Use of the Pediatric Symptom Checklist in a Low-Income, Mexican American Population

Abstract

When using the PSC, a new cutoff score of 12 for clinical significance should be considered if screening low-income, Mexican American children for behavioral problems. Additional study is indicated to determine the causes of the PSC's apparently lower sensitivity in Mexican American populations.

Screening for Behavioral Health Issues in Children Enrolled in Massachusetts Medicaid

“…Additionally, we found that Hispanic children were at higher risk for positive modifiers, although previous studies have found Hispanic individuals as a group to underreport BH symptoms compared with other ethnic groups. 22,34,35 One previous study even suggested that a lower cutpoint on the PSC would be needed to identify Mexican American children. 35 Although other studies report a relationship between race/ethnicity and positive scores on the PSC, 15,34,36 there has been no attempt to separate the impact of socioeconomic status.…”

“…22,34,35 One previous study even suggested that a lower cutpoint on the PSC would be needed to identify Mexican American children. 35 Although other studies report a relationship between race/ethnicity and positive scores on the PSC, 15,34,36 there has been no attempt to separate the impact of socioeconomic status. In this study of children insured by Medicaid (ie, controlling for socioeconomic status), race/ethnicity predicted positive modifiers, and minority children were more likely to be among those newly identified by BH screens.…”

Improving screening for externalizing behavior problems in very young children : applications of item response theory to evaluate instruments in pediatric primary care.

“…No published studies have investigated the potential utility of these readily available instruments with children under age 4, though targeting children in the preschool age range for screening is imperative for prevention efforts. In addition, some studies have suggested disparities in screening results derived from these instruments by sex Parcel & Menaghan, 1988), race (Jutte, Burgos, Mendoza, Ford, & Huffman, 2003;Simonian & Tarnowski, 2001;Simonian, Tarnowski, Stancin, Friman, & Atkins, 1991; Spencer, Fitch, GroganKaylor, & McBeath, 2005), and SES (Jellinek, Little, Murphy, & Pagano, 1995;Jellinek et al, 1999). While variability in symptom expression and perception across population 5 subgroups is known to exist (U.S. DHHS, 2001), bias in screening instruments can result in both over-identification and under-identification of children in certain groups, stymieing equitable and appropriately targeted primary and secondary prevention efforts (Spencer et al, 2005) and perpetuating social injustices and health disparities.…”

“…Differences in scores yielded by the PSC-17 and the BPI between groups differing by sex Parcel & Menaghan, 1988), race (Jutte et al, 2003;Simonian & Tarnowski, 2001;Simonian et al, 1991; Spencer et al, 86 2005), and SES (Jellinek et al, 1995;Jellinek et al, 1999;Simonian et al, 1991) have not been investigated at the level of item bias. Thus, the quality of measurement offered by these instruments for particular sociodemographic groups is unknown.…”

“…Thus, reliability and validity estimates reported for the PSC-17 and the BPI are dependent on the characteristics of the specific samples used, and application of these instruments with children not represented by these samples may result in changes in psychometric properties (Lord & Novick, 1968). Other shortcomings inherent in CTTbased methods of scale development and evaluation include (a) the untenable assumption that the standard error of measurement (SEM) is constant across all levels of the measured construct (Hambleton & Swaminathan, 1985;Nugent, 2005); (b) floor and ceiling effects (Hambleton, Swaminathan, & Rogers, 1991;Ware, 2003); (c) excessive length (Hambleton et al, 1991;Ware, 2003); and (d) the inability to extricate item-level bias from true group differences in levels of the measured construct (Hambleton & Swaminathan, 1985).These limitations may explain the variability in estimates of reliability and validity of the PSC-17 and BPI when used with groups of children differing by sex, race, and SES (Jellinek et al, 1995;Jellinek et al, 1999;Jutte et al, 2003; Navon, Nelson, Pagano, & Murphy, 2001;Parcel & Menaghan, 1988;Spencer et al, 2005 These vital questions of measurement quality cannot be answered using traditional CTT-based methods of scale evaluation. Alternative, advanced methods are available and are described in the next section.…”