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Psychometric evidence for assessing early childhood development in Brazil: the Child Development Diagnostic Form in
Ellayne Souza Cerqueira1,2, Michael E Reichenheim3, Ana Angélica Rodrigues Alves4
1Post-Graduation Program in Food, Nutrition and Health, School of Nutrition, Federal University of Bahia, Salvador, Brazil.
Insights
The Formulário de Observação Inicial do Desenvolvimento Infantil (FOIDI) shows strong validity for monitoring child development in Brazil. This validated tool supports early intervention and public health policies for vulnerable children.
Area of Science:
- Child Development
- Psychometrics
- Public Health
Background:
- Child development is influenced by socioeconomic factors.
- Brazil's Programa Criança Feliz (PCF) uses the FOIDI for developmental monitoring.
- The FOIDI lacked formal validation prior to this study.
Purpose of the Study:
- To evaluate the configural and metric validity of the FOIDI.
- To assess the FOIDI's reliability for children aged 0-36 months.
- To ensure the FOIDI is suitable for use in home-visiting programs.
Main Methods:
- Analysis of 183,974 assessments from 82,797 children in the PCF program.
- Confirmatory factor analyses were performed on seven age-specific cohorts.
- Evaluated model fit, factor loadings, convergent validity (AVE), and discriminant validity.
Main Results:
- Modules showed unidimensional or bidimensional structures with high factor loadings (0.519-0.903).
- Average Variance Extracted (AVE) was ≥0.50, confirming convergent validity.
- Discriminant validity was confirmed, and item refinement improved model parsimony.
Conclusions:
- The FOIDI demonstrates robust configural and metric validity for assessing child development in vulnerable populations.
- The refined FOIDI is a practical, reliable, and scalable tool for developmental surveillance.
- The validated FOIDI supports evidence-based public policies and home-visiting initiatives.
Introduction:
Child development is a multidimensional process influenced by socioeconomic conditions. The Programa Criança Feliz (PCF), Brazil's largest home-visiting initiative, uses the Formulário de Observação Inicial do Desenvolvimento Infantil (FOIDI) to monitor developmental milestones. Despite being widely implemented, the FOIDI had not previously undergone formal validation. This study evaluated configural and metric validity of FOIDI in a representative sample of Brazilian children aged 0-36 months.
Methods:
A total of 183 974 assessments from 82 797 children in PCF (2020-2023) were analysed. Cohorts for seven age groups were divided into three independent partitions. Initially, Horn's parallel analysis determined the number of underlying factors. Confirmatory factor analyses followed, using weighted least-squares mean and variance adjusted estimator and polychoric correlation matrices. Model fit was evaluated using root mean square error of approximation, comparative fit index and Tucker-Lewis index. Items with factor loadings<0.40 were considered unreliable. Modification indices (MIs; univariate Lagrange multiplier) and expected parameter changes were used to identify potential cross-loadings and residual correlations. Convergent validity was estimated using average variance extracted (AVE≥0.50); discriminant validity was assessed by comparing the square root of AVE with factor correlations.
Results:
Modules exhibited unidimensional (M3-M7) or bidimensional structures (M1-M2), with factor loadings ranging from 0.519 to 0.903. AVE was≥0.50 for all factors evaluated, supporting convergent validity. Discriminant validity was confirmed within the bidimensional modules. The removal of redundant items increased model parsimony without compromising informativeness.
Conclusion:
The FOIDI demonstrated robust configural and metric validity, capturing core aspects of child development across different age groups in contexts of socioeconomic vulnerability. The refined instrument proved suitable for home-visiting programmes, offering a practical, reliable and scalable tool for developmental surveillance and the support of public policies.
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