A guide for monitoring child development in low- and middle-income countries.
OBJECTIVE
In low- and middle-income countries, methods for clinicians to address difficulties in language, social-emotional, cognitive, behavioral, or neuromotor development during early childhood are lacking. To fill this gap, we designed, in Turkey, the Guide for Monitoring Child Development, which aims to aid clinicians in monitoring and supporting child development and the early detection and management of developmental difficulties. The Guide for Monitoring Child Development monitoring component is a practical, open-ended interview that catalyzes communication between clinicians and caregivers and obtains a portrayal of the child's development. We report on the development and psychometric properties of the Guide for Monitoring Child Development monitoring component for children aged 0 to 24 months.


METHODS
We examined the ages of attainment of Guide for Monitoring Child Development milestones and internal consistency in a cross-sectional study of healthy children receiving well-child care (study 1). In 2 clinical samples, we studied the interrater reliability between medical students and a child development specialist administering the guide (study 2), as well as the concurrent validity of the guide administered during a health visit and a comprehensive developmental assessment (study 3).


RESULTS
In study 1 (N = 510), item-total scale correlations ranged from 0.28 to 0.91. An age-dependent attainment pattern was seen in all of the milestones. In study 2 (N = 92), interrater reliability between medical-student pairs and between the child development specialist and students was high (kappa scores were 0.83-0.88). In study 3 (N = 79), the sensitivity, specificity, and positive and negative predictive values were 0.88, 0.93, 0.84, and 0.94, respectively.


CONCLUSIONS
The Guide for Monitoring Child Development is an innovative method for monitoring child development that is designed specifically for use by health care providers in low- and middle-income countries. Studies in Turkey provide preliminary evidence for its reliability and validity.
Ertem
Ilgi O
IO
Developmental-Behavioral Pediatrics Unit, Department of Pediatrics, Ankara University School of Medicine, Cebeci, Ankara, 06100 Turkey. ertemilgi@yahoo.com
Dogan
Derya G
DG
Gok
Canan G
CG
Kizilates
Sevim U
SU
Caliskan
Ayliz
A
Atay
Gulsum
G
Vatandas
Nilgun
N
Karaaslan
Tugba
T
Baskan
Sevgi G
SG
Cicchetti
Domenic V
DV
D002654:Child Care / Q000592:standards* / Q000639:trends; D002657:Child Development / Q000502:physiology*; D002669:Child Welfare; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic / Q000592:standards*; D015588:Observer Variation; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D014421:Turkey; D014481:United States; D014944:World Health Organization