-age children by asking parents a simple question, Jeffrey P. Brosco, M.D., said at the annual meeting of the Society for Developmental and Behavioral Pediatrics.
Asking parents explicitly, “Do you have any concerns about how your child is learning in school?” was a more sensitive screener than the Pediatric Symptom Checklist (PSC), a new study showed.
Even specific questions about academic performance on the PSC were less sensitive than the single question.
Primary care medical providers typically rely on informal caregiver reports to screen for school academic problems. Many doctors ask parents, “How is your child doing in school?” only to get the response, “fine,” said Dr. Brosco of the Mailman Center for Child Development at the University of Miami.
“We're particularly interested because we often see, as I'm sure many of you do, the 12- or the 13-year-old who has inattentive [attention-deficit hyperactivity disorder] or a reading disorder, and he or she has made it along for years barely getting by because they don't act out or create a lot of problems in school,” Dr. Brosco said.
A total of 51 parent-child pairs, recruited from a university general pediatrics practice and a county hospital general pediatrics clinic in urban Miami, completed the PSC and a questionnaire that included 15 screening questions about school and general health. School information was obtained directly from the school.
The children's mean age was 9 years, 41% were male, and the majority of children were identified by their parents as African American or Hispanic. The primary languages at home were English, Spanish, and French or French Creole
The question was drawn from Parents' Evaluation of Developmental Status (PEDS), a standardized, validated, and copyrighted screening test (www.pedstest.com
Fifty-six percent of parents answered “yes,” that they had concerns about how their child was learning at school. The sensitivity was 72.4% and specificity 52.2%.
Academic problems actually occurred in 21 children, defined as a cumulative grade point average in core subjects below 2.5.
Two other questions had similar sensitivity; asking parents whether they had concerns about a child's behavior in school (sensitivity 69%, specificity 56.5%), and asking parents whether a teacher had concerns about their child (sensitivity 74.1%, specificity 69.6%). A total PSC score of 26 or greater was not a sensitive measure of school academic problems (sensitivity 31%, specificity 86%).
There was no difference in responses by socioeconomic status, and the results were inconclusive as to the impact of the language spoken in the home.