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Observational Study
. 2020 Jan-Feb;96(1):66-75.
doi: 10.1016/j.jped.2018.07.008. Epub 2018 Aug 11.

Measuring early childhood development in Brazil: validation of the Caregiver Reported Early Development Instruments (CREDI)

Elisa Rachel Pisani Altafim  1 , Dana Charles McCoy  2 , Alexandra Brentani  3 , Ana Maria de Ulhôa Escobar  3 , Sandra J F E Grisi  3 , Günther Fink  4
Affiliations
Observational Study

Measuring early childhood development in Brazil: validation of the Caregiver Reported Early Development Instruments (CREDI)

Elisa Rachel Pisani Altafim et al. J Pediatr (Rio J). 2020 Jan-Feb.

Abstract
in English, Portuguese

Objective: The present study aims to analyze the psychometric properties and general validity of the Caregiver Reported Early Development Instruments (CREDI) short form for the population-level assessment of early childhood development for Brazilian children under age 3.

Method: The study analyzed the acceptability, test-retest reliability, internal consistency and discriminant validity of the CREDI short-form tool. The study also analyzed the concurrent validity of the CREDI with a direct observational measure (Inter-American Development Bank's Regional Project on Child Development Indicators; PRIDI). The full sample includes 1,265 Brazilian caregivers of children from 0 to 35 months (678 of which comprising an in-person sample and 587 an online sample).

Results: Results from qualitative interviews suggest overall high rates of acceptability. Most of the items showed adequate test-retest reliability, with an average agreement of 84%. Cronbach's alpha suggested adequate internal consistency/inter-item reliability (α>0.80) for the CREDI within each of the six age groups (0-5, 6-11, 12-17, 18-23, 24-29 and 30-35 months of age). Multivariate analyses of construct validity showed that a significant proportion of the variance in CREDI scores could be explained by child gender and family characteristics, most importantly caregiver-reported cognitive stimulation in the home (p<0.0001). Regarding concurrent validity, scores on the CREDI were significantly correlated with overall PRIDI scores within the in-person sample at r=0.46 (p<0.001).

Conclusions: The results suggested that the CREDI short form is a valid, reliable, and acceptable measure of early childhood development for children under the age of 3 years in Brazil.

Objetivo: O presente estudo visa analisar as propriedades psicométricas e a validade geral do formulário curto dos Instrumentos sobre o Desenvolvimento na Primeira Infância Relatado por Cuidados (CREDI) para avaliação em nível populacional do desenvolvimento na primeira infância de crianças brasileiras com menos de três anos.

Método: O estudo analisou a aceitabilidade, a confiabilidade teste-reteste, a consistência interna e a validade discriminante da ferramenta CREDI. O estudo também analisou a validade concorrente do CREDI com uma medida observacional direta (Projeto Regional sobre os Indicadores de Desenvolvimento na Infância do Banco Interamericano de Desenvolvimento; PRIDI). A amostra total inclui 1.265 cuidadores brasileiros de crianças de 0 a 35 meses (678 em uma amostra presencial e 587 em uma amostra on-line).

Resultados: Os resultados das entrevistas qualitativas sugerem altas taxas gerais de aceitabilidade. A maior parte dos itens mostrou confiabilidade teste-reteste adequada, com concordância média de 84%. O coeficiente alfa de Cronbach sugeriu consistência interna/confiabilidade entre itens (α > 0,80) para o CREDI em cada uma das seis faixas etárias (0-5 α = 6-11, 12-17, 18-23, 24-29 e 30-35 meses de idade). As análises multivariadas da validade do constructo mostraram que uma proporção significativa da variação nas pontuações do CREDI pode ser explicada pelo sexo da criança e pelas características familiares, mais importante o estímulo cognitivo em casa relatado pelo cuidador (p < 0,0001). Com relação à validade concorrente, as pontuações do CREDI foram significativamente correlacionadas às pontuações gerais do PRIDI na amostra presencial em r = 0,46 (p < 0,001).

Conclusões: Os resultados sugerem que o formulário curto CREDI é uma medida válida, confiável e aceitável de desenvolvimento na primeira infância para crianças com menos de três anos no Brasil.

Keywords: Avaliação da população; Brasil; Brazil; Child development; Desenvolvimento infantil; Estudos de validação; Measurement; Medicação; Population assessment; Validation studies.

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Figures

Figure 1
Figure 1
Concurrent validity. (A) Relations between age-normalized caregiver-reported CREDI z-scores and directly assessed PRIDI z-scores. (B) Relations between age-normalized caregiver-reported CREDI z-scores and directly assessed PRIDI z-scores by caregiver education.
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