Preliminary psychometric properties of a multidimensional comprehensive screening tool (MCOST) for early detection of psychosocial, behavioral, and neurocognitive deficits in pediatric cancer survivors: A prospective observational study

ABSTRACT Background: Childhood cancer and its treatment produce complex, multilayered effects across active treatment, maintenance, and survivorship phases. The focus of care has shifted toward early identification of difficulties related to biological functioning, somatic complaints, neurocognitive deficits, learning difficulties, emotion regulation, behavioral problems, and psychosocial functioning. Objectives: The primary objective was to develop a Multidimensional Comprehensive Screening Tool (MCOST) for children in maintenance and survivorship phases of cancer and the secondary objective was to evaluate its preliminary psychometric properties. Materials and Methods: A qualitative and cross-sectional design with purposive sampling was used. Following pretesting on 19 children, 59 participants [Male: 40 (67.8%); Mean age: 8.05 ± 1.94 years; Mean Social Quotient: 103.0 ± 12.31; 42 (71.2%) survivors] were included in the pilot. Tools used included the Vineland Social Maturity Scale (VSMS) for Social Quotient, Pediatric Quality of Life (PedsQL) for overall functioning, Mini-Mental Examination for Children (MMC) for cognitive deficits, and Child Behavior Checklist (CBCL) for behavioral issues. Results: MCOST comprises of 51 items across six domains on a 3-point Likert scale. It demonstrated excellent content validity (CVI > 0.90), no significant floor/ceiling effects, and strong internal consistency (α = 0.72 – 0.84). It showed good convergent validity with PedsQL, CBCL, MMC and reflected known-group validity across gender and treatment phase. Higher scores indicate higher deficits. Conclusion: MCOST exhibits strong preliminary psychometric properties and offers a unified alternative to multiple tools currently used by clinicians and researchers in pediatric oncology settings.