Test selection, adaptation, and evaluation: a systematic approach to assess nutritional influences on child development in developing countries.
BACKGROUND
Evaluating the impact of nutrition interventions on developmental outcomes in developing countries can be challenging since most assessment tests have been produced in and for developed country settings. Such tests may not be valid measures of children's abilities when used in a new context.


OBJECTIVE
We present several principles for the selection, adaptation, and evaluation of tests assessing the developmental outcomes of nutrition interventions in developing countries where standard assessment tests do not exist. We then report the application of these principles for a nutrition trial on the Indonesian island of Lombok.


METHODS
Three hundred children age 22-55 months in Lombok participated in a series of pilot tests for the purpose of test adaptation and evaluation. Four hundred and eighty-seven 42-month-old children in Lombok were tested on the finalized test battery.


METHODS
The developmental assessment tests were adapted to the local context and evaluated for a number of psychometric properties, including convergent and discriminant validity, which were measured based on multiple regression models with maternal education, depression, and age predicting each test score.


RESULTS
The adapted tests demonstrated satisfactory psychometric properties and the expected pattern of relationships with the three maternal variables. Maternal education significantly predicted all scores but one, maternal depression predicted socio-emotional competence, socio-emotional problems, and vocabulary, while maternal age predicted socio-emotional competence only.


CONCLUSIONS
Following the methodological principles we present resulted in tests that were appropriate for children in Lombok and informative for evaluating the developmental outcomes of nutritional supplementation in the research context. Following this approach in future studies will help to determine which interventions most effectively improve child development in developing countries.
Prado
Elizabeth L
EL
SUMMIT Institute of Development, University of Mataram, Indonesia. e.prado@lancaster.ac.uk
Hartini
Sri
S
Rahmawati
Atik
A
Ismayani
Elfa
E
Hidayati
Astri
A
Hikmah
Nurul
N
Muadz
Husni
H
Apriatni
Mandri S
MS
Ullman
Michael T
MT
Shankar
Anuraj H
AH
Alcock
Katherine J
KJ
D015362:Child Nutrition Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D016241:Child of Impaired Parents / Q000523:psychology; D002675:Child, Preschool; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D003906:Developing Countries; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007214:Indonesia; D007223:Infant; D008297:Male; D008423:Maternal Age; D009035:Mothers / Q000523:psychology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012951:Socialization