Validation of a culturally modified short form of the McCarthy Scales of Children’s Abilities in 6 to 8 year old Zimbabwean school children: a cross section study

Abstract

BackgroundThe burden of cognitive impairment among school children from developing communities is under reported due to lack of culturally appropriate screening tools. The objective of this study was to validate a culturally modified short form of the McCarthy Scales of Children Abilities (MSCA) in school children aged 6–8 years from varied backgrounds.MethodsOne hundred and one children aged 6–8 years attending mainstream classes were enrolled cross-sectionally from three schools: one rural and two urban. Two assessments were conducted on each child and the Short form MSCA was compared to an independent assessment by the educational psychologist.ResultsWhen comparing the results of the MSCA to local standard at -2SD, -1.5 SD and -1SD the sensitivity rates ranged from 17 to 50% with lower sensitivity at -2SD cut-off point. Specificity rates had less variation ranging from 95% to 100%. The number of children identified with cognitive impairment using -2SD, -1.5SD and -1SD below the mean for MSCA as a cut-off point were 3(3%), 7(7%) and 13(13%) respectively while the psychologist identified 18 (18%). The overall mean score on MSCA was 103 (SD 15). The rural children tended to score significantly lower marks compared to their peers from urban areas, mean (SD) 98(15) and 107(15) respectively, p=0.006. There was no difference in the mean (SD) scores between boys and girls, 103(17) and 103(15) respectively, p=0.995.ConclusionThe culturally modified short form MSCA showed high specificity but low sensitivity. Prevalence of cognitive impairment among 6 to 8 year children was 3%. This figure is high when compared to developed communities.

Risks for Child Cognitive Development in Rural Contexts

“…Previous studies on children’s cognitive development in rural contexts have shown somehow non-linear results (Nadel and Sagawa, 2002, pp. 1–105; Wells and Evans, 2003, p. 311; Foulkes and Mori, 2009, p. 83; Kandawasvika et al, 2012, p. 1; Miller and Votruba-Drzal, 2013, p. 234; Miller et al, 2013, p. 234; Förster and Rojas-Barahona, 2014, p. 476; Mykerezi et al, 2014, p. 17; Tine, 2014, 599; Castro and Rolleston, 2015, pp. 5–48; Gouin et al, 2015, p. 1) and a meta analysis is very difficult to be performed because these studies are based on different cognitive measures, have used different age samples and, perhaps more importantly, have used different criteria to define rural contexts (Hart et al, 2005, p. 1149).…”

“…This might explain the contradictory results of previous studies on the impact of living context on cognition (Wells and Evans, 2003, p. 311; Grace et al, 2006, pp. 1–28; McGrail and Humphreys, 2009, p. 124; Kandawasvika et al, 2012, p. 1; Förster and Rojas-Barahona, 2014, p. 476; Mykerezi et al, 2014, p. 17; Tine, 2014, p. 599; Castro and Rolleston, 2015, pp. 5–48; Gouin et al, 2015, p. 1).…”

The burden and predictors of cognitive impairment among 6- to 8-year-old children infected and uninfected with HIV from Harare, Zimbabwe: A cross-sectional study

“…For instance, the picture of a boat was unfamiliar with most children, so we substituted it with a picture of lorry. To make a cultural validation of the MSCA to the Shona language, 101 school-age children were enrolled, the detailed of which have been described elsewhere (Kandawasvika, Mapingure, Nhembe, Mtereredzi, & Stray-Pedersen, 2012). As no normative data were available from Zimbabwe, normative values from a South African population were used to convert the raw scales to standardized scores (Z score) (Richter, Griesel, & Rose, 1994).…”