RT Journal Article
SR Electronic
T1 The D-score: a metric for interpreting the early development of infants and toddlers across global settings
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e001724
DO 10.1136/bmjgh-2019-001724
VO 4
IS 6
A1 Ann M Weber
A1 Marta Rubio-Codina
A1 Susan P Walker
A1 Stef van Buuren
A1 Iris Eekhout
A1 Sally M Grantham-McGregor
A1 Maria Caridad Araujo
A1 Susan M Chang
A1 Lia CH Fernald
A1 Jena Derakhshani Hamadani
A1 Charlotte Hanlon
A1 Simone M Karam
A1 Betsy Lozoff
A1 Lisy Ratsifandrihamanana
A1 Linda Richter
A1 Maureen M Black
A1 ,
YR 2019
UL http://gh.bmj.com/content/4/6/e001724.abstract
AB Introduction Early childhood development can be described by an underlying latent construct. Global comparisons of children’s development are hindered by the lack of a validated metric that is comparable across cultures and contexts, especially for children under age 3 years. We constructed and validated a new metric, the Developmental Score (D-score), using existing data from 16 longitudinal studies.Methods Studies had item-level developmental assessment data for children 0–48 months and longitudinal outcomes at ages >4–18 years, including measures of IQ and receptive vocabulary. Existing data from 11 low-income, middle-income and high-income countries were merged for >36 000 children. Item mapping produced 95 ‘equate groups’ of same-skill items across 12 different assessment instruments. A statistical model was built using the Rasch model with item difficulties constrained to be equal in a subset of equate groups, linking instruments to a common scale, the D-score, a continuous metric with interval-scale properties. D-score-for-age z-scores (DAZ) were evaluated for discriminant, concurrent and predictive validity to outcomes in middle childhood to adolescence.Results Concurrent validity of DAZ with original instruments was strong (average r=0.71), with few exceptions. In approximately 70% of data rounds collected across studies, DAZ discriminated between children above/below cut-points for low birth weight (<2500 g) and stunting (−2 SD below median height-for-age). DAZ increased significantly with maternal education in 55% of data rounds. Predictive correlations of DAZ with outcomes obtained 2–16 years later were generally between 0.20 and 0.40. Correlations equalled or exceeded those obtained with original instruments despite using an average of 55% fewer items to estimate the D-score.Conclusion The D-score metric enables quantitative comparisons of early childhood development across ages and sets the stage for creating simple, low-cost, global-use instruments to facilitate valid cross-national comparisons of early childhood development.