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Questionnaires improve detection of psychosocial problems in children aged 2-4 years

12 June 2013

There is room for improvement in the early detection of psychosocial problems in preschool-aged children by the Dutch Preventive Child Healthcare. Meinou Theunissen, a researcher at the TNO research organization, has established which questionnaires could improve the detection of psychosocial problems in children aged 0-4 years. ‘If these questionnaires were implemented, it would give the Preventive Child Healthcare the right tools to identify which children in this age group have psychosocial problems. The child healthcare professionals currently only identify half of the children with problems. The questionnaires would really improve early detection’, says Theunissen. She will be awarded a PhD for her thesis by the University of Groningen on 17 June 2013.  

The aim of the questionnaires, which the child’s parent or guardian fills in, is to detect behavioural or emotional problems in young children, such as difficulty initiating contact, hyperactivity, anxiety, aggression, difficulty interacting with peers and withdrawn behaviour.

Early detection

The child healthcare physicians and nurses who work for the Preventive Child Healthcare see almost all children aged 0­4 years at routine well-child visits.. As they are in regular contact with parents and children, their role in the early detection of psychosocial problems in children is extremely important. However, there is still room for improvement. Theunissen found that a number of previous attempts to improve detection at a national level had not been particularly successful.

Validity of the questionnaires

Theunissen compared different questionnaires in her research. ‘A questionnaire must be good at distinguishing between behaviour that is normal and behaviour that differs from the norm’, she says. She used data from a large number of preventive child healthcare services in the Netherlands to determine which questionnaires were good at identifying psychosocial problems. She also looked at whether detection in children aged 0-4 would improve if the Preventive Child Healthcare used these questionnaires.


Based on her results Theunissen recommends the nationwide implementation in the Preventive Child Healthcare of the questionnaires that came out best in her research. This would ensure that children aged 2-4 are examined properly. Theunissen concludes that the Preventive Child Healthcare cannot simply rely on the clinical assessment of the child healthcare physician or nurse but should also use good questionnaires that have been validated. She also concludes that none of the questionnaires that she studied improved detection in children aged 6-14 months.

Curriculum Vitae

Meinou Theunissen (Horn, 1981) studied Psychology at Maastricht University. She is a researcher in the Department of Child Health at TNO in Leiden. Her research was supervised by Prof. S.A. Reijneveld, head of the Department of Health Sciences at the UMCG and scientific adviser to TNO, and Dr A.G.C. Vogels from the Department of Child Health at TNO. The research was funded by ZonMw. Theunissen’s thesis is entitled ‘The early detection of psychosocial problems in children aged 0-6 years by Dutch preventive child healthcare: professionals and their tools.’

Last modified:13 March 2020 02.16 a.m.
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