Jeong Joshua, McCann Juliet K, Onyango Silas, Ochieng Michael
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
African Population and Health Research Center, Nairobi, Kenya.
BMC Public Health. 2025 Feb 10;25(1):535. doi: 10.1186/s12889-025-21801-9.
Early childhood development (ECD) is a key determinant of long-term health, education, and wellbeing. However, one major global challenge is the lack of ECD assessment tools validated for use in low- and middle-income countries. To address this gap, the World Health Organization (WHO) launched in 2023 the Global Scales for Early Development, an open-access tool designed to generate reliable, valid, and internationally-comparable data on ECD for children aged 0-3 years globally. In this study, we examined the concurrent and convergent validity of the Global Scales for Early Development-long form (GSED-LF) for use with children aged 0-24 months in Kenya.
We analyzed baseline data collected in October-November 2023 as part of a cluster-randomized controlled trial evaluating a parenting program for improving ECD in rural Western Kenya. Primary caregivers (91% mothers) with a child under 24 months were enrolled across 64 villages in Busia and Homabay counties. The GSED-LF was administered to all children (N = 647). In a randomly selected sub-sample of children (N = 116), the Bayley Scales of Infant and Toddler Development (Bayley-III) and the Caregiver Reported Early Development Instruments (CREDI) were also administered to compare their scores with those from the GSED-LF. Concurrent validity of GSED-LF was assessed in terms of its correlations with Bayley-III and CREDI. Convergent validity of GSED-LF was examined with respect to parenting outcomes, including parental stimulation, home caregiving environment, and maternal mental health.
GSED-LF scores had moderate associations with those on the Bayley and CREDI across the domains of cognitive, language, and motor development. GSED-LF had small associations with socioemotional development and relatively weaker concurrent validity for younger children under 12 months. GSED-LF also demonstrated good convergent validity in terms of showing moderate associations with maternal and paternal stimulation and the home caregiving environment.
Overall, this study demonstrated the feasibility and initial validity of the GSED-LF as a direct assessment tool for use in rural Western Kenya. Additional psychometric analyses across diverse settings are needed to strengthen the reliability and validity evidence of the GSED-LF and establish it as a robust, globallyapplicable tool for assessing ECD in resource-limited settings.
幼儿发展（ECD）是长期健康、教育和幸福的关键决定因素。然而，一个主要的全球挑战是缺乏在低收入和中等收入国家经过验证的幼儿发展评估工具。为了填补这一空白，世界卫生组织（WHO）于2023年推出了全球早期发展量表，这是一个开放获取的工具，旨在为全球0至3岁儿童生成关于幼儿发展的可靠、有效且具有国际可比性的数据。在本研究中，我们检验了全球早期发展量表长版（GSED-LF）在肯尼亚0至24个月儿童中的同时效度和收敛效度。
我们分析了2023年10月至11月收集的基线数据，这些数据是一项整群随机对照试验的一部分，该试验评估了一项旨在改善肯尼亚西部农村地区幼儿发展的育儿项目。在布西亚县和霍马贝县的64个村庄招募了有24个月以下儿童的主要照料者（91%为母亲）。对所有儿童（N = 647）实施了GSED-LF。在随机抽取的儿童子样本（N = 116）中，还实施了贝利婴幼儿发展量表（Bayley-III）和照料者报告的早期发展工具（CREDI），以将其得分与GSED-LF的得分进行比较。通过GSED-LF与Bayley-III和CREDI的相关性评估GSED-LF的同时效度。从育儿结果方面检验GSED-LF的收敛效度，包括父母的激励、家庭照料环境和母亲的心理健康。
在认知、语言和运动发展领域，GSED-LF得分与贝利量表和CREDI得分存在中等程度的关联。GSED-LF与社会情感发展的关联较小，对于12个月以下的幼儿，其同时效度相对较弱。GSED-LF在与母亲和父亲的激励以及家庭照料环境呈现中等程度关联方面也显示出良好的收敛效度。
总体而言，本研究证明了GSED-LF作为肯尼亚西部农村地区直接评估工具的可行性和初步效度。需要在不同环境中进行更多的心理测量分析，以加强GSED-LF的可靠性和效度证据，并将其确立为在资源有限环境中评估幼儿发展的强大的、全球适用的工具。
