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. 2019 Apr;104(Suppl 1):S22-S33.
doi: 10.1136/archdischild-2018-315431.

Rating early child development outcome measurement tools for routine health programme use

Dorothy Boggs  1   2 , Kate M Milner  1   3 , Jaya Chandna  4 , Maureen Black  5   6 , Vanessa Cavallera  7 , Tarun Dua  7 , Guenther Fink  8 , Ashish Kc  9 , Sally Grantham-McGregor  10 , Jena Hamadani  11 , Rob Hughes  12   13 , Karim Manji  14 , Dana Charles McCoy  15 , Cally Tann  1   16 , Joy E Lawn  1
Affiliations

Rating early child development outcome measurement tools for routine health programme use

Dorothy Boggs et al. Arch Dis Child. 2019 Apr.

Erratum in

Abstract

Background: Identification of children at risk of developmental delay and/or impairment requires valid measurement of early child development (ECD). We systematically assess ECD measurement tools for accuracy and feasibility for use in routine services in low-income and middle-income countries (LMIC).

Methods: Building on World Bank and peer-reviewed literature reviews, we identified available ECD measurement tools for children aged 0-3 years used in ≥1 LMIC and matrixed these according to when (child age) and what (ECD domains) they measure at population or individual level. Tools measuring <2 years and covering ≥3 developmental domains, including cognition, were rated for accuracy and feasibility criteria using a rating approach derived from Grading of Recommendations, Assessment, Development and Evaluations.

Results: 61 tools were initially identified, 8% (n=5) population-level and 92% (n=56) individual-level screening or ability tests. Of these, 27 tools covering ≥3 domains beginning <2 years of age were selected for rating accuracy and feasibility. Recently developed population-level tools (n=2) rated highly overall, particularly in reliability, cultural adaptability, administration time and geographical uptake. Individual-level tool (n=25) ratings were variable, generally highest for reliability and lowest for accessibility, training, clinical relevance and geographical uptake.

Conclusions and implications: Although multiple measurement tools exist, few are designed for multidomain ECD measurement in young children, especially in LMIC. No available tools rated strongly across all accuracy and feasibility criteria with accessibility, training requirements, clinical relevance and geographical uptake being poor for most tools. Further research is recommended to explore this gap in fit-for-purpose tools to monitor ECD in routine LMIC health services.

Keywords: early child development tools; health systems; low and middle income countries; maternal, newborn and child health; metrics.

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Conflict of interest statement

Competing interests: The following authors on this paper have intellectual inputs and leadership roles for some of the tools reviewed: MDAT (JC), IYCD (VC, TD) and CREDI (DCM and GF). None of these authors rated any of these tools.

Figures

Figure 1
Figure 1
Programme cycle for design, implementation and scaling of early child development programmes.
Figure 2
Figure 2
Early child development (ECD) tools flow chart for multidomain matrix mapping and grading. IYCD, Infant and Young Child Development; LMIC, low- and middle-income countries.
Figure 3
Figure 3
Heat map matrix of early child development measurement tools 0–3 inclusion of identified times, ages and domains. (A) Population-level. (B) Individual-level (screening, ability and both screening and ability tools). (C) Screening tools. (D) Ability tools.
Figure 4
Figure 4
Heat map of accuracy and feasibility ratings for selected early child development (ECD) measurement tools.
Figure 5
Figure 5
Rating criteria characteristic heat map for early child development tools 0–3 years. (A) Population-level tools. (B) Individual-level screening tools. (C) Individual-level ability tools.
Figure 6
Figure 6
Early child development 0–3 tool overall rating mapped by each accuracy and feasibility criteria. (A) Population-level tools. (B) Individual-level screening tools. (C) Individual-level ability tools.
See this image and copyright information in PMC

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