A Brief Validated Alcohol Screener for Use in Clinical Pediatric Practice

To the Editor

I read with interest the article by Hammond et al ¹ on perceived barriers among pediatricians to the implementation of adolescent SBIRT (Screening, Brief Intervention, and Referral to Treatment). The study noted that while 88.4% of participants screened adolescents for alcohol and drug use annually, only 26.0% of participants used validated screening instruments. This represents an opportunity to integrate more effective and efficient screening tools in clinical practice.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the American Academy of Pediatrics (AAP) developed an evidence-based, 2-item brief screener ² for underage alcohol use, developmentally appropriate for children and adolescents from ages 9 to 18 years. Based on epidemiological and developmental data, the screener items assess clients’ alcohol use and that of their peers. Risk classifications based on item responses are linked to specific brief intervention options, adapted for implementation in clinical pediatric practice.

The NIAAA Brief Alcohol Use Screener was developed to promote the universal dissemination of SBIRT into clinical pediatric practice based on the screener’s brevity, ease of use, and developmental characteristics. The 2 items are tailored for this age period and include age-graded item responses, age-appropriate item wording and delivery, and developmentally informed criteria for determining alcohol use risk classifications. Recent validation studies using adolescents recruited from emergency department and primary care settings generated data supporting both the reliability and concurrent validity of risk classifications for the identification of adolescents with alcohol problems or alcohol use disorders (AUDs), ³ and their predictive validity for later onset of AUDs. ⁴ Our evaluations ⁵ of the NIAAA screener in a school-based, predominant minority sample of adolescents demonstrated better criterion validity than other, more widely used alcohol screeners, due to its ability to detect early-stage alcohol use problems, as well as strong predictive validity.

Please consider integrating this validated screener into your clinical pediatric practice.

Author Contributions

The author is solely responsible for study design, review of the first draft, approval of the final version and agrees to be accountable for the work.