Diagnostic Accuracy of the AHEAD Developmental Module Compared to the Trivandrum Developmental Screening Chart (TDSC) in Children Aged 1 Month to 5 Years

Abstract

Background: Early identification of developmental delays is critical for timely intervention. In India, the Trivandrum Developmental Screening Chart (TDSC) is a widely accepted tool but is limited in scalability and digital adaptability. The AHEAD Developmental Module is a novel digital screening tool designed to overcome such limitations.

Aim: To assess the diagnostic accuracy of the AHEAD Developmental Module compared to the TDSC in detecting developmental delays in children aged 1 month to 5 years.

Methods:

A cross-sectional validation study was conducted involving 800 children. Both the AHEAD Developmental Module and TDSC were administered to each participant, and results were compared against a gold-standard developmental paediatrician assessment. Diagnostic parameters such as sensitivity, specificity, predictive values, likelihood ratios, and kappa agreement were computed.

Results: The AHEAD module demonstrated a sensitivity of 64.1% (95% CI: 56.7–70.1%) and specificity of 94.5% (95% CI: 92.3–96.0%). The positive predictive value was 81.7%, and negative predictive value was 87.2%. The likelihood ratios (LR⁺ = 11.56, LR⁻ = 0.38) indicated high discriminative ability. Cohen’s Kappa was 0.627 (p < .001), suggesting substantial agreement with the TDSC, and PABAK was 0.72.

Conclusion: The AHEAD Developmental Module demonstrates substantial diagnostic accuracy and can serve as a viable, scalable, and culturally contextual alternative to conventional tools like the TDSC in community and clinical settings.