Refining the test items of a screening tool for Specific Learning Disorders through a Delphi survey

Abstract

Specific Learning Disorders (SpLD) are a group of conditions manifested by persistent challenges in reading, writing, and arithmetic, namely Dyslexia, Dysgraphia, and Dyscalculia respectively, affecting 5%-15% of children globally. Children with SpLD often have academic, occupational, societal and personal challenges and mental health issues impacting their families as well. However, Sri Lanka lacks an early identification program or a culturally relevant screening tool, underscoring a critical gap in its education and healthcare systems. To bridge this gap, a culturally appropriate screening tool was developed for primary school children. The initial 50-item pool was identified through a desk review, several in-depth interviews and a few focus group discussions to assess reading, writing, and arithmetic difficulties. The item pool required further refinement for face validity, age-appropriateness, usability for teachers, and time efficiency. A Delphi survey was employed to optimize the tool, drawing on expertise from national and international arenas in the fields of psychiatry, linguistics, psychology, public health, speech and language therapy, and education. The two-round Delphi process began with qualitative interviews followed by quantitative analyses of expert feedback in the first round. This was used for modification, addition, or removal of items. In the second round, experts reviewed the revised tool via email, culminating in a consensus on the final item pool. As a result, the Delphi process refined the tool to a 40-item pool, covering essential reading, writing, and arithmetic skills. This approach proved highly effective in creating a reliable and culturally relevant screening tool for SpLD in Sri Lanka. Through iterative improvements and expert contributions, the tool was refined to meet local cultural needs, making it a valuable resource for the early identification of learning disorders in primary school children in Sri Lanka, which will enable them to avoid adversities and have a better quality of life.