Application of the "Monitoring Child Development in Integrated Management of Childhood Illnesses Context" in Indian Infants and Toddlers

Objective: The objective of this study was to determine the diagnostic accuracy of "Monitoring Child Development in the Integrated Management of Childhood Illnesses Context" (MCDIC) for developmental screening of Indian children younger than 3 years. Method: A hospital-based study of diagnostic accuracy was conducted over 17 months after obtaining institutional ethics committee approval. Children younger than 3 years were included in this study. Children with acute illnesses and who presented without their primary caregiver were excluded from this study. The calculated sample size was 272. Eligible children were enrolled after informed consent and stratified by age. MCDIC (index tool) was administrated to primary caregivers by trained interviewers to identify "suspected/probable developmental delay (SDD/PDD)." The reference tools included Developmental Profile, Third Edition, which assessed developmental status based on General Developmental Score (GDS), and Vineland Adaptive Behavior Scale, Second Edition, which evaluated adaptive function based on Adaptive Behavior Composite (ABC). Parameters of diagnostic accuracy were computed according to the number of children with "SDD/PDD" and "developmental delay" (GDS and ABC < -2 SDs). Results: The number of eligible children was 312. The sensitivity of MCDIC was 88.0% (95% confidence interval [CI] 68.8-97.5), specificity 85.7 (95% CI 81.1-89.6), positive predictive value 34.9 (95% CI 28.0-42.5), and negative predictive value 98.8 (95% CI 96.6-99.6). Conclusion: MCDIC had a high sensitivity and specificity that were above 70% and 80%, respectively, and a high negative predictive value, making it a suitable tool for screening and surveillance of Indian children younger than 3 years.