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Member Research and Reports

Member Research and Reports

Kentucky: Identifying Unbiased Behavioral Rating Instruments for use with Preschoolers

 A new publication from Dr. Christina Studts, assistant professor of Health, Behavior & Society at the University of Kentucky College of Public Health, looks at the issue of bias in behavioral rating instruments used to evaluate disruptive behaviors in very young children. The paper appears in the Journal of Pediatric Psychology.

[Photo: Dr. Christina Studts]

Preschool-aged children with early-onset disruptive behavior problems are at risk for future negative outcomes, including: antisocial behaviors, drug use, and school failure. Data show that more than 20 percent of children in the US exhibit some form of these behaviors, from subthreshold to clinical levels. Presently most of the affected children do not receive behavioral services, particularly those in vulnerable and underserved groups.

To address early-onset disruptive behavior problems, it is crucial to employ objective, efficient identification of affected children and subsequent referral to behavioral services. But existing screening instruments for preschoolers are not ideal for pediatric primary care settings serving diverse populations.

Investigators examined 18 candidate items for a new brief screening instrument. They worked to identify those instruments exhibiting measurement bias (i.e., differential item functioning, DIF) by child characteristics.

Parents and guardians of preschool-aged children from four primary care settings completed two full-length behavioral rating scales. Items measuring disruptive behavior problems were tested for DIF by child race, sex, and socioeconomic status using two approaches: item response theory-based likelihood ratio tests and ordinal logistic regression.

Of 18 items, eight were identified with statistically significant DIF by at least one method, making them undesirable for screening diverse populations of children. These items were excluded from the new brief screening tool.

Children who are male, non-Hispanic Black children, and children from low socioeconomic status households at the highest risk of early-onset disruptive behavior. While this study was not designed to investigate possible explanations for DIF by child sex, race, and SES, future studies could explore the etiology of the observed disparities in item performance.

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