Advertisement

Screening Methods and When to Use Them

  • Tamsin Newlove-DelgadoEmail author
  • Tamsin J. Ford
Living reference work entry
  • 7 Downloads
Part of the Mental Health and Illness Worldwide book series (MHIW)

Abstract

In terms of child and adolescent mental health, screening can be conceptualized as identifying those young people who are at high risk of having a psychiatric disorder, due to having risk factors for the development of a disorder, and/or already having raised levels of psychopathology or experiencing psychiatric symptoms. The intention of screening should be to improve outcomes via prevention or early intervention. In child and adolescent psychiatry, there is often a significant window of time in which risk factors or early symptoms can be detected prior to the diagnosis of a full psychiatric disorder, making them suitable for screening.

Screening tools used in psychiatry are usually questionnaires or measures which have a threshold for determining whether or not a child is “screen-positive.” These tools can be used on an opportunistic basis or as part of a systematic program of targeted or universal screening – for example, in young offenders or school pupils. Those screening positive can then be referred for more comprehensive assessment.

However, no screening measures are completely accurate. Therefore, before deciding to use a tool in practice, it is important to consider whether it is validated for that population, the potential harms and benefits, and the impact of a false-negative or false-positive result. Finally, the decision to screen should also be influenced by how the result will inform management. It is potentially unethical to identify young people who may need further assessments and intervention, if the availability and/or effectiveness of these is limited.

Keywords

Screening Test accuracy Universal screening Targeted screening 

References

  1. Achenbach TM (1999) The child behavior checklist and related instruments. The use of psychological testing for treatment planning and outcomes assessment, 2nd edn. Lawrence Erlbaum Associates Publishers, Mahwah, pp 429–466Google Scholar
  2. Achenbach TM, Rescorla LA (2001) Manual for the ASEBA school-age forms & profiles: an integrated system of mult-informant assessment. Burlington: University of Vermont, Research Center for Children, Youth & Families.Google Scholar
  3. Aebi M, Kuhn C, Metzke CW, Stringaris A, Goodman R, Steinhausen HC (2012) The use of the development and well-being assessment (DAWBA) in clinical practice: a randomized trial. Eur Child Adolesc Psychiatry 21(10):559–567PubMedCrossRefGoogle Scholar
  4. Anderson JK, Ford T, Soneson E, Coon JT, Humphrey A, Rogers M, Moore D, Jones PB, Clarke E, Howarth E (2018) A systematic review of effectiveness and cost-effectiveness of school-based identification of children and young people at risk of, or currently experiencing mental health difficulties. Psychol Med 49(1):9–19.  https://doi.org/10.1017/S0033291718002490PubMedCrossRefGoogle Scholar
  5. Angold A, Costello EJ (2000) The child and adolescent psychiatric assessment (CAPA). J Am Acad Child Adolesc Psychiatry 39(1):39–48PubMedCrossRefGoogle Scholar
  6. APA (ed) (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association, ArlingtonGoogle Scholar
  7. Brondbo PH, Mathiassen B, Martinussen M, Heiervang E, Eriksen M, Moe TF, Saether G, Kvernmo S (2011) The strengths and difficulties questionnaire as a screening instrument for norwegian child and adolescent mental health services, application of UK scoring algorithms. Child Adolesc Psychiatry Ment Health 5:32PubMedPubMedCentralCrossRefGoogle Scholar
  8. Burns JR, Rapee RM (2018) School-based assessment of mental health risk in children: the preliminary development of the Child RADAR. Child Adolesc Mental Health.  https://doi.org/10.1111/camh.12258CrossRefGoogle Scholar
  9. Cheng S, Keyes KM, Bitfoi A, Carta MG, Koç C, Goelitz D, Otten R, Lesinskiene S, Mihova Z, Pez O, Kovess-Masfety V (2018) Understanding parent–teacher agreement of the strengths and difficulties questionnaire (SDQ): comparison across seven European countries. Int J Methods Psychiatr Res 27(1):e1589CrossRefGoogle Scholar
  10. Chitsabesan P, Kroll L, Bailey S, Kenning C, Sneider S, MacDonald W, Theodosiou L (2006) Mental health needs of young offenders in custody and in the community. Br J Psychiatry 188:534–540PubMedCrossRefGoogle Scholar
  11. Chitsabesan P, Lennox C, Theodosiou L, Law H, Bailey S, Shaw J (2014) The development of the comprehensive health assessment tool for young offenders within the secure estate. J Forensic Psychiatry Psychol 25(1):1–25CrossRefGoogle Scholar
  12. Cocker C, Minnis H, Sweeting H (2018) Potential value of the current mental health monitoring of children in state care in England. BJPsych Open 4(6):486–491PubMedPubMedCentralCrossRefGoogle Scholar
  13. Coghill D, Seth S (2015) Effective management of attention-deficit/hyperactivity disorder (ADHD) through structured re-assessment: the Dundee ADHD clinical care pathway. Child Adolesc Psychiatry Ment Health 9:52PubMedPubMedCentralCrossRefGoogle Scholar
  14. Costello EJ (2016) Early detection and prevention of mental health problems: developmental epidemiology and systems of support. J Clin Child Adolesc Psychol 45(6):710–717PubMedCrossRefGoogle Scholar
  15. Craddock N, Mynors-Wallis L (2014) Psychiatric diagnosis: impersonal, imperfect and important. Brit J Psychiat 204(2):93–95.  https://doi.org/10.1192/bjp.bp.113.133090PubMedCrossRefGoogle Scholar
  16. De Los Reyes A, Augenstein TM, Wang M, Thomas SA, Drabick DAG, Burgers DE, Rabinowitz J (2015) The validity of the multi-informant approach to assessing child and adolescent mental health. Psychol Bull 141(4):858–900PubMedPubMedCentralCrossRefGoogle Scholar
  17. Deighton J, Argent R, De Francesco D, Edbrooke-Childs J, Jacob J, Fleming I, Ford T, Wolpert M (2016) Associations between evidence-based practice and mental health outcomes in child and adolescent mental health services. Clin Child Psychol Psychiatry 21(2):287–296PubMedCrossRefGoogle Scholar
  18. Dowdy E, Ritchey K, Kamphaus RW (2010) School-based screening: a population-based approach to inform and monitor Children’s mental health needs. Sch Ment Heal 2(4):166–176CrossRefGoogle Scholar
  19. Dowdy E, Doane K, Eklund K, Dever BV (2011) A comparison of teacher nomination and screening to identify behavioral and emotional risk within a sample of underrepresented students. J Emot Behav Disord, 21(2):127–137.  https://doi.org/10.1177/1063426611417627CrossRefGoogle Scholar
  20. Eke H, Ford T, Newlove-Delgado T, Price A, Young S, Ani C, Sayal K, Lynn RM, Paul M, Janssens A et al (2019) Transition between child and adult services for young people with attention-deficit hyperactivity disorder (ADHD): findings from a British national surveillance study. Brit J Psychiat 1–7.  https://doi.org/10.1192/bjp.2019.131
  21. Fält E, Wallby T, Sarkadi A, Salari R, Fabian H (2018) Agreement between mothers’, fathers’, and teachers’ ratings of behavioural and emotional problems in 3–5-year-old children. PLoS One 13(11):e0206752–e0206752PubMedPubMedCentralCrossRefGoogle Scholar
  22. Fazel M, Hoagwood K, Stephan S, Ford T (2014) Mental health interventions in schools 1: mental health interventions in schools in high-income countries. Lancet Psychiatry 1(5):377–387PubMedPubMedCentralCrossRefGoogle Scholar
  23. Ford T, Hamilton H, Meltzer H, Goodman R (2007a) Child mental health is everybody’s business: the prevalence of contact with public sector services by type of disorder among British school children in a three-year period. Child Adolesc Mental Health 12(1):13–20CrossRefGoogle Scholar
  24. Ford T, Vostanis P, Meltzer H, Goodman R (2007b) Psychiatric disorder among British children looked after by local authorities: comparison with children living in private households. Br J Psychiatry 190(4):319–325PubMedCrossRefGoogle Scholar
  25. Ford T, Last A, Henley W, Norman S, Guglani S, Kelesidi K, Martin AM, Moran P, Latham-Cork H, Goodman R (2013) Can standardized diagnostic assessment be a useful adjunct to clinical assessment in child mental health services? A randomized controlled trial of disclosure of the development and Well-being assessment to practitioners. Soc Psychiatry Psychiatr Epidemiol 48(4):583–593PubMedCrossRefGoogle Scholar
  26. Frith E (2017) Access and waiting times in children and young people’s mental health services. Education Policy Institute, LondonGoogle Scholar
  27. Gardner W, Murphy M, Childs G, Kelleher K, Pagano ME, Jellinek M, McInerny TK, Wasserman RC, Nutting P, Chiappetta L, Sturner R (1999) The PSC-17: a brief pediatric symptom checklist with psychosocial problem subscales. A report from PROS and ASPN. Ambul Child Health 5(3):225–236Google Scholar
  28. Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38(5):581–586PubMedPubMedCentralCrossRefGoogle Scholar
  29. Goodman A, Goodman R (2009) Strengths and difficulties questionnaire as a dimensional measure of child mental health. J Am Acad Child Adolesc Psychiatry 48(4):400–403PubMedCrossRefGoogle Scholar
  30. Goodman R, Ford T, Richards H, Gatward R, Meltzer H (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 41(5):645–655PubMedCrossRefGoogle Scholar
  31. Goodman R, Ford T, Corbin T, Meltzer H (2004) Using the strengths and difficulties questionnaire (SDQ) multi-informant algorithm to screen looked-after children for psychiatric disorders. Eur Child Adolesc Psychiatry 13(2):ii25–ii31, 13PubMedGoogle Scholar
  32. Green H, McGinnity A, Meltzer H, Ford T, Goodman R (2005) Mental health of children and young people in Great Britain, 2004. Palgrave Macmillan, LondonGoogle Scholar
  33. Greenhalgh T (1997) How to read a paper. Papers that report diagnostic or screening tests. BMJ 315(7107):540–543PubMedPubMedCentralCrossRefGoogle Scholar
  34. Hacker K, Arsenault L, Franco I, Shaligram D, Sidor M, Olfson M, Goldstein J (2014) Referral and follow-up after mental health screening in commercially insured adolescents. J Adolesc Health 55(1):17–23PubMedCrossRefGoogle Scholar
  35. Hardy C, Hackett E, Murphy E, Cooper B, Ford T, Conroy S (2015) Mental health screening and early intervention: clinical research study for under 5-year-old children in care in an inner London borough. Clin Child Psychol Psychiatry 20(2):261–275PubMedCrossRefGoogle Scholar
  36. Humphrey N, Wigelsworth M (2016) Making the case for universal school-based mental health screening. Emot Behav Diffic 21(1):22–42.  https://doi.org/10.1080/13632752.2015.1120051CrossRefGoogle Scholar
  37. Jensen P, Roper M, Fisher P, Piacentini J, Canino G, Richters J, Rubio-Stipec M, Dulcan M, Goodman S, Davies M et al (1995) Test-retest reliability of the Diagnostic Interview Schedule for Children (DISC 2.1). Parent, child, and combined algorithms. Arch Gen Psychiatry 52(1):61–71PubMedCrossRefGoogle Scholar
  38. Kelly DM, Estaquio C, Léon C, Arwidson P, Nabi H (2017) Temporal trend in socioeconomic inequalities in the uptake of cancer screening programmes in France between 2005 and 2010: results from the Cancer Barometer surveys. BMJ open 7(12):e016941–e016941.  https://doi.org/10.1136/bmjopen-2017-016941PubMedPubMedCentralCrossRefGoogle Scholar
  39. Kidger J, Gunnell D, Biddle L, Campbell R, Donovan J (2009) Part and parcel of teaching? Secondary school staff’s views on supporting student emotional health and well-being. Br Educ Res J 36(6):919–935CrossRefGoogle Scholar
  40. Kraemer HC, Measelle JR, Ablow JC, Essex MJ, Boyce WT, Kupfer DJ (2003) A new approach to integrating data from multiple informants in psychiatric assessment and research: mixing and matching contexts and perspectives. Am J Psychiatry 160(9):1566–1577CrossRefGoogle Scholar
  41. Kuhn C, Aebi M, Jakobsen H, Banaschewski T, Poustka L, Grimmer Y, Goodman R, Steinhausen H-C (2017) Effective mental health screening in adolescents: should we collect data from youth, parents or both? Child Psychiatry Hum Dev 48(3):385–392PubMedCrossRefGoogle Scholar
  42. Lehmann S, Heiervang ER, Havik T, Havik OE (2014) Screening foster children for mental disorders: properties of the strengths and difficulties questionnaire. PLoS One 9(7):e102134PubMedPubMedCentralCrossRefGoogle Scholar
  43. Lichtenstein P, Halldner L, Zetterqvist J, Sjölander A, Serlachius E, Fazel S, Långström N, Larsson H (2012) Medication for attention deficit-hyperactivity disorder and criminality. N Engl J Med 367(21):2006–2014PubMedPubMedCentralCrossRefGoogle Scholar
  44. Lynn RM, Viner RM, Nicholls DE (2012) Ascertainment of early onset eating disorders: a pilot for developing a national child psychiatric surveillance system. Child Adolesc Mental Health 17(2):109–112CrossRefGoogle Scholar
  45. MacDonald K, Fainman-Adelman N, Anderson KK, Iyer SN (2018) Pathways to mental health services for young people: a systematic review. Soc Psychiatry Psychiatr Epidemiol 53(10):1005–1038PubMedPubMedCentralCrossRefGoogle Scholar
  46. McGorry PD, Mei C (2018) Early intervention in youth mental health: progress and future directions. Evid Based Ment Health 21(4):182PubMedCrossRefGoogle Scholar
  47. Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, Georgiades K, Heaton L, Swanson S, Olfson M (2011) Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 50(1):32–45PubMedCrossRefGoogle Scholar
  48. Moens MA, Weeland J, Van der Giessen D, Chhangur RR, Overbeek G (2018) In the eye of the beholder? Parent-observer discrepancies in parenting and child disruptive behavior assessments. J Abnorm Child Psychol 46(6):1147–1159PubMedPubMedCentralCrossRefGoogle Scholar
  49. Mowlem FD, Rosenqvist MA, Martin J, Lichtenstein P, Asherson P, Larsson H (2018) Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. Eur Child Adolesc Psychiatry 28(4):481–489PubMedPubMedCentralCrossRefGoogle Scholar
  50. Mrazek P, Haggerty R (1994) New directions in definitions. In: Mrazek PJ, Haggerty RJ (eds) Reducing risks for mental disorders: frontiers for preventive intervention research. National Academies Press (US), Washington, DCGoogle Scholar
  51. NatCen (2017) Supporting mental health in schools and colleges. Department for Education, LondonGoogle Scholar
  52. Novins DK, Green AE, Legha RK, Aarons GA (2013) Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review. J Am Acad Child Adolesc Psychiatry 52(10):1009–1025.e1018PubMedPubMedCentralCrossRefGoogle Scholar
  53. Papandrea K, Winefield H (2011) It’s not just the squeaky wheels that need the oil: examining teachers’ views on the disparity between referral rates for students with internalizing versus externalizing problems. Sch Ment Heal 3(4):222–235CrossRefGoogle Scholar
  54. Pat-Horenczyk R, Kenan AM, Achituv M, Bachar E (2014) Protective factors based model for screening for posttraumatic distress in adolescents. Child Youth Care Forum 43(3):339–351CrossRefGoogle Scholar
  55. Porta M, Greenland S, Last J (2008) A dictionary of epidemiology. Oxford University Press, New YorkGoogle Scholar
  56. Public Health England (2015) Criteria for appraising the viability, effectiveness and appropriateness of a screening programme [online]. Available at: https://www.gov.uk/government/publications/evidence-review-criteria-national-screening-programmes/criteria-for-appraising-the-viability-effectiveness-andappropriateness-of-a-screening-programme. Accessed 13 Feb 2020
  57. Pullmann MD, Jacobson J, Parker E, Cevasco M, Uomoto JA, Putnam BJ, Benshoof T, Kerns SEU (2018) Tracing the pathway from mental health screening to services for children and youth in foster care. Child Youth Serv Rev 89:340–354CrossRefGoogle Scholar
  58. Richardson R, Trepel D, Perry A, Ali S, Duffy S, Gabe R, Gilbody S, Glanville J, Hewitt C, Manea L, Palmer S, Wright B, McMillan D (2015) Screening for psychological and mental health difficulties in young people who offend: a systematic review and decision model. Health Technol Assess 19(1):1–128PubMedPubMedCentralCrossRefGoogle Scholar
  59. Rothì DM, Leavey G, Best R (2008) On the front-line: teachers as active observers of pupils’ mental health. Teach Teach Educ 24(5):1217–1231CrossRefGoogle Scholar
  60. Sheldrick RC, Benneyan JC, Kiss IG, Briggs-Gowan MJ, Copeland W, Carter AS (2015) Thresholds and accuracy in screening tools for early detection of psychopathology. J Child Psychol Psychiatry 56(9):936–948PubMedPubMedCentralCrossRefGoogle Scholar
  61. Siu AL (2016) Screening for depression in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 164(5):360–366PubMedCrossRefGoogle Scholar
  62. Smith SG, McGregor LM, Raine R, Wardle J, von Wagner C, Robb KA (2016) Inequalities in cancer screening participation: examining differences in perceived benefits and barriers. Psycho-oncol 25(10):1168–1174.  https://doi.org/10.1002/pon.4195PubMedPubMedCentralCrossRefGoogle Scholar
  63. Speechley M, Kunnilathu A, Aluckal E, Balakrishna MS, Mathew B, George EK (2017) Screening in public health and clinical care: similarities and differences in definitions, types, and aims - a systematic review. J Clin Diagn Res 11(3):Le01–le04PubMedPubMedCentralGoogle Scholar
  64. Splett JW, Trainor KM, Raborn A, Halliday-Boykins CA, Garzona ME, Dongo MD, Weist MD (2018) Comparison of universal mental health screening to students already receiving intervention in a multitiered system of support. Behav Disorders 43(3):344–356.  https://doi.org/10.1177/0198742918761339CrossRefGoogle Scholar
  65. Squires J, Bricker D, Twombly E (2002) Ages and stages questionnaires: social-emotional (ASQ: SE): apparent completed, child-monitoring system for social-emotional behaviors. Baltimore, Paul H BrookesGoogle Scholar
  66. Stone LL, Otten R, Engels RCME, Vermulst AA, Janssens JMAM (2010) Psychometric properties of the parent and teacher versions of the strengths and difficulties questionnaire for 4- to 12-year-olds: a review. Clin Child Fam Psychol Rev 13(3):254–274PubMedPubMedCentralCrossRefGoogle Scholar
  67. Taggart H, Lee S, McDonald L (2014) Perceptions of wellbeing and mental health in English secondary schools: a cross sectional study. Centre Forum, LondonGoogle Scholar
  68. Van Roy B, Groholt B, Heyerdahl S, Clench-Aas J (2010) Understanding discrepancies in parent-child reporting of emotional and behavioural problems: effects of relational and socio-demographic factors. BMC Psychiatry 10:56–56PubMedPubMedCentralCrossRefGoogle Scholar
  69. Wilson JMG, Jungner G, World Health Organization. (1968). Principles and practice of screening for disease / J. M. G. Wilson, G. Jungner. World Health OrganizationGoogle Scholar
  70. World Health Organization (2018) “Screening” Retrieved 12 May 2018, from https://www.who.int/cancer/prevention/diagnosis-screening/screening/en/
  71. Young S, Gudjonsson G, Chitsabesan P, Colley B, Farrag E, Forrester A, Hollingdale J, Kim K, Lewis A, Maginn S, Mason P, Ryan S, Smith J, Woodhouse E, Asherson P (2018) Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus. BMC Psychiatry 18(1):281PubMedPubMedCentralCrossRefGoogle Scholar
  72. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.College of Medicine and HealthUniversity of ExeterExeterUK
  2. 2.Department of PsychiatryUniversity of CambridgeCambridgeUK

Section editors and affiliations

  • F Verhulst
    • 1
  1. 1.Department of Child and Adolescent PsychiatryErasmus UniversityRotterdamThe Netherlands

Personalised recommendations