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Choosing the best child assessment instrument for a specific context: a methodology for engaging local experts
Marycatherine Arbour1, Kara A Murray, Sidney S Atwood
1Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. marbour@partners.org
Insights
Chilean experts used the Child Health and Nutrition Research Initiative (CHNRI) method to select child assessment instruments for 5- to 7-year-olds. Three instruments met most local priorities for identifying at-risk children.
Area of Science:
- Child Development
- Public Health Policy
- Educational Psychology
Background:
- Chile plans to expand early childhood development services to ages 5-7.
- A consensus on identifying at-risk children is lacking.
- This necessitates the selection of appropriate child assessment instruments.
Purpose of the Study:
- To facilitate a process for selecting a child assessment instrument.
- To incorporate local priorities and best practices into instrument selection.
- To address the need for identifying at-risk children in Chile.
Main Methods:
- Utilized the Child Health and Nutrition Research Initiative (CHNRI) priority-setting method.
- 21 Chilean experts defined and weighted ideal assessment instrument characteristics.
- 130 instruments were scored against expert-defined criteria and ranked.
Main Results:
- Instrument quality, administration site, domains assessed, and cost were highly weighted priorities.
- Ideal instruments should assess language, socioemotional well-being, mental health, and parenting abilities.
- Three instruments met 11 of 13 defined priorities, but none met all.
Conclusions:
- Local context is crucial for decisions on assessing developmental risk.
- The CHNRI method effectively identified trade-offs and prioritized assessment strategies.
- Three instruments were identified as best meeting Chile's local needs and priorities.
Objective:
Chile is considering expanding its system for early childhood development to include 5- to 7-year olds, but it has no consensus about how to identify at-risk children. This study facilitated a process for incorporating local priorities and best practices to choose a child assessment instrument.
Methods:
Using the priority-setting method of the Child Health and Nutrition Research Initiative (CHNRI), 21 Chilean experts defined and weighted ideal assessment instrument characteristics; 130 instruments were scored according to how closely they matched experts' ideal definitions. Instruments were ranked by score under different inclusion criteria.
Results:
Experts weighted instrument quality highest (95 on 1-100 scale), followed by administration site (87), domains assessed (82), cost (80), administrator (76), Spanish version (75), time (75), and prior use in Chile (53). Experts agreed that an ideal instrument (1) would reliably assess language, socioemotional well-being, mental health, and parenting abilities, (2) could be administered at schools or home, and (3) could be administered by teachers or parents. No single instrument matched all Chilean priorities. Three instruments met 11 of 13 priorities (age; quality; administration at school, home, or waiting rooms; assess language and socioemotional domains; administered by teachers, parents, or psychologists; time ≤30 minutes). Including mental health or parenting abilities ranked instruments whose composite scores were 35% lower.
Conclusion:
Decisions about how to assess children at developmental risk should be informed by local context. The CHNRI method provided a useful process that made explicit mutually exclusive priorities, quantified trade-offs of different assessment strategies, and identified 3 of the instruments that best met local needs and priorities.
