Psychometric properties of the Rapid Neurodevelopmental Assessment in detecting social- emotional problems during routine child developmental monitoring in primary healthcare

Abstract

Background The global prevalence of social-emotional problems in children and adolescents is nearly double in First Nations populations compared to non-First Nations, highlighting health inequities due to the impact of colonisation. Addressing this requires culturally responsive social-emotional screening in primary health, enhanced by a simple, psychometrically sound tool. The Rapid Neurodevelopmental Assessment, Australian Edition (RNDA:Australia), is user-friendly, incorporates child observations and parental input, and can be used by primary healthcare providers. This study evaluated the RNDA:Australia’s performance in screening social-emotional problems during routine health checks with First Nations children. Methods Working with an Aboriginal Community Controlled Health Organisation in Australia, children (60% male, 92% identifying as First Nations) aged 3 to 16 years (M = 8.40, SD = 3.33) and a caregiver participated in this study as part of a health check. The convergence with, and accuracy of, children’s scores derived from single-item measures of seven social-emotional problems on the RNDA:Australia was compared to their corresponding multi-item scores from the parent-report Behavior Assessment System for Children 3rd Edition (BASC-3). Results Each of the single-items measures on the RNDA:Australia were significantly correlated with the corresponding multi-item construct on the BASC-3, except for anxiety. The total accuracy of the RNDA:Australia relative to the BASC-3 was 58 to 81%, with high sensitivity for four of the seven items: hyperactivity (90%), attention problems (87%), externalising problems (82%) and behaviour symptoms index (88%). Sensitivity of the remaining items ranged from 14–71% and specificity ranged from 29–88%. The measure showed an average positive predictive value of 50% and negative predictive value of 75%. Conclusions The single-item measures within the RNDA:Australia’s behaviour domain showed good convergent validity relative to the BASC-3. Most items had acceptable accuracy, comparable with similar screening measures. These findings further support the RNDA:Australia’s integration into First Nations’ child health checks, allowing for a rapid, holistic assessment of child development to improve health equity.