. 2023 Jan 24;13(1):e062562.

doi: 10.1136/bmjopen-2022-062562.

Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries

Vanessa Cavallera¹, Gillian Lancaster², Melissa Gladstone³, Maureen M Black^{4

5}, Gareth McCray², Ambreen Nizar⁶, Salahuddin Ahmed⁷, Arup Dutta⁸, Romuald Kouadio E Anago⁹, Alexandra Brentani¹⁰, Fan Jiang¹¹, Yvonne Schönbeck¹², Dana C McCoy¹³, Patricia Kariger¹⁴, Ann M Weber¹⁵, Abbie Raikes¹⁶, Marcus Waldman¹⁶, Stef van Buuren^{12

17}, Raghbir Kaur¹⁸, Michelle Pérez Maillard¹⁸, Muhammad Imran Nisar⁶, Rasheda Khanam¹⁹, Sunil Sazawal⁸, Arsène Zongo⁹, Mariana Pacifico Mercadante¹⁰, Yunting Zhang²⁰, Arunangshu D Roy⁷, Katelyn Hepworth¹⁶, Günther Fink²¹, Marta Rubio-Codina²², Fahmida Tofail²³, Iris Eekhout¹², Jonathan Seiden¹³, Rebecca Norton¹⁸, Abdullah H Baqui¹⁹, Jamila Khalfan Ali²⁴, Jin Zhao²⁵, Andreas Holzinger²⁶, Symone Detmar¹², Samuel Nzale Kembou⁹, Farzana Begum⁶, Said Mohammed Ali²⁷, Fyezah Jehan^{6

28}, Tarun Dua¹⁸, Magdalena Janus²⁹

Affiliations

¹ Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland cavallerav@who.int.
² School of Medicine, Keele University, Keele, UK.
³ Department of Women and Children's Health, Institute of Life COurse and Medical Sciences, University of Liverpool, Liverpool, UK.
⁴ International Education, RTI International, Research Triangle Park, North Carolina, USA.
⁵ Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
⁶ Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan.
⁷ Research, Projahnmo Research Foundation, Dhaka, Bangladesh.
⁸ Center for Public Health Kinetics, CPHK Global, Pemba, Zanzibar, Tanzania.
⁹ IPA Côte d'Ivoire, Innovations for Poverty Action, Abidjan, Côte d'Ivoire.
¹⁰ Department of Pediatrics, University of São Paulo Medical School, São Paulo, Brazil.
¹¹ Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shangai, People's Republic of China.
¹² Department of Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands.
¹³ Education Policy and Program Evaluation, Harvard Graduate School of Education, Cambridge, Massachusetts, USA.
¹⁴ Center for Effective Global Action, University of California Berkeley School of Public Health, Berkeley, California, USA.
¹⁵ School of Public Health, University of Nevada Reno, Reno, Nevada, USA.
¹⁶ Health Promotion, University of Nebraska Medical Center College of Public Health, Omaha, Nebraska, USA.
¹⁷ Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, University of Utrecht, Utrecht, Netherlands.
¹⁸ Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
¹⁹ International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
²⁰ Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
²¹ Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
²² Social Protection and Health Division, Inter-American Development Bank, Washington, DC, USA.
²³ Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
²⁴ Research Division, Public Health Laboratory, Pemba, Zanzibar, Tanzania.
²⁵ Department of Developmental and Behavioural Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shangai, People's Republic of China.
²⁶ IPA Francophone West Africa, Innovations for Poverty Action, Abidjan, Côte d\'Ivoire.
²⁷ Institution Head, Public Health Laboratory, Pemba, Zanzibar, Tanzania.
²⁸ Paediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan.
²⁹ Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.

PMID: 36693690
PMCID: PMC9884878
DOI: 10.1136/bmjopen-2022-062562

Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries

Vanessa Cavallera et al. BMJ Open. 2023.

. 2023 Jan 24;13(1):e062562.

doi: 10.1136/bmjopen-2022-062562.

Authors

Affiliations

¹ Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland cavallerav@who.int.
² School of Medicine, Keele University, Keele, UK.
³ Department of Women and Children's Health, Institute of Life COurse and Medical Sciences, University of Liverpool, Liverpool, UK.
⁴ International Education, RTI International, Research Triangle Park, North Carolina, USA.
⁵ Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
⁶ Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan.
⁷ Research, Projahnmo Research Foundation, Dhaka, Bangladesh.
⁸ Center for Public Health Kinetics, CPHK Global, Pemba, Zanzibar, Tanzania.
⁹ IPA Côte d'Ivoire, Innovations for Poverty Action, Abidjan, Côte d'Ivoire.
¹⁰ Department of Pediatrics, University of São Paulo Medical School, São Paulo, Brazil.
¹¹ Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shangai, People's Republic of China.
¹² Department of Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands.
¹³ Education Policy and Program Evaluation, Harvard Graduate School of Education, Cambridge, Massachusetts, USA.
¹⁴ Center for Effective Global Action, University of California Berkeley School of Public Health, Berkeley, California, USA.
¹⁵ School of Public Health, University of Nevada Reno, Reno, Nevada, USA.
¹⁶ Health Promotion, University of Nebraska Medical Center College of Public Health, Omaha, Nebraska, USA.
¹⁷ Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, University of Utrecht, Utrecht, Netherlands.
¹⁸ Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
¹⁹ International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
²⁰ Child Health Advocacy Institute, National Children's Medical Center, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
²¹ Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
²² Social Protection and Health Division, Inter-American Development Bank, Washington, DC, USA.
²³ Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh.
²⁴ Research Division, Public Health Laboratory, Pemba, Zanzibar, Tanzania.
²⁵ Department of Developmental and Behavioural Pediatrics, National Children's Medical Center, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shangai, People's Republic of China.
²⁶ IPA Francophone West Africa, Innovations for Poverty Action, Abidjan, Côte d\'Ivoire.
²⁷ Institution Head, Public Health Laboratory, Pemba, Zanzibar, Tanzania.
²⁸ Paediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan.
²⁹ Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.

PMID: 36693690
PMCID: PMC9884878
DOI: 10.1136/bmjopen-2022-062562

Abstract

Introduction: Children's early development is affected by caregiving experiences, with lifelong health and well-being implications. Governments and civil societies need population-based measures to monitor children's early development and ensure that children receive the care needed to thrive. To this end, the WHO developed the Global Scales for Early Development (GSED) to measure children's early development up to 3 years of age. The GSED includes three measures for population and programmatic level measurement: (1) short form (SF) (caregiver report), (2) long form (LF) (direct administration) and (3) psychosocial form (PF) (caregiver report). The primary aim of this protocol is to validate the GSED SF and LF. Secondary aims are to create preliminary reference scores for the GSED SF and LF, validate an adaptive testing algorithm and assess the feasibility and preliminary validity of the GSED PF.

Methods and analysis: We will conduct the validation in seven countries (Bangladesh, Brazil, Côte d'Ivoire, Pakistan, The Netherlands, People's Republic of China, United Republic of Tanzania), varying in geography, language, culture and income through a 1-year prospective design, combining cross-sectional and longitudinal methods with 1248 children per site, stratified by age and sex. The GSED generates an innovative common metric (Developmental Score: D-score) using the Rasch model and a Development for Age Z-score (DAZ). We will evaluate six psychometric properties of the GSED SF and LF: concurrent validity, predictive validity at 6 months, convergent and discriminant validity, and test-retest and inter-rater reliability. We will evaluate measurement invariance by comparing differential item functioning and differential test functioning across sites.

Ethics and dissemination: This study has received ethical approval from the WHO (protocol GSED validation 004583 20.04.2020) and approval in each site. Study results will be disseminated through webinars and publications from WHO, international organisations, academic journals and conference proceedings.

Registration details: Open Science Framework https://osf.io/ on 19 November 2021 (DOI 10.17605/OSF.IO/KX5T7; identifier: osf-registrations-kx5t7-v1).

Keywords: Developmental neurology & neurodisability; EPIDEMIOLOGY; International health services; MENTAL HEALTH; PUBLIC HEALTH; Paediatric neurology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Development chart. Reproduced with permission from Van Buuren and Eekhout.

**Figure 2**
Study sampling schema diagram. ECDI, Early Childhood Development Index; GSED, Global Scales for Early Development.

See this image and copyright information in PMC

References

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Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries

Affiliations

Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical