Early developmental screening tools constructed in Latin American countries: umbrella review

Multiple early childhood development (ECD) screening instruments have been developed in Latin America.

The objective of this study was to describe ECD screening tests for children under 4 years of age constructed in Latin American countries in the context of healthcare, currently in use.

A systematic review of literature published until April 2024 was conducted to identify screening tests constructed in Latin America. The search for each test was expanded, and individual records were completed. Authors of the instruments and/or their validations were identified and contacted to corroborate the information. An ECD screening test was defined as one that assesses at least three different domains. Only tests used in the healthcare system were included in the study. Those without publications and/or accessible information were excluded from the study.

Twenty-one tests constructed in nine countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Peru, and Uruguay) were included, many used in different countries of the region. Seven were constructed and/or validated in the past 5 years. They predominantly consist of direct assessment or questions to primary caregivers. Four were validated for online use, and one for virtual use. In the validation, most combined different psychometric analyses, with heterogeneity in methodology and reference patterns. Median summary sensitivity was 0.67 (95% confidence interval [CI] 0.34-1.0), and specificity was 0.71 (95% CI 0.42-1.0).

The ECD screening tests developed in Latin America show thorough validation and ongoing updates, though they exhibit some variability. Direct assessment using paper predominates. The consistency of the instruments, when used in different countries and populations, stands out.