• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
J Epidemiol Community Health. Aug 1995; 49(4): 431–436.
PMCID: PMC1060134

The ten questions screen for childhood disabilities: its uses and limitations in Pakistan.

Abstract

OBJECTIVE--To assess the accuracy of the ten questions screen as a measure of childhood disability for epidemiologic studies in populations lacking resources for professional assessment of children's development and functioning. DESIGN--Household survey and screening of children in phase one followed by clinical assessments in phase two. SETTING--Karachi, Pakistan. PARTICIPANTS--A cluster sample of 6365 children, aged 2 to 9 years, screened using the ten questions and a subsample referred for clinical assessments. MAIN RESULTS--Although the sensitivity of the ten questions as a global screen for serious cognitive, motor, and seizure disabilities is high (84-100%), its sensitivity for identifying and distinguishing specific types of disability and for detecting vision, hearing, and mild disabilities, overall, is limited (generally < 80% and as low as 4% for mild vision disability). The predictive value of a positive screening result is also limited-using the ten questions in surveys without clinical confirmation results in overestimation of the prevalence of serious disability by more than 300%. CONCLUSIONS--The ten questions screen is not an assessment tool. Its utility lies in its ability to screen or select a fraction of the population at high risk for serious disability. As a screening tool, it allows scarce diagnostic and other professional resources to be efficiently directed toward those at high risk.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Hetzel BS, Potter BJ, Dulberg EM. The iodine deficiency disorders: nature, pathogenesis and epidemiology. World Rev Nutr Diet. 1990;62:59–119. [PubMed]
  • Brown KH, Solomons NW. Nutritional problems of developing countries. Infect Dis Clin North Am. 1991 Jun;5(2):297–317. [PubMed]
  • Yunes J, Chelala C, Blaistein N. Children's health in the developing world: much remains to be done. World Health Forum. 1994;15(1):73–76. [PubMed]
  • Richman N. After the flood. Am J Public Health. 1993 Nov;83(11):1522–1524. [PMC free article] [PubMed]
  • Bähr J, Wehrhahn R. Life expectancy and infant mortality in Latin America. Soc Sci Med. 1993 May;36(10):1373–1382. [PubMed]
  • Pison G, Trape JF, Lefebvre M, Enel C. Rapid decline in child mortality in a rural area of Senegal. Int J Epidemiol. 1993 Feb;22(1):72–80. [PubMed]
  • Hagberg B, Hagberg G, Olow I. The changing panorama of cerebral palsy in Sweden. IV. Epidemiological trends 1959-78. Acta Paediatr Scand. 1984 Jul;73(4):433–440. [PubMed]
  • Stanley FJ, Watson L. Trends in perinatal mortality and cerebral palsy in Western Australia, 1967 to 1985. BMJ. 1992 Jun 27;304(6843):1658–1663. [PMC free article] [PubMed]
  • Bhushan V, Paneth N, Kiely JL. Impact of improved survival of very low birth weight infants on recent secular trends in the prevalence of cerebral palsy. Pediatrics. 1993 Jun;91(6):1094–1100. [PubMed]
  • Zaman SS, Khan NZ, Islam S, Banu S, Dixit S, Shrout P, Durkin M. Validity of the 'Ten Questions' for screening serious childhood disability: results from urban Bangladesh. Int J Epidemiol. 1990 Sep;19(3):613–620. [PubMed]
  • Thorburn M, Desai P, Paul TJ, Malcolm L, Durkin M, Davidson L. Identification of childhood disability in Jamaica: the ten question screen. Int J Rehabil Res. 1992;15(2):115–127. [PubMed]
  • Durkin MS, Davidson LL, Desai P, Hasan ZM, Khan N, Shrout PE, Thorburn MJ, Wang W, Zaman SS. Validity of the ten questions screened for childhood disability: results from population-based studies in Bangladesh, Jamaica, and Pakistan. Epidemiology. 1994 May;5(3):283–289. [PubMed]
  • Durkin MS, Wang W, Shrout PE, Zaman SS, Hasan ZM, Desai P, Davidson LL. Evaluating a ten questions screen for childhood disability: reliability and internal structure in different cultures. J Clin Epidemiol. 1995 May;48(5):657–666. [PubMed]
  • Natale JE, Joseph JG, Bergen R, Thulasiraj RD, Rahmathullah L. Prevalence of childhood disability in a southern Indian city: independent effect of small differences in social status. Int J Epidemiol. 1992 Apr;21(2):367–372. [PubMed]
  • Shrout PE, Newman SC. Design of two-phase prevalence surveys of rare disorders. Biometrics. 1989 Jun;45(2):549–555. [PubMed]
  • Chamie M. Survey design strategies for the study of disability. World Health Stat Q. 1989;42(3):122–140. [PubMed]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...