McLean R K, Tully L A, Brinley S K, Carl T, Turnell A, Northam J C, Dadds M R
School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.
School of Medicine and Psychology, The Australian National University, Canberra, Australia.
Clin Child Fam Psychol Rev. 2025 Mar;28(1):1-21. doi: 10.1007/s10567-024-00506-2. Epub 2024 Nov 14.
Children develop rapidly in the preschool period, making accurate appraisals of mental health (MH) difficult. The preschool years are a key period for early identification of MH concerns and could benefit from multi-informant, universal MH screening (UMHS). This systematic review aimed to identify multi-informant UMHS measures for preschool-aged children, and to examine their clinical utility, effectiveness, and acceptability. Studies reporting the predictive and incremental validity, effectiveness or acceptability of parent and educator-report UMHS measures for children aged 3-5 years were identified through CINAHL, Embase, ERIC, Medline, PsycINFO, Scopus and Web of Science. Studies were excluded if screening was not the primary focus, not universal, single informant, or primarily focussed on Autism Spectrum Disorder. A total of 11 studies using 10 measures was identified. Ten studies screened for broad MH difficulties. Three educator-report and one parent- and educator-report measures had acceptable predictive validity. One study reporting incremental validity found that adding educator-report to parent ratings significantly improved the identification of MH concerns. No studies reported on effectiveness. Three studies that explored acceptability reported strong support for either UMHS in general or specific measures. There are promising results that UMHS can accurately identify child MH concerns in the preschool period using parent and educator reports. However, with few of the examined measures reaching the benchmark standards for predictive validity and only one study examining incremental validity, further research is needed to establish clinical utility. UMHS with preschool populations appears to be acceptable; future studies should further examine multi-informant screening in preschool populations. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; https://www.crd.york.ac.uk/prospero ; registration number: CRD 42022383426).
儿童在学龄前阶段发育迅速，这使得准确评估心理健康状况变得困难。学龄前阶段是早期识别心理健康问题的关键时期，多信息源的通用心理健康筛查（UMHS）可能会有所帮助。本系统评价旨在确定针对学龄前儿童的多信息源UMHS措施，并考察其临床效用、有效性和可接受性。通过CINAHL、Embase、ERIC、Medline、PsycINFO、Scopus和Web of Science等数据库，检索了报告针对3至5岁儿童的家长和教育工作者报告的UMHS措施的预测效度、增量效度、有效性或可接受性的研究。如果筛查不是主要重点、不具有普遍性、为单一信息源或主要关注自闭症谱系障碍，则排除相关研究。共识别出11项使用10种测量方法的研究。10项研究筛查了广泛的心理健康问题。三项教育工作者报告的测量方法以及一项家长和教育工作者报告的测量方法具有可接受的预测效度。一项报告增量效度的研究发现，在家长评分中加入教育工作者报告能显著改善对心理健康问题的识别。没有研究报告有效性。三项探讨可接受性的研究报告称，总体上对UMHS或特定测量方法有强烈支持。有一些很有前景的结果表明，UMHS可以通过家长和教育工作者的报告准确识别学龄前儿童的心理健康问题。然而，由于所考察的测量方法中只有少数达到预测效度的基准标准，且仅有一项研究考察了增量效度，因此需要进一步研究以确定其临床效用。针对学龄前人群的UMHS似乎是可接受的；未来的研究应进一步考察学龄前人群中的多信息源筛查。本系统评价已在国际前瞻性系统评价注册库（PROSPERO；https://www.crd.york.ac.uk/prospero ；注册号：CRD 42022383426）注册。
