Validation of the Malawi Developmental Assessment Tool for children in the Dominican Republic: Preliminary results

Abstract

Background This study initiated the validation process of a translated and adapted version of the Malawi Developmental Assessment Tool (MDAT) for children in the Dominican Republic (DR). Like Malawi before the development of the MDAT, the DR did not have early childhood development (ECD) tools explicitly designed for low-resource areas that are also valid assessments of child development. We chose MDAT because it underwent a rigorous validation process and retained measurements of test items that were culturally adaptable from the Denver Developmental Screening Test II. We aimed to test the internal consistency and inter-rater reliability of the MDAT in children under the age of two years living in low-income neighborhoods in Santo Domingo in 2017. Methods and findings Forty-two children from 2 to 24 months of age (mean = 11.26, SD = 6.37, boys = 22, girls = 20) and their corresponding caregiver participated in the study. We conducted a cross-sectional, pre-experimental study. The primary outcome measure was an index of ECD, as assessed by the Dominican adaptation of the MDAT. The tool evaluates children in four domains: social, fine motor, language, and gross motor. To determine internal consistency, we obtained Spearman-Brown split-half reliability for each sub-scale. The results showed a good consistency (>.6) for social, fine motor, and gross motor, and an acceptable consistency (>.5) for language. Second, to test the inter-rater reliability, we conducted a Kendall’s Taub test of independence for both the general scale and each sub-scale. Significant r τ scores ranged from .923 to .966, indicating appropriate inter-rater reliability. Third, we correlated the age variable with each subscale to determine if the development scale followed a progression of abilities that are expected to increase with maturation. The age variable correlated positively with all the subscales (social r = .887, p < .001; fine motor r = .799, p < .001; language r = .834, p < .001; gross motor r = .805, p < .001), indicating that the older the child, the better scores in the development measurements, as expected. There were no adverse events. This study, however, has multiple limitations. We did not gather information about socioeconomic position, which is an important variable when assessing child development; however, all participants lived in a low-income neighborhood. Given that this is the first ECD tool specific to the Dominican Republic, norm-referenced scores for the Dominican population do not yet exist. This study sample size is insufficient to make inferences about the national population. Conclusions This study represents the first attempt to obtain a valid tool to screen for development milestones in children living in poverty in the DR. More research is needed to refine the instrument. The availability of the tool will enable impact evaluations of ECD intervention programs and the development of evidence-based public po...

The role of sociodemographic and psychosocial variables in early childhood development: A secondary data analysis of the 2014 and 2019 Multiple Indicator Cluster Surveys in the Dominican Republic

“…Fourth, the Dominican Republic adopted in 2021, to use at a national scale, the Dominican Child Development Measurement System (Sistema de Medición del Desarrollo Infantil Dominicano, SIMEDID), based on a study conducted in 2017 [54] that was an adaptation of the Malawi Developmental Assessment Tool [55]. Nationwide, systematic data collection using SIMEDID is expected to begin in 2022 for the first time in the country.…”

The Role of Sociodemographic and Psychosocial Variables in Early Childhood Development: A Secondary Data Analysis of the 2014 Multiple Indicator Cluster Survey in the Dominican Republic

“…Anecdotally, many institutions report to have used the Denver Developmental Screening Test II (54) and other self-made assessments, but systematic data collection has yet to occur. An instrument under consideration to use at a national scale for this purpose is the Dominican Screener for Childhood Development (55), an adaptation of the Malawi Developmental Assessment Tool (56).…”

Instruments to identify risk factors associated with adverse childhood experiences for vulnerable children in primary care in low- and middle-income countries: A systematic review and narrative synthesis

“…In Congo, the MDAT instrument was used to assess 42 children aged from 2 to 24 months (mean = 11.26, SD = 6.37, boys = 22, girls = 20) in four domains of social, fine, and gross PLOS GLOBAL PUBLIC HEALTH motor skills and language. In this population, the instrument showed good consistency in the social and fine, and gross motor skills variables, while language indicated acceptable consistency (>.5) [86]. The internal consistency and inter-rater reliability of the MDAT were tested using Kendall's Taub test.…”