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The Survey of Well-being of Young Children
(SWYC)
Ellen C. Perrin, M.D.R. Christopher Sheldrick, Ph.D.
We have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in this CME activity.
We do not intend to discuss an unapproved/investigative use of a commercial product/device in this presentation.
Historical perspective
• Rosie D. lawsuit• CBHI• Available Instruments
– Lengthy– Proprietary– Scoring complex– Fragmented
Our goals
• Surveillance Instrument (birth to 5)– First level screening– Integrate “behavior” and “development”– Include family context/risks– Quick to fill out, score & interpret– “Developmental growth curve”
• Free and in public domain• Amenable to electronic format
– Computer– Telephone– Internet
DevelopmentBehavior
Family Context
DevelopmentBehavior•Internalizing•Externalizing
Family Risk
Baby Pediatric Symptom
Checklist (BPSC)
Preschool Pediatric Symptom Checklist
(PPSC)
Development•Delays•Autism
Behavior•Internalizing•Externalizing
Family Risk
Baby Pediatric Symptom
Checklist (BPSC)
Preschool Pediatric Symptom Checklist
(PPSC)
Milestones
Parent’s Observations of
Social Interactions (POSI)
DevelopmentBehavior
FAMILY RISK FACTORS
Family Risk
FAMILY RISK FACTORSDepressionPHQ-2Substance AbuseAlcoholTobacco Other drugsParental DiscordHunger
Four Domains
• Social-emotional-behavioral– BPSC (Birth to 18 months) – 12 items– PPSC (18 months to 5 years) – 18 items
• Cognitive, Language and Motor– Milestones (each WCV) – 10 items
• Autism– POSI (18 to 36 months) – 7 items
• Family Risks– Each WCV - 11 items
SWYCPsychometrics!
• Latent variable modeling• Comparative effectiveness
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8
Item 9
Item 10
Item 11
Item 12
Item 13
Item 14
Item 15
Item 16
Item 17
Item 18
Social/emotional problems
f1
f2
f3
Latent variable modelingPPSC bifactor model
general factor
item clusters
•Reliability
•Differential Item Functioning
SES ?
PPSC
ASQ-SE
PPSC
ASQ-SE
PRIMARY CARE SAMPLESensitivity Specificity
Total Internalizing Externalizing
CBCL 1.5-5
Total Internalizing Externalizing
CBCL 1.5-5
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
PPSC
ASQ-SE
Sensitivity Specificity
PPSC
ASQ-SE
Total Internalizing Externalizing
CBCL 1.5-5
Total Internalizing Externalizing
CBCL 1.5-5
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
CLINIC SAMPLE
Sensitivity Specificity
ADHD Anxiety Behavior or Conduct Any diagnosis
Parent report of existing diagnosisSpecificity
PPSC
ASQ-SE
CBCL 1.5-5
0.0
0.2
0.4
0.6
0.8
1.0
Other SWYC studies
• POSI v MCHAT• Milestones v ASQ-3• BPSC v ???
Example SWYC Forms
12-Month 24-MonthMilestones
Social/ Emotional Behavior
Page 2 (on the back)
12-Month 24-MonthAutism
Family RiskQuestions
Summary• Surveillance/first level screening instrument• Includes
– Cognitive, language, motor, and social-emotional development
– Autism spectrum disorders– Family context/risks
• Compares well with older instruments• Free, public domain• English and Spanish• Convertible to computer platform
– Tailored for child’s age– Link to follow-up questionnaires
