The development and validation of the screening test for the early prediction of school success (STEPSS) : a screen of cognitive functioning in four- and five-year old children with varying health conditions

The purpose of the present study was to construct and validate a brief screening instrument to support parent(s) and preschool/kindergarten teachers in monitoring and screening for cognitive impairment and/or delay in preschoolers. The target population of interest is all preschoolers at-risk for poor psychosocial and school outcomes due to chronic and acute dysfunction of the central nervous system (CNS). The accessible populations of interest to the present study are pediatric cancer survivors, preschoolers with alcohol related neurodevelopmental disorder (ARND), being preterm low birth weight, and/or diagnosed with various learning disabilities. The past practice of waiting until an at-risk child experienced poor school outcomes before being referred for cognitive assessment toward tailoring an intervention is no longer defensible. For the present study, a 61-item screening instrument (18 memory items, 19 verbal ability items, 15 attention items, and 9 demographic items) was pilot tested with parents, playschool teachers, and kindergarten teachers to rate preschoolers on overt behaviours associated with cognitive functioning. A criterion-referenced framework was used to establish a performance standard and set a cut score based on a sample of 151 normally functioning preschoolers aged 4:0- to 5:11-years. The various empirical and substantive analyses conducted resulted in a revised scale of 28 items (10 memory, 11 verbal ability, and 7 attention) titled, Screening Test for the Early Prediction of School Success (STEPSS). Given the need for a future study to validate the STEPSS with clinical groups of preschoolers, the screening instrument is intended to provide the empirical evidence needed to refer at-risk preschoolers for assessment with more comprehensive cognitive batteries. Constructing and validating the STEPSS is important for two reasons: 1) to fill a gap in the types of instruments available for monitoring and assessing cognitive functioning in at-risk preschool populations; and 2) to alleviate the current delay in targeting interventions for preschoolers because of the practice of depending upon the school system to monitor and identify poor cognitive functioning