Mire, Sarah S.2023-01-01August 2022022-08-19https://hdl.handle.net/10657/13220Background: Primary care physicians (PCPs) frequently see pediatric patients with developmental delays and developmental disorders (DD/D) during well child checks. PCPs who operate within organizations that have adopted a collaborative behavioral health model are well-positioned to regularly screen for psychosocial symptomatology among this population because they have regular access both to behavioral health clinicians (e.g., psychologists, social workers) and to patients; are often viewed as authority figures by parents; and generally have longstanding relationships and involvement in children’s care throughout the developmental period. Psychosocial screening is particularly important for youth with DD/D because of the high rate of co-occurring behavioral and emotional difficulties common to this population. While the most widely used primary care psychosocial screener, the Pediatric Symptom Checklist-17 (PSC-17), is validated for use with typically developing children, it has been unclear whether this measure accurately identifies psychosocial comorbidities for pediatric patients with DD/D. Purpose: The present study assessed the accuracy of the PSC-17 for identifying psychosocial impairment in children with DD/D. Evaluating the psychometric properties of this instrument when used with this population was the overarching purpose of this study. Thus, the following research question was addressed: does the PSC-17 accurately identify psychosocial concerns among pediatric patients with DD/D? Methods: Data collected from 3,596 pediatric patients at a primary care clinic affiliated with a large hospital system in metropolitan Texas were analyzed for this study; 174 of these patients had DD/D (e.g., global and specific developmental delays and/or developmental disorders [e.g., autism spectrum disorder [ASD], intellectual disability]) at the time of PSC-17 administration. Descriptive analyses, measurement invariance testing, internal consistency evaluations, sensitivity and specificity calculations, and receiver operating characteristic (ROC) analyses were conducted to assess the psychometric properties of the PSC-17 and address the aforementioned research question. Results: Descriptive statistics showed that sample demographics regarding DD/D and psychosocial diagnosis and impairment aligned with prior studies which used larger, national samples. Hierarchical confirmatory factor analyses (CFAs) supported measurement invariance for children with DD/D compared to children of typical development. Internal consistency of the PSC-17 was adequate-to-strong for children with and without DD/D. However, the sensitivity and specificity results as well as the ROC analyses were inconsistent with prior studies of the PSC-17, likely due to the use of psychosocial diagnoses as true positives. Conclusions: The results of the descriptive, measurement invariance, and descriptive analyses support the use of the PSC-17 for universal primary care screening for all children, including those with DD/D. Replication of the findings related to the descriptive statistics, measurement invariance, and the internal consistency analyses will enhance confidence that the PSC-17 can validly and reliably identify psychosocial impairment in children with DD/D. Future studies should continue to examine PSC-17 psychometric properties for children with DD/D in order to address the limitations of the sensitivity and specificity calculations and ROC analyses. Accurate psychosocial screening in children with DD/D is critical, because the timely and accurate identification of psychosocial comorbidities in those with DD/D can facilitate early and accurate intervention needs and recommendations, which ultimately may enhance long-term functioning of children with DD/D and their families.application/pdfengThe author of this work is the copyright owner. UH Libraries and the Texas Digital Library have their permission to store and provide access to this work. Further transmission, reproduction, or presentation of this work is prohibited except with permission of the author(s).Developmental delayDevelopmental disorderPrimary careScreeningPsychosocial comorbidities2023-01-01Thesisborn digital