Adaptation and validation of the disruptive behaviour disorders teacher rating scale as a screening tool for early detection of disruptive behaviour disorders in schools in a lower-middle income setting

Abstract

Abstract Background Despite the need to curb the menace resulting from the negative trajectory of disruptive behaviour disorders (DBD) in societies of the world today, there is yet a dearth of locally standardised tools for the early detection of these disorders in Nigeria. This study was aimed at standardising the DBD teacher rating scale (DBD-TRS) to be culturally specific using teachers’ ratings of their students. Objectives To establish norm scores for the three categories of DBD on the DBD-TRS, to evaluate the reliability, validity, predictive power, sensitivity and specificity of DBD-TRS items for identifying DBD symptoms amongst children/adolescents between the ages of 4 and 16 years. Methods A cross-sectional survey of the five divisions of Lagos was conducted using multi-stage sampling technique. A randomly selected sample of teachers from a selection of regular schools across the five divisions of Lagos retrospectively rated systematically selected samples of their students in absentia; by referring to the names in their class registers for the recently concluded school session. The DBD-TRS and the previously validated strengths and difficulties questionnaire (SDQ) were used for the ratings. Results Ratings were completed for 1508 children/adolescents by 197 teachers from 30 regular schools. The norm scores for the three categories of DBD were determined by gender, age, and grade/class. Satisfactory psychometric properties were established for the DBD rating scale. All DBD items had high negative predictive power and positive predictive power, high specificity, and low false positive rates. However, ADHD items had lower PPP (0.23–0.55). Conclusion The DBD rating scale demonstrated sufficient technical merits to be used as a preliminary tool for identifying children that may require further clinical evaluation by mental health experts for behavioural disorders.