Van Wiechen Developmental Test

In addition to the validation of the overall PEDS, validity of the PEDS language items was assessed, using the Van Wiechen developmental test as reference standard (43, 55–57). This Dutch instrument is a modification of the Gesell test and is routinely used by all PCHC Centers in the Netherlands and Belgium to monitor the development of all children from birth to the age of 4 years. It consists of a set of 57 developmental indicators to assess motor behavior, speech, communication, and social skills based on physicians' observations and interviewing the parents. A total of 23 indicators cover language development and communication and are called language milestones. All PCHC professionals are trained to asses and register mile stones in the PCHC system according to a uniform protocol. For this paper, the Van Wiechen communication and language items were used. In a large community-based sample of Dutch children, test characteristics of the Van Wiechen language items for the age group 36–48 months showed an Area Under the Curve (AUC) of 0.83%, with an average sensitivity of 66.1%, specificity of 87.5%, positive predictive value (PPV) of 29.2%, and a negative predictive value (NPV) of 98.8% (58).

In a study in Australia, agreement between ratings of parental PEDS language concerns and clinical assessment was high (86–90%); agreement between teacher PEDS language concerns and clinical assessment was lower and more varied (63–80%) (59). In this study, parental and professional caregiver PEDS language concerns were combined to provide complementary information and capture all possible language concerns of a specific child. Subsequently this combined concerns variable was validated; reference standard was the Van Wiechen developmental test, communication and language items (see above) (60, 61). For this study, the PCHC professionals were asked to judge the Van Wiechen language and communication items as “sufficient” or “not sufficient,” at the age of 3 years and a year later.