Assessment of parenting and developmental problems in toddlers: development and feasability of a structured interview

Background: Assessment of (early signs of ) parenting and developmental problems in young
children by preventive child health care (CHC) workers is recommended, but no validated
instruments exist. The aim of this project was to develop and test an instrument for early detection
and assessment of problems in toddlers, using the perspectives and experience of both the parent
and the professional.

Methods: Using an iterative process, we adapted and expanded a structured interview on need for
parenting support into the Structured Problem Analysis of Raising Kids (SPARK). The SPARK consists
of 16 subject areas, ranging from somatic health to family issues. The SPARK was tested in daily
practice for feasibility and discriminative capacity. The sample consisted of all toddlers aged 18
months living in Zeeland, a province of the Netherlands, during the study period (n = 1140).

Results: The response rate was 97.8%. Although the median level of support needed according to
the SPARK was low, 4.5% of the toddlers and their parents required intensive help or immediate
action. The risk assessment showed 2.9% high, 16.5% increased and 80.6% low risk for parenting
and developmental problems. The risk assessment of the CHC professional was associated with
known risk factors for child maltreatment.

Conclusions: This study shows that a structured interview, named the SPARK, is feasible in daily
practice and clarifies risks and care needs for parenting and developmental problems in toddlers.