Child Development Review

Infant Development Inventory (IDI): birth to 18 months (Ireton, 1994, 2006)

Child Development Review (CDR): 18 months – kindergarten (Ireton, 1990, 2006)

The Infant Development Inventory and the Child Development Review are described together because they have similar formats. They are the briefest screening questionnaires and are, therefore, the most parent-friendly.

The Infant Development Inventory briefly asks parents to describe their baby, report the infant’s activities, their questions and concerns about their baby’s health, development, behavior, etc., and how they are doing as parents. They are asked to report their child’s developmental skills in five areas – social, self help, gross motor, fine motor and language – by using the Infant Development Chart on the backside of the parent questionnaire. This chart includes monthly developmental milestones.

The Infant Development Chart also may be used by the professional as a child observation guide or as a guide for interviewing parents about age-related developmental skills.

IDI Research
Norms:  Developmental skills are located in the Chart at an age level by/during which at least 75 percent of children display the behavior.  These norms are based on previous research with the Child Development Inventory.

Validity (Accuracy):  Our thanks to Dianne Creighton, Alberta Children's Hospital for her research.  Initial study of eight-month olds (N=86) compared parents' IDI reports to developmental test results (Bayley Scale). Results from the two sources, classified as Delayed or Typical for age, were quite comparable. The majority of children delayed on the test were identified by parental report (Sensitivity .85), while classification as "typically developing" was similar for both measures (Specificity .77).

A second study of 202 eight-month-olds, including 48 low birth weight infants, compared  the accuracy of parents' IDI reports and two developmental screening tests, (Fagan Test of Infant Intelligence and the Bayley Infant Neuro-developmental Screen) for identifying children with delayed development.

Among the three screening measures, the parents' IDI report  was most strongly related to full Bayley test results indicating Delay or Typical development. Parents' IDI reports and Bayley test results were strikingly similar. Sensitivity .90 and  Specificity .93.

Comment:  In most cases, parents' IDI reports provide an accurate indicator of their  children's developmental status. This is especially important when you consider the difficulties in testing infants and young children.

Child Development Review - Parent Questionnaire
The CDR (18 months – kindergarten) was derived from years of research and practical experience with all the other child development inventories. It is brief, yet comprehensive, providing information about the child’s health, development and adjustment, and about the parent’s functioning.

The parent completes the front side of the CDR, which includes two sections: 1) six questions, and 2) a 26 item possible problems checklist. The six questions include – describe your child, child’s activities, child’s strengths, child’s special problems or disabilities, parent’s questions and concerns and “How are you doing as a parent?” The comprehensive problems list covers health, growth, hearing, vision, habits (eating, elimination, sleeping), aches and pains, energy, motor symptoms, language symptoms, behavior and emotional problems. The back side of the CDR contains a Child Development Chart for the first five years. The professional may use this chart in three ways: first, as an observation guide, second as a parent interview guide, and third, as a parent handout. This chart helps determine the child’s developmental in five areas – social, self-help, gross motor, fine motor, and language. The developmental skills and age norms are from research with the CDI (Child Development Inventory).

Parent’s responses to the six questions and problems checklist are classified as indicating 1) No problem; 2) a Possible problem; or 3) Possible major problem. The Child Development Chart results are compared to age norms, and classified as “typical” for age in all areas, or as “borderline” or “delayed” in one or more areas of development. Guidelines for identifying indicators of need for follow-up are described in the manual.

CDR Research
Parent’s responses to the CDR questions indicating problems or concerns about the child’s development are related to placement in early childhood special education. Problems Checklist: Language and motor problems reported by parents are related to placement in early childhood special education. A few problems also predict poor performance in kindergarten, for example, “Slow to catch on: does not seem to understand well.”

Preschool Screening: CDR Validity for Screening
Harold Ireton, Ph. D.
University of Minnesota

Three and Four-year-olds (N=220)

This study determined the accuracy of parents' CDR reports for screening for developmental and related problems among three and four year olds. These children were being screened for health, vision and hearing, and development as part of the South Saint Paul, Minnesota schools' preschool screening program.

South Saint Paul is a working class primarily white community that is representative of many communities. Children in this community have an average IQ of 100. Most parents are high school graduates (83%), some are college graduates (14%) and a few have not competed high school (3%).

Two-hundred-and-twenty children were screened using the D.I.A.L. developmental test: 53 children (24%) were referred for follow-up assessment based on test results.
Forty-one children were assessed. As a result, 25 received preschool special education services (11% of children screened).

Parents CDR reports were obtained independent of the standard developmental testing.

The frequencies of parents' responses to the six CDR questions and 25 problems checklist were determined - 15% of parents reported problems or disabilities and 3% reported them as a major problem or disability. 38% had some concerns, and 4% expressed them as major.

From the problems checklist, parents were least often concerned about their child’s health and growth (5%) and were more often concerned about their child’s development, especially their language development (9%), and most often concerned about their child’s behavior problems (15%).

Here we describe the accuracy of parents' reports of problems or no problems as indicators of children's needs for special education services. Parents' CDR reports of problems/no problems were compared to children's subsequent placement in early childhood special education.

CDR Parent Questionnaire results (questions 1, 4, 5 plus problems checklist) were classified as indicating 1 = No problem; 2 = Possible problem; and 3 = Possible major problem. The CDR overall results for each child were similarly classified.

Results: CDR overall results (questions plus problems list) identified the majority (68%) of special education students and indicated no significant problems for the large majority (88%) of the other children who passed screening. In technical terms, sensitivity is .68; specificity is .88.

Parents of special education students (n=25), when compared to parents of other children (n=195), more often reported signs of problems on the PQ as follows:
    CDR Questions and Problems List:
1.    Negative child description: 4% vs. .5%
4.    Major Health/Disability: 8% vs. 2.5%
5.    Major Concern: 12% vs. 3%
Problems (1 or more): 44% vs. 10%

    Eight CDR problems items were more common among the 25 children placed in special education. These include:
•    Does not seem to see well.
•    Does not talk well for age.
•    Speech is difficult to understand.
•    Does not seem to understand well.
•    Clumsy, awkward; runs poorly.
•    Clumsy doing things with hands.
•    Immature; acts much younger than age.
•    Passive; seldom shows initiative.

The two items in bold print above were strong predictors of future poor performance in kindergarten, based on teachers' ratings.

These results indicate that parents' CDR reports provide accurate indicators of children's developmental problems and need for follow-up assessment. Most parents recognize and report their children's problems. Parents should be more systematically involved in screening and assessment to determine their children's functioning and needs.

Wisconsin’s Child Development Days: In 1990, the CDD program using the CDR-PQ was initiated in two Wisconsin communities, Chippewa Falls and Cornell. Currently, the program is being used in over 100 Wisconsin communities. The results described here are for 29 school districts. Two thousand two hundred twenty-five 2 1/2 to 3 1/2-year-old children participated. The population size of this age group ranged from 40 to 350. The impact of CDD was evaluated by reviewing the results in terms of (a) parent/child participation, (b) referral rated of children for various services, and (c) results of questionnaires completed by parents and professionals.

Participation and Referrals: Among the 2,225 children seen, 8% (n=173) were referred for multidisciplinary team evaluation to determine eligibility for early childhood/special education service. Thirteen parents declined to participate. Of the children who were assessed, 73% (n=123) of children screened were directed toward other community resources, including Head Start, social services, public health, and audiologists.

Parent and professional questionnaires: Parents, teachers and community representatives completed questionnaires regarding their perceptions of the program’s strengths and weaknesses as well as their suggestions for improvement.

Use of the CDR in a Pediatric Clinic
Barbara Felt and Mary O’Connor, Ambulatory Pediatrics. 2004; Vol.3,1. Pp.2-8
Parents of toddlers and preschoolers in a primary care clinic serving inner city, low-income children completed the CDR-Parent Questionnaire prior to the well-child visit with the pediatric resident. Identification of parents’ concerns regarding their child’s behavior was highter for parents completing the CDR (122) than for a control group (135). Physicians having the CDR results at the start of the visit were more likely to identify and discuss behavioral concerns and problems with parenets.

The authors conclude that “Use of the CDR-Parent Questionnaire increased the rate of identification and discussion of behavioral issues. . .The parents were readily able to complete the CDR. . .The use of the parent questionnaire may have helped parents organize their concerns and given them the mesage that the doctor was interested in such issues.”

For more information, please request a free copy of the book, Child Development Inventories in Education and Health Care.

Articles from this book, including descriptions of tools, uses in education and health care and research and how Child Development Review provides a system for screening, not just a tool. See the book Introduction, pages 1-16.

CONTEXT;  Extensive research with the Child Development Inventory, which is an
assessment-level tool for use with young children whose development is suspect.

SCREENING TOOLS: These brief parent questionnaires are abbreviated versions
of the Child Development Inventory designed for narrower age groups (Infants;
Toddlers and Preschoolers).  

Health Care Settings example articles are on pages 73 -97.

Education Settings on pages 17 - 52,  See especially page 39 - 41 (220 preschool children) and page 45-51 (2,2253 year olds)

NOTE:  PreschoolDevelopment Inventory was revised and renamed Child Development Review - Parent Questionnaire.

American Academy of Pediatrics Screening Tool Recommendations