Design and preliminary validation of the verbal skill scale in the dental setting: An anxiety scale for children

Abstract

Purpose: The purpose of this study was to design and examine the validity of a scale that uses the verbal performance of children as an indicator of dental anxiety. Methods: A total of 128 healthy 4- to 6-year-olds were included. The first sessions consisted of a dental examination; in the second session, identical dental treatment was provided to all subjects. In each session, a short communication was done for verbal assessment. During treatment, Frankl and clinical anxiety rating scales were utilized to assess the child's anxiety. Construct validity was assessed using Spearman's correlation coefficient; a factor analysis, concurrent validity, and inter-rater reliability were determined by kappa agreement statistics. Chi-square and Fisher's exact tests were used to assess the difference between sexes. Results: The agreement between the raters was high and significant (k=0.71, P<.001). Intraclass correlation coefficient of 50 same children (28 boys and 22 girls) across a 2-week period showed a strong correlation (correlation=0.8, P<.001). Spearman's correlation coefficient revealed a high and significant correlation between the measures (P<.001). The kappa values ranged from 0.58 to 0.67, suggesting moderate to good agreement between measures. Conclusions: The verbal skill scale is a reliable and valid measure of assessing child dental anxiety in a clinical context.