Background: Because PEDS®’ is quite brief and enjoys abundant supporting research, it has been included in the National Survey of Children’s Health, National Survey on Early Childhood Health (NSECH), Promoting Healthy Developmental Survey (PHDS), California Health Interview Survey (CHIS), California First Five Survey, Calgary and Toronto’s Public Health Departments. (Abstracts and commentary from a range of studies, appear at the bottom of this document). When used in surveys, PEDS® has traditionally differed from (clinical) PEDS® in that it eliminates all open-ended questions and includes several others items that encourage parents to indicate concerns about their child’s vision, hearing, health, and global developmental status.
Challenges: While helpful in population-focused needs assessment and public health mapping studies, PEDS® in a survey format cannot be used to clinical care because it does not elicit parents’ actual concerns. Verbatim comments are essential for focusing an encounter, i.e., choosing parent education materials, creating a follow-up plan and a problem checklist, identifying the types of referrals needed, and managing visit length by reducing the ever problematic, “oh by the way” concerns. Parents who have been encouraged to give voice to their concerns are far more likely to follow through with recommendations.
An additional challenge when using PEDS® as a closed-ended survey is that Spanish speakers seem to have difficulty with the questions and thus have suspiciously low rates of risk. Translation problems seem explanatory (since translation problems have dogged other measures such as the Pediatric Symptom Checklist). Further, some questions, even in English, have varied across studies, making it hard for researchers to compare findings across studies. Scoring for PEDS® within surveys, even though established within the PHDS survey, seems to be a continuing mystery to many researchers, requiring hours of uncompensated input from PEDS®’ staff.
Solutions: As a consequence, we have created an electronic, official version of Survey PEDS®. This features the 12 questions with CATI (computer-assisted telephone interview) style prompts for the closed-ended responses; all much improved over that used in earlier surveys, and all questions and responses have been the focus of very careful translation into Spanish, i.e., vetted by more than 20 Spanish-English speaking health care providers, and then trialled against clinical PEDS® and shown to have a high level of agreement (98%).
Scoring is automated and thus both error free and a substantial time-saver over hand-scoring. The scoring service also automatically computes the child’s exact chronological age with corrections for prematurity up to 24 months of age. The results parallel clinical PEDS®: high risk, moderate risk, low risk but concerned, or low risk/not concerned.
Other features of the online scoring service are brief recommendations about the apparent needs of each child and family (e.g., for speech-language evaluation, information on child-rearing, more vigilant monitoring of developmental-behavioral status, mental health services, etc.). The service also offers the (optional) Modified Checklist of Autism in Toddlers, and will soon have the 6 – 8 skill focused questions at each age from PEDS®: Developmental Milestones, along with translations into languages other than English and Spanish.
The Survey PEDS® online scoring service also provides, optionally, space to type in parents’ exact comments. This enables interviewers to capture the specific types of concerns parents have, and thus use Survey PEDS® in both population research and clinical care. Additional information, mostly clinical in nature, returned from our site include summary reports for parents, referral letters if needed, and ICD-9 and procedure codes. The service also houses an administrative panel so that licensed users can review records of all screens administered and view of summary of overall results.
Although the Survey PEDS® service costs, research discounts apply and per use fees range from $1.03 to $1.37, depending on volume. The site can be used in various ways as follows:
The Survey PEDS® scoring service can be used in various ways:
- Accessing the site when administering PEDS®. Results are returned in real time;
- Collecting PEDS® answers within your own software/database and sending, usually at the end of your study, a batch submission that we score and return for you (and for which we will send formatting specifications, and the Survey PEDS® questions to include in your software). You would then concatenate the Excel type database we return into your own; and/or
- a truly integrated approach where parents’ comments are sent to our server, scored, and returned into your software/database (we can send the details on how to create and program the 25 or so fields needed in your software, but some IT support will be needed on your end as well).
We are happy to discuss the pros and cons of each approach according to how your project is structured, the skill levels of interviewers, their needs for real-time results, etc. Please contact us through our website (electronic inquiries).
Abstracts on PEDS® as used in population research studies
Several studies fromToronto Public Health and Calgary Public Health (abstracted near the bottom of this document) used clinical PEDS® in a CATI and capitalized on our scoring service.