Early identification of social-emotional problems: Applicability of the Infant-Toddler Social Emotional Assessment (ITSEA) at its lower age limit.

ITSEA is an often recommended tool for assessment of social-emotional problems and competence delays in children aged 12-36 months, but concerns have been raised about low variability and age-inappropriate questions for children as young as 12 months. This study explored ITSEA's (1) psychometric properties, (2) properties concerning the detection of clinically significant problems and competence delays and (3) discriminant validity at 12 months. A total of 102 children with high versus low risk scores on marker measures of developmental status and parenting stress obtained at 6 months, were selected from a longitudinal population-based study to participate in the present study. Risk status was operationalized as Bayley III Screening Test (Bayley, 2005a. Bayley scales of infant and toddler development: Screening test manual (3rd ed.). San Antonio, TX: Pearson) Composite Subscale scores and Parenting Stress Index total score (PSI, 3rd edition, Abidin, 1995. Parenting Stress Index. Professional manual. (3rd ed.). Odessa, FL: Psychological Assessment Resources). At 12 months, ITSEA was administered to parents as a structured interview to identify guidance needs and to collect qualitative information about the items, and the assessment of developmental level and parenting stress was repeated. All ITSEA domains and subscales were found to be relevant. However, nearly all respondents needed guidance. Moreover, there were substantial floor/ceiling effects on subscale level and one item had to be discarded. ITSEA was used in combination with the Bayley-III Screener and PSI to detect cases with clinically significant scores, with ITSEA making a unique contribution to case detection. Dysregulation problems were the most frequently detected, and the differences between high-risk and low-risk group children and gender differences indicated adequate discriminant validity. The results suggest that ITSEA may be meaningfully applied even among children as young as 12 months.