Receptive language skills among young children in rural Guatemala: The relationship between the Test de Vocabulario en Imagenes Peabody and a translated and adapted version of the Mullen Scales of Early Learning

Abstract

Background: Children in low-and lower middle income countries (LMICs) often have poorer language skills compared with children from high-income countries. Limited availability of culturally and linguistically appropriate assessment measures in LMICs, especially for young children, can hinder early identification and prevention efforts. Here, we describe receptive language (RL) skills among young children in rural Guatemala and report on the validity of a translated and culturally adapted developmental measure of RL. Methods: Children (n = 157; m = 53.6 months, range = 42-68 months) enrolled in a prospective cohort study of postnatally acquired Zika virus infection were administered the Test de Vocabulario en Imagenes Peabody (TVIP) and the RL scale from a translated and adapted version of the Mullen Scales of Early Learning (MSEL). Performance on the TVIP was compared with the Latin American normative sample. Correlational analysis examined the relationship between performance on the TVIP and the MSEL-RL.Results: Mean scores were significantly below the normative sample mean on the TVIP, t(126) = −11.04, p < .001; d = 1.00. Performance on the TVIP among children who passed the practice items (n = 127) was significantly positively associated with performance on the MSEL-RL (r = .50, p < .001), but not significantly associated with age or gender. Older age (p < .0001) and female gender (p = .018) were associated with passing the TVIP practice items. Conclusions: Delays in RL vocabulary were identified among young children in rural Guatemala on the TVIP. The association between scores on the TVIP and the RL scale of the MSEL provides preliminary support for the construct validity of this translated and adapted version of the MSEL. Edwin J. Austrias and Flor M. Muñoz are co-senior authors.

Reliability and Validity of an Adapted and Translated Version of the Mullen Scales of Early Learning (AT‐MSEL) in Rural Guatemala

“…However, few developmental tests have been standardized and validated for use in low resource countries, particularly in Latin America (Fernald et al, ; Semrud‐Clikeman et al, ). Current results supported the reliability and validity the AT‐MSEL (Connery, Colbert, et al, ) in rural Guatemala. This project lends further support to an emerging literature suggesting tests developed in high‐income countries can be used to assess children in low resource settings when measures are carefully translated, adapted, and applied (Boivin et al, ; Bornman et al, 2018; Chernoff et al, ; Heckman, ; Holding et al, ; Mitchell et al, ).…”

“…Current results supported the reliability and validity the AT-MSEL (Connery, Colbert, et al, 2019) in rural Guatemala. This project lends further support to an emerging literature suggesting tests developed in high-income countries can be used to assess children in low resource settings when measures are carefully translated, adapted, and applied Bornman et al, 2018;Chernoff et al, 2018;Heckman, 2008;Holding et al, 2018;Mitchell et al, 2017).…”

“…Given the resulting smaller sample size for reliability analyses, we were not able to evaluate interrater reliability and internal consistency within age-groups. Therefore, although this study showed strong evidence of reliability across age correlations between performance on the receptive language subscale of the AT-MSEL and an external criterion measure in 42-68 month old children (Connery, Colbert, et al, 2019), we did not have other measures available to assess the criterion validity of the other scales.…”

“…In order to improve accessibility of neurodevelopmental assessment in low resource settings, future work should evaluate the reliability of administrators with varying levels of educational attainment and experience, such as community health workers or utilizing less resource intensive training models. Third, although we previously reported significant correlations between performance on the receptive language subscale of the AT‐MSEL and an external criterion measure in 42–68 month old children (Connery, Colbert, et al, ), we did not have other measures available to assess the criterion validity of the other scales. Finally, although reliability and validity should be evaluated when a test is translated and adapted, the lack of a representative normative sample often remains an issue depending on the purpose and focus of the study.…”

“…The primary aim of this project was to evaluate the reliability and validity of an adapted and translated version of the MSEL (AT‐MSEL; Connery et al, ) in rural Guatemala. We did not seek to establish metric equivalence to the original English version of the MSEL because the purpose of our larger study was to compare children within the community to one another and not to compare them to the US normative sample.…”