Validation of Rashtriya Bal Swasthya Karyakrama screening tool for Early Developmental Delay

Abstract

Background: Early identification of developmental delay is critical for timely intervention, particularly in low- and middle-income countries. The Rashtriya Bal Swasthya Karyakram (RBSK) developmental screening tool is widely used in India, yet evidence on its validation is limited. Objective: To validate the RBSK developmental screening tool against the Ages and Stages Questionnaire (ASQ) among children aged 0–3 years. Methods: A cross-sectional validation study was conducted among 262 children attending selected rural and urban primary health centers in Bengaluru. Children were screened using both RBSK and ASQ tools across multiple developmental domains. Sensitivity, specificity, predictive values, likelihood ratios, accuracy, and agreement (Kappa statistics) were calculated. Results: RBSK identified developmental delay in 13% of children compared to 10.7% by ASQ. The tool demonstrated high sensitivity (96.4%), specificity (97.0%), and accuracy (97.0%). Agreement between RBSK and ASQ was substantial across domains, particularly in gross and fine motor development, with comparatively lower agreement in the social domain. Conclusion: The RBSK developmental screening tool shows excellent validity and substantial agreement with ASQ, supporting its use as a reliable, feasible, and cost-effective screening instrument for early detection of developmental delay at the community level.