BACKGROUND AND OBJECTIVES

Kindergarten is a privileged opportunity to observe children’s behavior in a natural context. This possibility detects signs of derangement in motor and neuropsychological development that are not previously observed. This study aims to assess the feasibility of the screening of ignored neurodevelopmental disorders by observing child behavior and interviewing parents and teachers with structured questionnaires.

METHODS

23 children, aged 36–61 months, attending two Hebraic schools in Turin and Trieste entered the study. The protocol included three different tests:

ABAS II for Parents (241 items) and for Caregivers (216 items): investigating Communication, Preschool/School skills, Self-control, Playing/leisure, Socializing, Self-care, Home care/School, Environmental use, Health, and Safety.

Structured observation of child behavior during classroom life by expert Neurodevelopmental Disorders Therapists with a checklist containing over 461 items to carefully detect delays in the acquisition of a given capacity according to age-related international developmental nomograms, with special attention to language skills (phonetics, grammar-morphosyntax and comprehension).

Test “Valutazione del Linguaggio” (TVL): an Italian test for the evaluation of language, specifically vocabulary, phonetics, grammar-morphosyntax and comprehension. The protocol included 4 items of TVL: comprehension of simple phrases, replaying simple and complex phrases, replaying of words and image labelling.

After obtaining written informed consent by parents, both forms of ABAS-II were sent for online compilation.
Later, expert Neurodevelopmental Disorders Therapists observed and interacted with 23 children in one classroom session, during which the TVL was also performed.

RESULTS

In the 23 children without previous diagnoses of neuro-psychiatric disorders, the application of ABAS II pointed out 11 cases with at least one (range 1–4) domain not yet settled with chronological age.
The integration of the four tests resulted in the recognition of 4 cases in which undetected developmental deficits were evident:

2 cases of phonetics language deficit

1 case of cognition deficit

1 case of social communication deficit

CONCLUSIONS

This experience shows that structured external observation in a kindergarten is a feasible and promising approach for the screening and early detection of neurodevelopmental disorders.
ABAS II provides information about daily skills of children but shows low sensitivity as a preliminary screening tool: expert observation seems necessary in detecting suspicious cases.

Notes: 

Villa Santa Maria Foundation, Tavernerio (Como), Italy