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Population Health Metrics
Published in: Population Health Metrics 1/2017

Open Access 01-12-2017 | Research

Development and validation of an early childhood development scale for use in low-resourced settings

Authors: Dana Charles McCoy, Christopher R. Sudfeld, David C. Bellinger, Alfa Muhihi, Geofrey Ashery, Taylor E. Weary, Wafaie Fawzi, Günther Fink

Published in: Population Health Metrics | Issue 1/2017

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Abstract

Background

Low-cost, cross-culturally comparable measures of the motor, cognitive, and socioemotional skills of children under 3 years remain scarce. In the present paper, we aim to develop a new caregiver-reported early childhood development (ECD) scale designed to be implemented as part of household surveys in low-resourced settings.

Methods

We evaluate the acceptability, test-retest reliability, internal consistency, and discriminant validity of the new ECD items, subscales, and full scale in a sample of 2481 18- to 36-month-old children from peri-urban and rural Tanzania. We also compare total and subscale scores with performance on the Bayley Scales of Infant Development (BSID-III) in a subsample of 1036 children. Qualitative interviews from 10 mothers and 10 field workers are used to inform quantitative data.

Results

Adequate levels of acceptability and internal consistency were found for the new scale and its motor, cognitive, and socioemotional subscales. Correlations between the new scale and the BSID-III were high (r > .50) for the motor and cognitive subscales, but low (r < .20) for the socioemotional subscale. The new scale discriminated between children’s skills based on age, stunting status, caregiver-reported disability, and adult stimulation. Test-retest reliability scores were variable among a subset of items tested.

Conclusions

Results of this study provide empirical support from a low-income country setting for the acceptability, reliability, and validity of a new caregiver-reported ECD scale. Additional research is needed to test these and other caregiver reported items in children in the full 0 to 3 year range across multiple cultural and linguistic settings.
Appendix
Available only for authorised users
Footnotes
1
Although not representative of the core ECD domains, one item—whether the child was frequently too sick to play—was borrowed from the MICS ECDI and included alongside the motor items to test its utility in the <3 age group. This health item was tested in the qualitative and quantitative pilots but not included in reliability or validity analyses of the total CREDI scale.
 
2
In several cases, items appropriate for younger ages (down to 12 months) were included to assess their suitability for older children living in an under-studied, at-risk sample.
 
3
In the case of items of child behavior traditionally measured using Likert response scales (e.g., never/sometimes/often/always), we integrated “frequency anchors” into the questions themselves to indicate the prevalence of behavior necessary to achieve a “yes” versus a “no” response (e.g., “Does the child get along well with other children most of the time?”). These frequency anchors were selected to discriminate between adaptive vs. non-adaptive behavior for each item.
 
Literature
1.
Fink G, Peet E, Andrews K, McCoy DC, Sudfeld CR, Danaei G, Ezzati M, Fawzi WW. Schooling and wage income losses due to early childhood developmental delays in low- and middle-income countries: National, regional and global estimates. Am J Clin Nutr. 2015;104:104–12.CrossRef
2.
Heckman JJ. Skill formation and the economics of investing in disadvantaged children. Science. 2006;312:1900–2.CrossRefPubMed
3.
Nores M, Barnett WS. Benefits of early childhood interventions across the world: (Under) Investing in the very young. Econ Educ Rev. 2010;29:271–82.CrossRef
4.
Shonkoff JP. Building a new biodevelopmental framework to guide the future of early childhood policy. Child Dev. 2010;81:357–67.CrossRefPubMed
5.
Snow CE, Van Hemel SB. Early childhood assessment: Why, what, and how. Washington: The National Academies Press; 2008.
6.
7.
Hui CH, Triandis HC. Measurement in cross-cultural psychology a review and comparison of strategies. J Cross-Cult Psychol. 1985;16:131–52.CrossRef
8.
Peña ED. Lost in translation: Methodological considerations in cross‐cultural research. Child Dev. 2007;78:1255–64.CrossRefPubMed
9.
Keller H, Yovsi R, Borke J, Kärtner J, Jensen H, Papaligoura Z. Developmental consequences of early parenting experiences: Self‐recognition and self‐regulation in three cultural communities. Child Dev. 2004;75:1745–60.CrossRefPubMed
10.
Mischel W, Ayduk O, Berman MG, Casey BJ, Gotlib IH, Jonides J, Shoda Y. ‘Willpower’ over the life span: Decomposing self-regulation. Soc Cogn Affect Neurosci. 2010;6:252–6.CrossRefPubMedPubMedCentral
11.
Molden DC, Dweck CS. Finding“meaning” in psychology: a lay theories approach to self-regulation, social perception, and social development. Am Psychol. 2006;61:192.CrossRefPubMed
12.
Moffitt TE, Arseneault L, Belsky D, Dickson N, Hancox RJ, Harrington H, Caspi A. A gradient of childhood self-control predicts health, wealth, and public safety. Proc Natl Acad Sci U S A. 2011;108:2693–8.CrossRefPubMedPubMedCentral
13.
Raver CC. Placing emotional self-regulation in sociocultural and socioeconomic contexts. Child Dev. 2004;75:346–53.CrossRefPubMed
14.
15.
Janus M, Offord DR. Development and psychometric properties of the Early Development Instrument (EDI): A measure of children’s school readiness. Can J Behav Sci. 2007;39:1.CrossRef
16.
Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. JAMA. 2009;301:2252–9.CrossRefPubMed
17.
18.
Sabanathan S, Wills B, Gladstone M. Child development assessment tools in low-income and middle-income countries: how can we use them more appropriately? Arch Dis Child. 2015;100:482–8.CrossRefPubMedPubMedCentral
19.
Masanja H, Smith ER, Muhihi A, Briegleb C, Mshamu S, Ruben J, Neovita Tanzania Study Group. Effect of neonatal vitamin A supplementation on mortality in infants in Tanzania (Neovita): A randomised, double-blind, placebo-controlled trial. Lancet. 2015;385:1324–32.CrossRefPubMed
20.
Ministry of Health, Community Development, Gender, Elderly and Children [Tanzania], Ministry of Health [Zanzibar], National Bureau of Statistics, Office of the Chief Government Statistician, & ICF International. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015–2016: Key Indicators. In: The Demographic and Health Surveys (DHS) Program. 2016. https://​www.​dhsprogram.​com/​pubs/​pdf/​SR233/​SR233.​pdf. Accessed 16 Nov 2016.
21.
Bradburn NM, Sudman S, Wansink B. Asking questions: The definitive guide to questionnaire design--for market research, political polls, and social and health questionnaires. 1st ed. San Francisco: John Wiley & Sons; 2004.
22.
Desimone LM, Le Floch KC. Are we asking the right questions? Using cognitive interviews to improve surveys in education research. Educ Eval Policy Anal. 2004;26:1–22.CrossRef
23.
Durkin MS, Davidson LL, Desai P, Hasan ZM, Khan N, Shrout PE, Zaman SS. Validity of the Ten Questions Screen for childhood disability: results from population-based studies in Bangladesh, Jamaica, and Pakistan. Epidemiol. 1994;5:283–9.CrossRef
24.
Bayley N. Bayley Scales of Infant and Toddler Development. San Antonio: The Psychological Corporation; 2006.
25.
Albers CA, Grieve AJ. Review of Bayley Scales of infant and toddler development—third edition. J Psychoeduc Assess. 2007;25:180–90.CrossRef
26.
McGrath N, Fawzi WW, Bellinger D, Robins J, Msamanga GI, Manji K, Tronick E. The timing of mother-to-child transmission of human immunodeficiency virus infection and the neurodevelopment of children in Tanzania. Pediatr Infect Dis J. 2006;25:47–52.CrossRefPubMed
27.
McDonald CM, Manji KP, Kupka R, Bellinger DC, Spiegelman D, Kisenge R, Duggan CP. Stunting and wasting are associated with poorer psychomotor and mental development in HIV-exposed Tanzanian infants. J Nutr. 2013;143:204–14.CrossRefPubMed
28.
Sudfeld CR, McCoy DC, Fink G, Muhihi A, Bellinger DC, Masanja H, Fawzi WW. Malnutrition and its determinants are associated with suboptimal cognitive, communication, and motor development among Tanzanian children. J Nutr. 2015;145:2705–14.CrossRefPubMed
29.
30.
Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1994;6:284.CrossRef
31.
Blair C, Razza RP. Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Dev. 2007;78:647–63.CrossRefPubMed
32.
Caspi A, Moffitt TE, Newman DL, Silva PA. Behavioral observations at age 3 years predict adult psychiatric disorders: Longitudinal evidence from a birth cohort. Arch Gen Psychiatry. 1996;53:1033–9.CrossRefPubMed
33.
34.
Metadata
Title
Development and validation of an early childhood development scale for use in low-resourced settings
Authors
Dana Charles McCoy
Christopher R. Sudfeld
David C. Bellinger
Alfa Muhihi
Geofrey Ashery
Taylor E. Weary
Wafaie Fawzi
Günther Fink
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Population Health Metrics / Issue 1/2017
Electronic ISSN: 1478-7954
DOI
https://doi.org/10.1186/s12963-017-0122-8

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