Reliability of the Indonesian version of the School-Years Screening Test for Evaluation of Mental Status-Revised as a cognitive screening tool for children

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Ferriandis Harsono
Purboyo Solek
Kusnandi Rusmil


Background Developmental and behavioral problems are among the most common conditions of childhood. These problems affect 12−16% of children in the United States and 13−18% of children in Indonesia. Early detection of developmental deficits among children requires clinicians to screen with accurate tools. Cognitive function screening in children has been increasingly used in many clinical and educational settings. The School-Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) is becoming a widely-used, reliable, and valid cognitive screening tool for children aged 4−15 years. Prior to our study, there was no Indonesian language version of the SYSTEMS-R.
Objective To determine the reliability of the Indonesian translation of the SYSTEMS-R.
Methods A cross-sectional study was conducted in children aged 4−15 years who understood the Indonesian language and did not have neurologic or communication impairments. Data were analysed to determine reliability (internal consistency and inter-rater reliability) of the Indonesian version of SYSTEMS-R. Internal consistency was determined using Cronbach’s alpha formula. Internal consistency is a reflection of inter-item correlation and item-to-total correlation. Inter-rater reliability was determined using the Bland-Altman method.
Results This study was conducted on 133 children aged 4−15 years in a kindergarten, elementary, junior high, and senior high school in Bandung. The Indonesian version of SYSTEMS-R had significant internal consistency (Cron bach’s alpha 0.936−0.941), and the scores obtained by two raters had good agreement (difference within mean + 1.96 SD).
Conclusion The Indonesian version of SYSTEMS-R is reliable for use as a cognitive screening tool for Indonesian children. [Paediatr Indones. 2016;56:149-54.].

Article Details

How to Cite
Harsono F, Solek P, Rusmil K. Reliability of the Indonesian version of the School-Years Screening Test for Evaluation of Mental Status-Revised as a cognitive screening tool for children. PI [Internet]. 1Jul.2016 [cited 19Aug.2019];56(3):149-. Available from:
Developmental Behavioral & Community Pediatrics
Received 2016-08-18
Accepted 2016-08-18
Published 2016-07-01


1. Glascoe FP, Marks KP. Developmental-behavioral screening and surveillance. In: Kliegman RM, Stanton BF, Schor NF, St. Geme III JW, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier; 2011. p. 39-40.
2. Sitaresmi MN, Ismail D, Wahab A. Risk factors of developmental delay: a community-based study. Paediatr Indones. 2008;48:161–5.
3. Boyle CA, Decoufle P, Yeargin-Allsopp M. Prevalence and health impact of developmental disabilities in US children. Pediatrics. 1994;93:399-403.
4. Bailey DB, Hebbeler K, Scarborough A, Spiker D, Mallik S. First experiences with early intervention: a national perspective. Pediatrics. 2004;113:887-96.
5. Wiguna T, Setyawati N, Kaligis F. Uji diagnostik working memory rating scale (WMRS) versi Bahasa Indonesia dan proporsi anak sekolah dasar dengan kesulitan belajar dan defisit working memory di Jakarta. Sari Pediatri. 2012;14:191-7.
6. Santos LHC, Pimentel RF, Rosa LGD, Muzzolon SRB, Antoniuk SA, Bruck I. Cognitive and behavioral screening of children with learning disabilities: a preliminary study. Rev Paul Pediatr. 2012;30:93-9.
7. Bernal P, Estroff DB, Aboudarham JF, Murphy M, Keller A, Jellinek MS. Psychosocial morbidity: the economic burden in a pediatric health maintenance organization sample. Arch Pediatr Adolesc Med. 2000;154:261-6.
8. Navon M, Nelson D, Pagano M, Murphy M. Use of the pediatric symptom checklist in strategies to improve preventive behavioral health care. Psychiatr Serv. 2001;52:800-4.
9. Bornholt LJ, Ajersch S, Fisher IH, Markham RH, Ouvrier RA. Cognitive screening for children and adolescent: general limits or ceiling effects? J Child Neurol. 2010;25:567-71.
10. Ouvrier RA, Hendy J, Bornholt LJ, Black FH. SYSTEMS: School-years screening test for the evaluation of mental status. J Child Neurol. 1999;14:772-80.
11. Bornholt LJ, Spencer FH, Fisher IH, Ouvrier RA. Cognitive screening for young children: development and diversity in learning contexts. J Child Neurol. 2004;19:313–7.
12. Fisher L, Spencer F, Ouvrier RA. SYSTEMS-R cognitive screening for children & adolescent. Australia: Watervale Systems; 2010. p. 1-2.
13. Spencer FH, Bornholt LJ. Investigating moderators of test–retest reliability in screening children’s cognitive functioning. Aus J Ed Dev Psych. 2005;5:91–106.
14. Spencer FH, Bornholt LJ, Ouvrier RA. Test reliability and stability of children’s cognitive functioning. J Child Neurol. 2003;18:5–11.
15. Ouvrier RA, Hendy J, Bornholt LJ, Black FH. SYSTEMS manual, guide for administration and scoring. Australia: the Children’s Hospital at Westmead and The University of Sydney; 2000. p. 5-16.
16. Satari MH, Wirakusumah FF. Konsistensi penelitian dalam bidang kesehatan. Bandung: Refika Aditama; 2010. p. 74-5.
17. Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. Am J Health Syst Pharm. 2008;65:2276-84.
18. Azwar S. Reliabilitas dan validitas. 4th ed. Yogyakarta: Pustaka Pelajar; 2013. p. 25—136.
19. McDowell I. Measuring health: a guide to rating scale and questionnaires. 3rd ed. USA: Oxford University Press; 2006 [cited 2014 September 29]. Available from:
20. Portney LG, Watkins MP. Foundations of clinical research: application to practice. 3rd ed. New Jersey: Prentice Hall; 2008. p. 588-621.
21. Sedgwick P. Limits of agreement (Bland-Altman method). BMJ. 2013;346:f1630.
22. Myles PS, Cui J. Using the Bland–Altman method to measure agreement with repeated measures. Br J Anaesth. 2007;99:309-11.
23. Visser L, Ruiter SAJ, van der Meulen BF, Ruijssenaars WAJJM, Timmerman ME. A review of standardized developmental assessment instruments for young children and their applicability for children with special needs. Journal of Cognitive Education and Psychology. 2012;11:102-7.
24. Campbell JM, Brown RT, Cavanagh SE, Vess SF, Segall MJ. Journal of Pediatric Psychology. 2008;33:999-1014.