Red Flags for Early Referral for Infant Mental Health: Content Validation of a Tool

There is growing evidence about the psychological distress and mental health issues experienced by infants with developmental problems. Problems related to developmental issues can be mitigated with early identification and intervention. A simple screening measure is needed to identify infants at risk for mental health issues to make informed decisions about further assessment and interventions. In this background, the present study aimed to develop a checklist to identify infants with psychological distress and at risk for mental health issues without the need to administer full-scale socioemotional tools and intended to be used by primary care professionals for early identification of risk factors followed by intervention to reduce the risk. Early identification of infants at risk in view of the limited resources would help in reducing the impact of early trajectories on the socioemotional health of any infant. The present study aims to develop a checklist for rapid screening. In view of the limited resources of low-income countries, early identification of infants at risk is important. This would help in reducing the impact of early trajectories on the socioemotional health of infants. The checklist was based on the “functional and emotional developmental approach” and a literature review of early indicators of psychological distress and mental health issues in infants. The checklist was prepared using objective terms which were further evaluated by mental health experts using standard methods. Accordingly, a content validity index (CVI) was calculated to determine the relevance and clarity of the items. Based on the CVI, 16 items were retained in the final checklist, which was reported to have excellent relevance (CVI = 0.91) and clarity (CVI = 0.84). The checklist is concise with adequate content validity and has the potential to be used in primary care settings to screen infants at risk for psychological distress and mental health issues and make appropriate referrals.