VALIDITY OF THE 10 QUESTIONS SCREEN FOR CHILDHOOD DISABILITY - RESULTS FROM POPULATION-BASED STUDIES IN BANGLADESH, JAMAICA, AND PAKISTAN

An international study to validate the Ten Questions screen for seriou s childhood disability was undertaken in communities in Bangladesh, Ja maica, and Pakistan, where community workers screened more than 22,000 children ages 2-9 years. All children who screened positive, as well as random samples of those who screened negative, were referred for cl inical evaluations. Applying comparable diagnostic criteria, the sensi tivity of the screen for serious cognitive, motor, and seizure disabil ities is acceptable (80-100%) in all three populations, whereas the po sitive predictive values range from 3 to 15%. These results confirm th e usefulness of the Ten Questions as a low cost and rapid screen for t hese disabilities, although not for vision and hearing disabilities, i n populations where few affected children have previously been identif ied and treated. They also show that the value of the Ten Questions fo r identifying disability in underserved populations is limited to that of a screen; more thorough evaluations of children screened positive are necessary to distinguish true- from false-positive results and to identify the nature of the disability if present.