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The D-score: a metric for interpreting the early development of infants and toddlers across global settings
- Weber, Ann M;
- Rubio-Codina, Marta;
- Walker, Susan P;
- van Buuren, Stef;
- Eekhout, Iris;
- Grantham-McGregor, Sally M;
- Araujo, Maria Caridad;
- Chang, Susan M;
- Fernald, Lia CH;
- Hamadani, Jena Derakhshani;
- Hanlon, Charlotte;
- Karam, Simone M;
- Lozoff, Betsy;
- Ratsifandrihamanana, Lisy;
- Richter, Linda;
- Black, Maureen M;
- Attanasio, Orazio;
- Darmstadt, Gary L;
- Doove, Bernice M;
- Galasso, Emanuela;
- Jervis, Pamela;
- Medhin, Girmay;
- Menezes, Ana MB;
- Pitchik, Helen;
- Reynolds, Sarah;
- Schady, Norbert
- et al.
Published Web Location
https://doi.org/10.1136/bmjgh-2019-001724Abstract
Introduction
Early childhood development can be described by an underlying latent construct. Global comparisons of children's development are hindered by the lack of a validated metric that is comparable across cultures and contexts, especially for children under age 3 years. We constructed and validated a new metric, the Developmental Score (D-score), using existing data from 16 longitudinal studies.Methods
Studies had item-level developmental assessment data for children 0-48 months and longitudinal outcomes at ages >4-18 years, including measures of IQ and receptive vocabulary. Existing data from 11 low-income, middle-income and high-income countries were merged for >36 000 children. Item mapping produced 95 'equate groups' of same-skill items across 12 different assessment instruments. A statistical model was built using the Rasch model with item difficulties constrained to be equal in a subset of equate groups, linking instruments to a common scale, the D-score, a continuous metric with interval-scale properties. D-score-for-age z-scores (DAZ) were evaluated for discriminant, concurrent and predictive validity to outcomes in middle childhood to adolescence.Results
Concurrent validity of DAZ with original instruments was strong (average r=0.71), with few exceptions. In approximately 70% of data rounds collected across studies, DAZ discriminated between children above/below cut-points for low birth weight (<2500 g) and stunting (-2 SD below median height-for-age). DAZ increased significantly with maternal education in 55% of data rounds. Predictive correlations of DAZ with outcomes obtained 2-16 years later were generally between 0.20 and 0.40. Correlations equalled or exceeded those obtained with original instruments despite using an average of 55% fewer items to estimate the D-score.Conclusion
The D-score metric enables quantitative comparisons of early childhood development across ages and sets the stage for creating simple, low-cost, global-use instruments to facilitate valid cross-national comparisons of early childhood development.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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