title: Can screening 4-5 year olds accurately identify children who will have teacher-reported mental health problems when children are aged 6-7 years?
abstract: OBJECTIVE
  To assess the screening accuracy of information obtained from parents of 4-5-year-old children for the purpose of identifying the children who have teacher-reported mental health problems when they are aged 6-7 years.
  
  
  METHODS
  The study used data from the Longitudinal Study of Australian Children (LSAC) obtained when children were aged 4-5 years and 6-7 years. The level of children's mental health problems was assessed using the Strengths and Difficulties Questionnaire (SDQ) completed by parents when children were aged 4-5 years and by teachers when children were aged 6-7 years (n=2163). When children were aged 4-5 years, parenting skills were assessed using three questionnaires developed for the parent-completed LSAC questionnaire and maternal mental health was assessed using the Kessler Psychological Distress Scale (K6).
  
  
  RESULTS
  When the level of parent-reported childhood mental health problems at 4-5 years old was used to identify children with teacher-reported mental health problems (i.e. a score in the "abnormal" range of the teacher-reported SDQ Total Difficulties Scale) when the children were aged 6-7 years, sensitivity was 26.8%, positive predictive value was 22.8%, and specificity was 92.9%. The addition of further information about the characteristics of children and their parents made only a small improvement to screening accuracy.
  
  
  CONCLUSIONS
  Targeted interventions for preschool children may have the potential to play an important role in reducing the prevalence of mental health problems during the early school years. However, current capacity to accurately identify preschoolers who will experience teacher-reported mental health problems during the early school years is limited.
authors.affiliation: Discipline of Public Health, School of Population Health, University of Adelaide, Adelaide, SA, Australia alyssa.sawyer@adelaide.edu.au.
authors.forename: Alyssa C P
authors.initials: AC
authors.lastname: Sawyer
authors.affiliation: Discipline of Public Health, School of Population Health, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Chittleborough
authors.affiliation: Discipline of Public Health, School of Population Health, University of Adelaide, Adelaide, SA, Australia School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: John W
authors.initials: JW
authors.lastname: Lynch
authors.affiliation: Discipline of Paediatrics, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Baghurst
authors.affiliation: Discipline of Public Health, School of Population Health, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Murthy N
authors.initials: MN
authors.lastname: Mittinty
authors.affiliation: Discipline of Paediatrics, University of Adelaide, Adelaide, SA, Australia Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, SA, Australia.
authors.forename: Amy L E
authors.initials: AL
authors.lastname: Kaim
authors.affiliation: Discipline of Paediatrics, University of Adelaide, Adelaide, SA, Australia Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, SA, Australia.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sawyer
mesh_terms: D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005178:Faculty / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000379:methods; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D010290:Parents; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
keywords: Mental health; preschool children; screening programmes; targeted interventions