Can social communication and attention disturbances at 18 months of age be detected by the public health nurse screening in the first year of life? The Copenhagen County Child Cohort (CCCC) 2000

Ugeskr Læger 2007;169(11):1001-1005

Introduction: The prevention of disorders in social communication and attention is hampered by the lack of effective tools to screen in the first year of living. In Denmark public health nurses perform screening of physical and mental health in all infants, and at the age of 8-10 months a standardised test, BOEL, is performed to screen for hearing loss plus social communication and attention disturbances.

Method: The predictive value of abnormal reactions at the BOEL test at 8-10 months of age was investigated in a subpopulation of 211 children from the CCCC 2000. Predictions were calculated in relation to outcome concerning psychopathological disturbances in social communication and attention, diagnosed by child psychiatric assessment at 18 months.

Results: Communication and attention disturbances at 18 months were predicted by the BOEL test with predictive validity of positive test (PV pos) 29%, and the predictive validity of negative test (PV neg) 95%. The BOEL test was found superior to the general clinical judgement by the public health nurses.

Conclusion: The infant mental health screening by public health nurses seems to have potential concerning early identification of social communication and attention disturbances by using the BOEL test, but investigations of larger populations and with a longer time of observation are needed.