TY  - JOUR
AU  - Wells, Sarah L.
AU  - Baillargeon, Raymond H.
PY  - 2025
DA  - 2025/02/08
TI  - Evaluating Screening Guidelines for Disruptive Behavior Problems in Children: A Systematic Review of the Accuracy of Parents’ Concerns
JO  - OBM Integrative and Complementary Medicine
SP  - 009
VL  - 10
IS  - 01
AB  - Disruptive behavior problems (DBPs) in young children are early indicators of potential disruptive behavior disorders (DBD), which can lead to negative health and social outcomes. Secondary prevention strategies that target DBPs may facilitate early interventions and reduce these risks. Current Canadian pediatric practice guidelines provide an example one such strategy and suggest screening for DBPs only if a child’s parent reports concerns about their behavior. This systematic review sought to determine if parents’ concerns can provide enough information to justify a decision in favour of, or against, screening for DBPs. The protocol was registered on Prospero (CRD42021157492), and no funding was received. Six databases were searched (March 23–26, 2022) for prospective, retrospective, or naturalistic studies assessing the diagnostic accuracy of parents' concerns. Studies were included if they elicited parents' concerns about their child's behavior via an index test, used a reference standard to identify DBPs in children aged 0-5, and reported true/false positive and true/false negative outcomes. Studies were excluded if they did not include children in the target age range, did not report the outcomes of interest, used inappropriate sampling methods, measured heterogeneous mental health problems, elicited heterogeneous concerns from parents, or if they were not a primary analysis of data. Risk of Bias was assessed using the QUADAS-2 tool, and results were synthesized to produce calibrated estimates of the accuracy of parents’ concerns in the form of weighted kappa coefficients. Of 53 studies reviewed, only one met the eligibility criteria. Moderate agreement was found between the absence of DBPs and parents' concerns (k = 0.533, 95% CI: 0.501-0.564) and fair agreement for the presence of DBPs and parents’ concerns (k = 0.255, 95% CI: 0.238-0.272). These findings suggest that parents' concerns alone may not be sufficiently accurate to guide clinical screening decisions, highlighting a significant gap in the literature. Further research is needed to validate this approach. Until more data becomes available, clinicians should be cautious when interpreting the presence or absence of parents’ concerns about their child’s behavior, and in using parents’ concerns when making decisions to screen for DBPs.
SN  - 2573-4393
UR  - https://doi.org/10.21926/obm.icm.2501009
DO  - 10.21926/obm.icm.2501009
ID  - Wells2025
ER  -