Psychometrics of psychosocial behavior items under age 6 years: Evidence from Nebraska, USA.

Because healthy psychosocial development in the first years of life is critical to lifelong well-being, governmental, and nongovernmental organizations are increasingly interested in monitoring psychosocial behaviors among populations of children. In response, the World Health Organization is developing the Global Scales of Early Development Psychosocial Form (GSED PF) to facilitate population-level psychosocial monitoring. Once validated, the GSED PF will be an open-access, caregiver-reported measure of children's psychosocial behaviors that is appropriate for infants and young children. This study examines the psychometric validity evidence from 45 items under consideration for inclusion in the GSED PF. Using data from N = 836 Nebraskan (USA) children aged 180 days to 71 months, results indicate that scores from 44 of the 45 (98%) items exhibit positive evidence of validity and reliability. A bifactor model with one general factor and five specific factors best fit the data, exhibited strong reliability, and acceptable model fit. Criterion associations with known predictors of children's psychosocial behaviors were in the expected direction. These findings suggest that measurement of children's psychosocial behaviors may be feasible, at least in the United States. Data from more culturally and linguistically diverse settings is needed to assess these items for global monitoring.

Debido a que el desarrollo sicosocial en los primeros años de vida es crítico para el bienestar de toda la vida, las organizaciones gubernamentales y no gubernamentales están más y más interesadas en observar vigilantemente las conductas sicosociales en la población infantil. Como respuesta, la Organización Mundial de la Salud está desarrollando el Formulario Sicosocial de las Escalas Globales del Temprano Desarrollo (GSED PF) para facilitar la observación sicosocial alerta al nivel del grupo de población. Una vez que se haya convalidado, el GSED PF será una medida de acceso abierto, que reportará el cuidador, sobre las conductas sicosociales de los niños que son apropiadas para infantes y niños pequeñitos. Este estudio examina la evidencia de la validez sicométrica de 45 puntos bajo consideración para ser incluidos en el GSED PF. Usando datos de N = 836 niños de Nebraska (Estados Unidos), de edad entre 180 días y 71 meses, los resultados indican que los puntajes de 44 de los 45 (98%) puntos muestran evidencia positiva de validez y confiabilidad. Un modelo bifactorial con un factor general y cinco factores específicos, que mejor encaja con los datos, mostró una fuerte confiabilidad y un modelo aceptable que encaja. Las asociaciones de criterio con factores de predicción conocidos acerca de las conductas sicosociales de los niños se encontraban en la dirección esperada. Estos resultados sugieren que la medida de las conductas sicosociales de los niños pudiera ser posible, por lo menos en los Estados Unidos. Se necesitan datos de escenarios más diversos cultural y lingüísticamente para evaluar estos puntos para la estar alerta en la observación global.

Profiles of Quality in Three Distinct Early Childhood Programs Using the Brief Early Childhood Quality Inventory (BEQI).

Quality early childhood care and education (ECCE) is important for young children's holistic healthy development. As ECCE scales, contextually relevant and feasible measurement is needed to inform policy and programs on strengths and areas for improvement. However, few measures have been designed for use across diverse contexts. Drawing on principles of mixed methods design, this study reports on a new approach to ECCE quality measurement: the Brief Early Childhood Quality Inventory. Using data from the USA, Liberia, and Colombia, results indicate variation in the items perceived as highly relevant to each setting and in the characteristics of classrooms including the degree of child autonomy, the types of activities, and in child/educator interactions and dialogue. However, despite this variation, a small set of items indicate potential functionality as cross-country anchor items. Findings lend support to the idea that quality measures can have some common elements with room for adaptation within and across settings. Future work in this area should address the possibility that the significance of these practices for child development also varies across settings.

La qualité de l'Education et de la Protection de la Petite Enfance (EPPE) est importante pour le développement sain et holistique des jeunes enfants. À mesure que l'EPPE évolue, des mesures contextuellement pertinentes et réalisables sont nécessaires pour informer les politiques et les programmes sur les points forts et les domaines à améliorer. Cependant, peu de mesures ont été conçues pour être utilisées dans divers contextes géographiques. S'appuyant sur les principes des méthodes mixtes, cette étude présente une nouvelle approche de la mesure de la qualité de l'EPPE appelé le Bref Inventaire de la Qualité de la Petite Enfance. À l'aide de données provenant des États-Unis, du Libéria et de la Colombie, les résultats indiquent des variations dans les éléments perçus comme très pertinents dans chaque contexte et dans les caractéristiques des salles de classe, y compris le degré d'autonomie de l'enfant, les types d'activités et les interactions et le dialogue entre l'enfant et l'éducateur. Cependant, malgré cette variation, un petit ensemble d'éléments indique une fonctionnalité potentielle en tant qu'éléments d'ancrage transnationaux. Les résultats appuient l'idée que les mesures de la qualité peuvent avoir des éléments communs avec une marge d'adaptation dans et entre les localités. Les travaux futurs dans ce domaine devraient aborder la possibilité que l'importance de ces pratiques pour le développement de l'enfant varie également d'un endroit à l'autre.

The creation of the Global Scales for Early Development (GSED) for children aged 0-3 years: combining subject matter expert judgements with big data.

INTRODUCTION: With the ratification of the Sustainable Development Goals, there is an increased emphasis on early childhood development (ECD) and well-being. The WHO led Global Scales for Early Development (GSED) project aims to provide population and programmatic level measures of ECD for 0-3 years that are valid, reliable and have psychometrically stable performance across geographical, cultural and language contexts. This paper reports on the creation of two measures: (1) the GSED Short Form (GSED-SF)-a caregiver reported measure for population-evaluation-self-administered with no training required and (2) the GSED Long Form (GSED-LF)-a directly administered/observed measure for programmatic evaluation-administered by a trained professional. METHODS: We selected 807 psychometrically best-performing items using a Rasch measurement model from an ECD measurement databank which comprised 66 075 children assessed on 2211 items from 18 ECD measures in 32 countries. From 766 of these items, in-depth subject matter expert judgements were gathered to inform final item selection. Specifically collected were data on (1) conceptual matches between pairs of items originating from different measures, (2) developmental domain(s) measured by each item and (3) perceptions of feasibility of administration of each item in diverse contexts. Prototypes were finalised through a combination of psychometric performance evaluation and expert consensus to optimally identify items. RESULTS: We created the GSED-SF (139 items) and GSED-LF (157 items) for tablet-based and paper-based assessments, with an optimal set of items that fit the Rasch model, met subject matter expert criteria, avoided conceptual overlap, covered multiple domains of child development and were feasible to implement across diverse settings. CONCLUSIONS: State-of-the-art quantitative and qualitative procedures were used to select of theoretically relevant and globally feasible items representing child development for children aged 0-3 years. GSED-SF and GSED-LF will be piloted and validated in children across diverse cultural, demographic, social and language contexts for global use.

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

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).

Racial, ethnic and nativity inequalities in gestational diabetes mellitus: The role of racial discrimination.

Introduction: Racial/ethnic minority and foreign-born women in the United States are at high risk of experiencing racial discrimination, which is associated with adverse health outcomes. Although racial discrimination is associated with metabolic disturbances such as insulin resistance and type 2 diabetes, more studies should examine its effect on gestational diabetes mellitus (GDM), which is highest among racial/ethnic minority and foreign-born women. Methods: We used New York City Pregnancy Risk and Assessment Monitoring System survey data (2012-2014) linked with birth certificate items (N = 4084) in bivariate and multivariate analyses to examine racial/ethnic/nativity differences in racial discrimination, and to test if racial discrimination explains racial/ethnic/nativity inequalities in GDM. Results: The 12-month prevalence of racial discrimination (9.5%) varied across race/ethnicity and nativity status, with Black, Hispanic and foreign-born women having the highest prevalence. Interaction effects indicate that US-born Black and Hispanic women are at increased risk of racial discrimination compared to their foreign-born counterparts. Women with GDM had statistically higher prevalence of racial discrimination (14%) compared with women without GDM (9%). Racial discrimination was associated with a 57% increased unadjusted risk of GDM (RR = 1.57, 95% CI [1.19, 2.06]) that decreased to 24% after adjusting for all covariates (RR = 1.24, 95% CI [0.87, 1.78]). Discussion: The high proportion of racial/ethnic minority and foreign-born women experiencing racial discrimination, and its potential impact on GDM, underscores the importance of culturally informed screening and intervention approaches by trained professionals.

Estimates of a multidimensional index of nurturing care in the next 1000 days of life for children in low-income and middle-income countries: a modelling study.

BACKGROUND: Nurturing care is crucial for children's ongoing development during the pre-primary education period, or the next 1000 days of life. We generated nationally representative prevalence estimates of access to ten basic indicators of nurturing care among children aged 3-4 years in low-income and middle-income countries (LMICs). METHODS: We applied multiple imputation and predictive modelling to data on children living in LMICs. Individual-level data on ten indicators were from UNICEF's Multiple Indicator Cluster Surveys and the Demographic Health Surveys Program, and we included data on all children aged 36 to 59 months for whom the surveys asked relevant questions on parenting and child development. We defined minimally adequate care as receiving at least one of two indicators in each of five dimensions of nurturing care: responsive caregiving, early learning, safety and security, nutrition, and health. We used a two-step multi-level multiple imputation procedure to address missing data across individuals, indicators, and countries. Using imputed datasets, we generated a set of expected-a-posteriori estimates of the percentage and overall number of children receiving each indicator of nurturing care, as well as overall minimally adequate care, for each country, country income grouping, and region, and across all LMICs. For the 54 countries with individual-level data on all indicators, we also produced subgroup estimates of nurturing care on the basis of household wealth, child sex, and urbanicity. FINDINGS: We included individual-level data collected between 2005 and 2019 on 426 349 children aged 3-4 years in 104 LMICs. Across the 137 LMICs considered in our modelling, we estimated that 62·0 million (90% credible interval [CrI] 51·6-71·7) children aged 3-4 years, equivalent to 25·4% (90% CrI 21·2-29·4) of that age group in LMICs, were receiving minimally adequate nurturing care at the time of assessment, leaving 181·9 million (172·2-192·3) without adequate care. Access to care was highest for nutrition (86·2% [84·2-88·2], or 210·3 million [205·4-215·1], with healthy weight), and lowest for early learning (29·3% [21·5-39·6], or 71·5 million [52·5-96·6], in early childhood care and education), responsive caregiving (29·7% [25·6-34·9], or 72·4 million [62·4-85·0], experiencing adequate stimulation from non-maternal caregivers), and safety and security (32·3% [28·3-36·7], or 78·7 million [68·9-89·5], living without physical punishment). Gaps were evident in the estimates, with 50·8% (38·3-60·7) of children from upper middle-income countries receiving minimally adequate care compared with 5·6% (4·8-6·4) in low-income countries. Within 54 countries with complete child-level data, 10·7% (10·4-10·9) of children from households in the lowest wealth quintile had access to minimally adequate care compared with 41·2% (40·7-41·7) in the highest quintile. Inequalities were also large by urbanicity (17·7% [17·5-18.0] rural vs 32·2% [31·8-32.6] urban) but smaller by child sex (23·9% [23·6-24·2] girls vs 22·1% [21·9-22·4] boys). INTERPRETATION: Most children in LMICs are not receiving minimally adequate nurturing care during the next 1000-day period. Further investments in indicator measurement and resources for preschool-age children are needed, particularly for low-income populations and in the domains of responsive caregiving, early learning, and safety and security. FUNDING: None.

Measuring early childhood development: considerations and evidence regarding the Caregiver Reported Early Development Instruments.

Reflecting a burgeoning political interest in supporting young children around the world, global demand for reliable, valid, and scalable assessments of early childhood development (ECD) is on the rise. One of the more popular sets of tools for measuring the ECD of children under age 3 is the Caregiver Reported Early Development Instruments (CREDI), which includes both a long form for research and evaluation and a short form for population-level monitoring. In this commentary, we describe the goals and limitations of the CREDI, research to support its use as a population-level ECD instrument, as well as the major gaps in its evidence base. We also discuss how the work of Alderman and colleagues (in this issue) addresses some of these outstanding gaps, highlighting several critical areas for future research.

Contextual variation in young children's acquisition of social-emotional skills.

This study examined variation in the timing of 5,447 infants' and toddlers' reported acquisition of 12 basic social-emotional skills across and within 11 developing and developed country sites. Although children differed significantly across sites in when they attained social-emotional skills on average (e.g., M age Brazil = 20.50 months vs. M age India = 26.92 months), there was also substantial heterogeneity across skills. For example, children in Pakistan were reported to demonstrate sympathy on average seven months earlier than their peers in Ghana, whereas the opposite was true for sharing. Overall, country-level health and education were strongly associated (r > .60) with earlier site-level skill attainment. In addition to heterogeneity across sites, we also observed notable within-site variability in skill development (ICCs = .03 to .38). Future research is needed to identify sources of variability and how to promote skills that matter within a given context.

Association of Friday School Report Card Release With Saturday Incidence Rates of Agency-Verified Physical Child Abuse.

Importance: Corporal punishment is a leading risk factor for physical abuse. Strong anecdotal evidence from physicians and other professionals working in child protection suggest that punishment-initiated physical abuse for school-aged children increases after release of report cards. However, no empirical examination of this association has occurred. Objective: To examine the temporal association between school report card release and incidence rates (IRs) of physical abuse. Design, Setting, and Participants: This retrospective study reviewed calls to a state child abuse hotline and school report card release dates across a single academic year in Florida. Data were collected in a 265-day window from September 8, 2015, to May 30, 2016, in the 64 of 67 Florida counties with report card release dates available (16 960 days). Participants included all children aged 5 to 11 years for whom calls were made. A total of 1943 verified cases of physical abuse were reported in the study period in the 64 counties. Data were analyzed from October 2017 through May 2018. Exposures: School report cards release across a single academic year, measured daily by county. Main Outcomes and Measures: Daily counts of calls to a child abuse hotline that later resulted in agency-verified incidents of child physical abuse across a single academic year by county. Results: During the academic year, 167 906 calls came in to the child abuse hotline for children aged 5 to 11 years; 17.8% (n = 29 887) of these calls were suspected incidents of physical abuse, and 2017 (6.7%) of these suspected incidents were later verified as cases of physical abuse before excluding the 3 counties with no release dates available. Among the 1943 cases included in the analysis (58.9% males [n = 1145]; mean [SD] age, 7.69 [1.92] years), calls resulting in verified reports of child physical abuse occurred at a higher rate on Saturdays after a Friday report card release compared with Saturdays that do not follow a Friday report card release (IR ratio, 3.75; 95% CI, 1.21-11.63; P = .02). No significant association of report card release with IRs was found for any other days of the week. Conclusion and Relevance: This association of school report card release and physical abuse appears to illustrate a unique systems-based opportunity for prevention.