Concurrent Validity and Feasibility of Short Tests Currently Used to Measure Early Childhood Development in Large Scale Studies

Abstract

In low- and middle-income countries (LIMCs), measuring early childhood development (ECD) with standard tests in large scale surveys and evaluations of interventions is difficult and expensive. Multi-dimensional screeners and single-domain tests (‘short tests’) are frequently used as alternatives. However, their validity in these circumstances is unknown. We examined the feasibility, reliability, and concurrent validity of three multi-dimensional screeners (Ages and Stages Questionnaires (ASQ-3), Denver Developmental Screening Test (Denver-II), Battelle Developmental Inventory screener (BDI-2)) and two single-domain tests (MacArthur-Bates Short-Forms (SFI and SFII), WHO Motor Milestones (WHO-Motor)) in 1,311 children 6–42 months in Bogota, Colombia. The scores were compared with those on the Bayley Scales of Infant and Toddler Development (Bayley-III), taken as the ‘gold standard’. The Bayley-III was given at a center by psychologists; whereas the short tests were administered in the home by interviewers, as in a survey setting. Findings indicated good internal validity of all short tests except the ASQ-3. The BDI-2 took long to administer and was expensive, while the single-domain tests were quickest and cheapest and the Denver-II and ASQ-3 were intermediate. Concurrent validity of the multi-dimensional tests’ cognitive, language, and fine motor scales with the corresponding Bayley-III scale was low below 19 months. However, it increased with age, becoming moderate-to-high over 30 months. In contrast, gross motor scales’ concurrence was high under 19 months and then decreased. Of the single-domain tests, the WHO-Motor had high validity with gross motor under 16 months, and the SFI and SFII expressive scales showed moderate correlations with language under 30 months. Overall, the Denver-II was the most feasible and valid multi-dimensional test and the ASQ-3 performed poorly under 31 months. By domain, gross motor development had the highest concurrence below 19 months, and language above. Predictive validity investigation is needed to further guide the choice of instruments for large scale studies.

Developmental delay in the Amazon: The social determinants and prevalence among rural communities in Peru

“…The age group was determined to assess early child development which can be measured by using, Ages and Stages Questionnaire, with good accuracy [14]. Also, to catch children while they are still involved in early child development activities (breast feeding, consuming micronutrients, growth monitoring check-ups).…”

ASQ-3: Validation of the Ages and Stages Questionnaire for the detection of neurodevelopmental disorders in Argentine children

“…The studies conducted by Rubio-Codina et al in Colombia did not find a correlation between performance in the ASQ-3 and the Bayley Scales of Infant and Toddler Development -American versionswithout considering population characteristics and local validations for any of the two scales. 25 A pilot study to compare the ASQ-3, the PRUNAPE, and the PRE-PRUNAPE screenings in Argentina showed that the ASQ-3 had the highest specificity and was more easily implemented. 26 Lastly, the frequency of neurodevelopmental disorders in the studied population was assessed, and it was consistent with the frequency of developmental delay reported for South American countries, with a higher incidence of deleterious socio-environmental factors (violence, inattention or neglect), growth deficit, and disease control.…”

ASQ-3: validación del Cuestionario de Edades y Etapas para la detección de trastornos del neurodesarrollo en niños argentinos

“…Los trabajos de Rubio-Codina y cols., no han encontrado, en Colombia, correlación entre el desempeño en el ASQ-3 con el test del desarrollo de Bayley usando versiones americanas, sin tener en cuenta las características de la población con validaciones locales para ninguna de las dos pruebas. 25 Un estudio piloto entre ASQ-3, PRUNAPE y PRUNAPE Prepesquisa en Argentina mostró la especificidad más alta para el ASQ-3 y mayor facilidad de implementación. 26 Por último, se evaluó la frecuencia de trastornos del neurodesarrollo en la población estudiada, que concordó con la frecuencia de retrasos en el desarrollo reportada para países sudamericanos, con mayor incidencia de factores deletéreos socioambientales (violencia, abandono o negligencia), déficit en el crecimiento físico y en el control de enfermedades.…”