Comparative Use of the Ages and Stages Questionnaires in Low‐ and Middle‐Income Countries

Aim: To map the breadth of use of the Ages and Stages Questionnaires (ASQ) in low‐ and middle‐income countries (LMICs) across world regions, and examine procedures for ASQ translation, adaptation, psychometric evaluation, and administration. Method: We conducted a review of all original, peer‐reviewed studies written in English referencing use of the ASQ in LMICs. We used a consensus rating procedure to classify each article into one of four categories: feasibility study, psychometric study, prevalence study, or research study. Results: We analysed 53 peer‐reviewed articles written in English detailing use of the ASQ in LMICs. We found evidence of ASQ use in 23 LMICs distributed across all world regions. The ASQ was translated into 16 languages. Just over half of the studies reported parent completion of the ASQ (50.9%). We identified eight feasibility studies, 12 psychometric studies, and nine prevalence studies. Study type varied by economy and region. Interpretation: Findings suggest broad global use of the ASQ in a range of countries and cultural and linguistic contexts. There is need for further validation studies across all cited regions and countries and in countries ready to begin to design systems for providing universal developmental screening services

Situation Analysis of Early Intervention in Republic of Serbia

Early Childhood Intervention (ECI) services help ensure fulfilment of internationally mandated rights, strengthen inclusive societies, and support children and families. This situation analysis, jointly supported by the Early Childhood Program of Open Society Foundations and UNICEF Serbia, examined the status of ECI services in Serbia. The analysis was part of a project to identify opportunities for the development of ECI in the country. A primarily quantitative, mixed-method approach documented existing ECI infrastructure and service provision. Data were collected from a focus group with parents, field observations, and interviews with key stakeholders belonging to Health, Education, and Social Welfare sectors, advisory board meetings, and a survey completed by professionals serving children with disabilities (e.g., teachers, medical professionals, therapists) and a survey completed by parents of children with disabilities. 184 parents and 416 professionals participated. Professionals and parents agreed parents are often the first to suspect the child has developmental needs. Over half of parents and professionals indicated pediatricians should screen children for delays. There was less agreement on who should assess and serve children. Systemic barriers include lack of time, high caseloads, insufficient human resources, cost, and attitudes toward children with disabilities. Existing infrastructure and disciplines, university programs and emerging training on ECI, patronage nursing, pediatric, and developmental counseling unit services, preschool institutions, and amenable policies and legislation may facilitate the development of ECI services. A shift from a medical to a social and interdisciplinary or transdisciplinary service delivery approach through the Routines-Based Intervention (RBI) model; cross-sector alignment and agreements with program standards and quality indictors; and clear protocols and standardized practices will improve existing services. Piloting ECI services delivered through home visits, at centers, and within inclusive preschools will guide subsequent service development. A financial and efficiency analysis will inform caseloads and service intensity and duration.Parents and professionals need opportunities to learn about contemporary, evidence-based ECI practices

Situation Analysis of Early Intervention in Republic of Serbia

Early Childhood Intervention (ECI) services help ensure fulfilment of internationally mandated rights, strengthen inclusive societies, and support children and families. This situation analysis, jointly supported by the Early Childhood Program of Open Society Foundations and UNICEF Serbia, examined the status of ECI services in Serbia. The analysis was part of a project to identify opportunities for the development of ECI in the country. A primarily quantitative, mixed-method approach documented existing ECI infrastructure and service provision. Data were collected from a focus group with parents, field observations, and interviews with key stakeholders belonging to Health, Education, and Social Welfare sectors, advisory board meetings, and a survey completed by professionals serving children with disabilities (e.g., teachers, medical professionals, therapists) and a survey completed by parents of children with disabilities. 184 parents and 416 professionals participated. Professionals and parents agreed parents are often the first to suspect the child has developmental needs. Over half of parents and professionals indicated pediatricians should screen children for delays. There was less agreement on who should assess and serve children. Systemic barriers include lack of time, high caseloads, insufficient human resources, cost, and attitudes toward children with disabilities. Existing infrastructure and disciplines, university programs and emerging training on ECI, patronage nursing, pediatric, and developmental counseling unit services, preschool institutions, and amenable policies and legislation may facilitate the development of ECI services. A shift from a medical to a social and interdisciplinary or transdisciplinary service delivery approach through the Routines-Based Intervention (RBI) model; cross-sector alignment and agreements with program standards and quality indictors; and clear protocols and standardized practices will improve existing services. Piloting ECI services delivered through home visits, at centers, and within inclusive preschools will guide subsequent service development. A financial and efficiency analysis will inform caseloads and service intensity and duration.Parents and professionals need opportunities to learn about contemporary, evidence-based ECI practices

Physician Awareness of Developmental Screening and Referral in the State of Kuwait

OBJECTIVE: In the State of Kuwait, family physicians and pediatricians are responsible for identifying and referring children at risk of disability. The aims of this study were to better understand physician (1) use of developmental screening instruments, (2) referral practices for children at risk of developmental disability, (3) interpretation of screening results, and (4) anticipatory guidance topics prioritized over child screening. METHODS: A nonprobability volunteer, self-selection sample of family physicians, general practitioners, and pediatricians (n = 398) completed a 60-item paper questionnaire. Items assessed included: (1) practitioner familiarity with, belief in, and use of screening instruments; (2) familiarity with early childhood intervention services; (3) perceived barriers to screening implementation; and (4) anticipatory topics prioritized over screening. Logistic regression was used to test a priori hypotheses. RESULTS: In general, family doctors and pediatricians practicing in public hospitals and primary health care centers in the State of Kuwait do not use or know how to use a developmental screening instrument, while over half prioritized immunization counseling over child screening. Screening confidence and training on using screening instruments increased the likelihood of tool use. Staff shortages, time constraints, and a perceived lack of Arabic screening instruments were barriers to tool use. CONCLUSION: Raising health care providers\u27 awareness of standardized developmental screening instruments and establishment of an early identification system in the State of Kuwait are needed. Standardization and adaptation of technically sound Arabic-language screening tools for use in the State of Kuwait and physician training programs on screening are recommended

Cultural Adaptation and Psychometric Validation of the Ages and Stages Questionnaires for use in Georgia

Low- and middle-income countries need simple, technically sound developmental screening tools. The Ages and Stages Questionnaires, 3rd edition (ASQ-3) is widely accepted as a scientifically reliable and valid, user-friendly, and easy-to-learn and administer tool. This study documents the cultural adaptation, validation, and standardization of the Georgian ASQ-3 for children 1–66 months. The parents of 2974 children from one to 66 months completed the Georgian ASQ-3. We compared mean domain scores to the US normative sample, and performed multivariate analyses to detect variables associated with ASQ-3 cutoff scores. Cronbach\u27s alpha values for all age groups varied from 0.643 to 0.824 across areas. We found significant differences in cutoff points between the Georgian ASQ-3 and US reference population in most domains across age groups. Child gender was associated with Communication (B, 0.453; p = 0.01), Fine Motor (B, 0.457; p = 0.01) and Personal–Social (B, 0.576; p = 0.001) with scores for girls more frequently distributed above the cutoff. We found administration of the Georgian ASQ-3 was easy after adaptation. We recommend additional research to investigate sensitivity and specificity and gender differences

Recent methodological and statistical advances: a latent variable growth modeling framework

Since the late 1970s, we have witnessed a gradual increase in the complexity of theoretical models that attempt to explain development in substance use and related problem behaviors (e.g., Akers & Cochran, 1985; Patterson et al., 1992; Sampson, 1988, 1992; Sampson & Laub, 1990). The field has moved away from an emphasis on cross-sectional person-centered data toward a wider examination of the developmental nature of behavior over time, person–environment interactions, and the social context as an interactive, interdependent network that exerts influence on all its members (e.g., Conger, 1997). This social–contextual framework for studying change necessitates a broad conceptual approach that is not subsumed by any single theory. The conceptual movement to examine substance use behavior from both a developmental and contextual perspective parallels recent methodological and statistical advances in the analysis of change. The search for the best methods to address complex issues in behavior change has been a persistent theme of recent developmental research (e.g., Collins & Horn, 1991; Collins & Sayer, 2001; Duncan et al., 1999; Gottman, 1995) and has prompted a shift in analytic strategies. Rather than focusing on homogeneous populations and inter-individual variability, analysts are turning to new methods to explore both inter- and intra-individual variability and heterogeneity in growth trajectories of substance use.Historically, research into prevention intervention has included efficacy and effectiveness studies, both of which generally incorporate a longitudinal design to examine mediators and long-term effects