2-5 (FTF-T)
The toddler version of the FTF (FTF-T) is a questionnaire which clarifies parents' perceptions of their childs difficulties and strengths with various developmental areas.
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About the FTF-T questionnaire
The toddler version of the FTF (FTF-T) is a questionnaire designed for examination of children ages 2-5. It was recently developed by researchers and clinicians with many years’ experience examining children with neuropsychiatric problems through the lenses of psychiatry, psychology and speech and language pathology (Kadesjö, Miniscalco, Hagberg & Gillberg, unpublished). The purpose of the FTF-T is to find out how parents perceive their child’s strengths and difficulties in different areas of development. Results from this questionnaire are not to be used as the sole basis for diagnosis, but rather as part of a comprehensive examination process (Kadesjö et al., unpublished). FTF-T is meant to aid in early detection of children with ESSENCE problems, and thereby enable further examination and intervention.
How is the FTF-T scored?
The FTF-T consists of 124 items, each being a statement which the respondent assesses as either 0 (“Does not apply”), 1 (“Applies sometimes/to some extent”) or 2 (“Applies”). The items are divided into 8 different areas of development: motor skills, executive function, perception, memory, language, learning, social skills and behaviour. Most domains are further divided into two or more subdomains.
There are also so-called “influence questions” after each domain, in which parents are asked to summarise whether the child’s behaviour creates difficulties in everyday life.
Finally, parents are asked to freely describe their child’s greatest strengths as well as whatever problems they are most worried about. This assessment should be based on the child’s behaviour over the last three months.
How is the FTF-T validated?
The FTF-T was first normed for children ages 25-40 months in a master’s thesis in speech and language pathology (Johansson & Karlsson, 2015). The FTF-T language domain was validated against the Bayley Scales of Infant Development – third version (Bayley-III) language scale, and parents were asked to fill out an evaluation form detailing their experiences of FTF-T. A total of 33 children (and their parents) took part in the study. The norming results for FTF-T showed that attention/hyperactivity had the highest average of any domain, while social skills and behaviour had the lowest averages. The validation showed that there were no significant links between the FTF-T language domain and the Bayley-III language scale. The results of the evaluation form showed that parents were generally happy with FTF-T. Suggested improvements were also brought forth.
Another study examined prevalence of language disorder and developmental profiles found by the FTF-T among 100 children who had screened positive at the 2.5 year language screening at the child care centre, but negative at the autism screening performed on the same occasion (Schachinger-Lorentzon et al., 2018). The study sought to answer the following questions: 1) Which types of language disorders would a speech and language pathologist diagnose the children with? 2) Do the parents find that their children struggle with language or any of the other developmental areas included in the FTF-T? 3) What is the relationship between parental concerns expressed in the FTF-T and various language disorders?
Out of the 100 children examined, 87 (29 girls, 58 boys) met criteria for a language disorder (ICD-10). The more severe the language problems were, the more worried parents were about other developmental areas like motor skills, learning and social behaviour. Somewhat surprisingly, few problems in other developmental areas were addressed by parents during the clinical examination process. Possible explanations for this might be: i) parents of toddlers who screen positive at age 2.5 are careful about reporting problems in other developmental areas according to the FTF-T, ii) parents are not aware of these problems, iii) parents seem to primarily recognise difficulties in language and language-related areas, e.g. social competence, iv) the questionnaire needs further improvement in order to detect such difficulties, v) the children might in fact not have shown any such difficulties or vi) parents might have a hard time recognising such issues, e.g. perception problems, in a toddler.
The FTF-T is still being validated. The 100 children are currently being followed up using the Five to Fifteen-R (FTF-R).