Validation of a developmental screening tool from a national health program in India for screening speech-language disorders among children

Background: Rashtriya Bal Swasthya Karyakram (RBSK) is a Government of India initiative that aims to develop a structured approach toward child health screening and early intervention. Objectives The current study aimed to validate the RBSK developmental screening tool incorporated within a mobile-based application for screening of speech and language delays/disorders among children below 6 years of age Methods A total of 235 caregiver-child dyads including 96 children aged below 2;6 years; months and 139 children between 2;6 and 6;0 years participated in the study. Children underwent developmental screening by a Speech Language Pathologist (SLP) using the RBSK screening tool and specific speech-language screening using the Language Evaluation Scale Trivandrum (LEST) followed by detailed evaluation by another SLP, blinded to the results of the screening. Each item in the RBSK and LEST screening tools was rated as ‘yes’ or ‘no’ by observing the child’s performance. Results and conclusion Detailed assessment by the SLP identified 133 children with typical speech and language development and 102 children with speech and language disorders. The sensitivity and specificity (95% CI) of the RBSK screening tool against both detailed assessment by SLP and LEST screening with one-item criteria were similar at 100% (87.23-100) and 97.1% (89.82-99.65) respectively in the younger group and 97.33% (90.70-99.68) and 92.19% (82.70-97.41) respectively in the older age group. The RBSK screening tool implemented via an mhealth application by SLPs demonstrated adequate psychometric properties for screening speech-language disorders among children less than six years of age.