Toward the testing of instruments to be used in identifying severely mentally retarded children

The identification of severely mentally retarded children in developing countries is an extremely challenging task; it is made even more difficult if one aims to obtain prevalence and incidence rates that are comparable in different countries. It is the premise of this paper that before such an awesome task is initiated, pilot tests must be run to develop measurement tools that work in each of the countries to be studied. Primary attention has been placed on the development of a screening measure that presumably will be used to identify children who will be examined further by a diagnostician. Although costly, a two-stage process of case identification has many advantages, including less biased estimation of rates of rare disorders such as severe mental retardation and a reduction in the number of children missed who need treatment. While the specifics of the diagnostic stage of the case-identification procedure are yet to be worked out, we should proceed to pilot testing of the Belmont screening measure, not only to develop and test it further in the field but also to gain a concrete idea of the feasibility of working in the various developing countries around the world.