Polihronis Christine, Cloutier Paula, Robson Scott, Beaudin Kayla, Blackburn Josée, Dawson Cindy, Cappelli Mario
Knowledge Institute on Child and Youth Mental Health and Addictions, CHEO, Ottawa, Ontario, Canada.
Mind Matters Team, CHEO Research Institute, Ottawa, Ontario, Canada.
Paediatr Child Health. 2025 Apr 3;30(4):312-319. doi: 10.1093/pch/pxae103. eCollection 2025 Jul.
Communimetric screening tools convey functional impairment and action required, helping clinicians identify and communicate patient's needs and actions within a measurement framework. We examined the feasibility of using the HEADS-ED Under 6, a communimetric mental health (MH) and developmental screening and triage tool for children under 6, within 1Call1Click.ca, a regional coordinated access and navigation program in Eastern Ontario. We explored utility validity to understand how the HEADS-ED Under 6 is used to help intake workers screen, inform their level of need decision, and establish a cut-off for recommending interventions targeting moderate levels of need or higher.
Using a prospective cohort design, intake workers at 1Call1Click.ca screened all children under 6 using the HEADS-ED Under 6 from June 2021 to August 2023. Correlations and an Analysis of variance examined how total scores were associated with the level of need, and Receiver Operator Curve analysis examined sensitivity and specificity for identifying moderate levels of need or higher.
In total, 589 children under 6 were screened with the HEADS-ED Under 6. Utility validity was demonstrated by significant associations between level of need and HEADS-ED Under 6 domains and total scores. A total score of ≥6 supported decision-making for moderate levels of need or higher (Area Under Curve = 0.807).
The HEADS-ED Under 6 is a brief, easy, and valid screening tool, that can be used by clinicians to identify the level of action/impairment, communicate the severity of MH and developmental needs, and determine the level of need for services.
综合测量筛查工具可传达功能损害情况及所需采取的行动，有助于临床医生在测量框架内识别并交流患者的需求与行动。我们在安大略省东部的区域协调接入与导航项目1Call1Click.ca中，检验了使用6岁以下儿童心理健康（MH）及发育筛查与分诊工具HEADS-ED Under 6的可行性。我们探究了实用效度，以了解HEADS-ED Under 6如何用于帮助接待工作人员进行筛查、告知其需求水平决策，并确定针对中度及以上需求水平推荐干预措施的临界值。
采用前瞻性队列设计，1Call1Click.ca的接待工作人员在2021年6月至2023年8月期间使用HEADS-ED Under 6对所有6岁以下儿童进行筛查。相关性分析和方差分析检验总分与需求水平的关联，受试者操作特征曲线分析检验识别中度及以上需求水平的敏感性和特异性。
共有589名6岁以下儿童接受了HEADS-ED Under 6筛查。需求水平与HEADS-ED Under 6各领域及总分之间存在显著关联，证明了实用效度。总分≥6支持对中度及以上需求水平的决策制定（曲线下面积 = 0.807）。
HEADS-ED Under 6是一种简短、简便且有效的筛查工具，临床医生可使用它来识别行动/损害水平、传达MH及发育需求的严重程度，并确定服务需求水平。
