A new measure for infant mental health screening: development and initial validation

Background: Mental health problems are a major public health challenges, and strategies of early prevention are needed. Effective prevention depends on feasible and validated measures of screening and intervention. Previous research has demonstrated potentials for infant mental health screening by community health nurses (CHN) in existing service settings in Denmark. This study was conducted to describe the development of a service setting based measure to screen for infant mental health problems, to investigate problems identified by the measure and assess the validity and feasibility in existing public health settings. Methods: Experts within the field developed a short, feasible and comprehensive measure. A consecutive sample of 2973 infants from 11 municipalities around the city of Copenhagen was screened at 9-10 months. Face validity and feasibility were evaluated among CHNs. Data on child and family factors and the results of screening were included in descriptive analyses. Exploratory factor analysis (EFA) was used to assess content validity. Results: The measure identified problems of communication and interaction in 20.7% of the children, problems of eating in 20.1%, attention problems in 15.9% and problems of emotional regulation in 14.3%. Significant gender differences were seen. EFA demonstrated that among 27 items 11 items were clustering into five areas: Problems of eating, emotions, attention, language and communication and attachment, respectively. High face validity and feasibility was demonstrated, and the participation was 91%. Conclusions: The new measure shows potentials for infant mental health screening. However, further exploration of construct validity and reliability is needed.