Bedford, H; Walton, S; Ahn, J; (2013) Measures of Child Development: A review. UCL Institute of Child Health: London, UK.

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Abstract

PURPOSE OF THE REVIEW: The Department of Health Policy Project Team asked the Policy Research Unit in the Health of Children, Young People and Families (CPRU) to conduct a piece of work as follows. To identify and review the range of existing standardised instruments/tools that could be used to measure children’s developmental progress at age 2–2 1/2 years, to enable a population level outcome measure that meets specific criteria to be selected. This should pay specific attention to tools that could be used as part of the 2-2½ years Healthy Child Programme (HCP) review and, include an analysis of the advantages and disadvantages of the different tools for the purpose of a population level outcome measure. The aspects of children’s development to consider are physical, social and emotional, cognitive and speech and language. METHODS: We conducted a review using systematic methods to search the literature for papers citing measures of child development. Other sources were also used including a search of the Internet, gathering review papers and consulting experts. 35 measures were identified for further examination. Only those that covered all the domains of interest were examined in more detail. Finally, the two measures which seemed most suitable for the stated purpose were assessed against pre-determined requirements set out by the Department of Health. FINDINGS: Thirty five measures met our inclusion criteria, 32 of these were identified through the systematic search, with 13 of these covering all the domains of interest. These included measures completed by parents (n=3), measures completed by health professionals based on the direct observation of a child’s skills (n=7), and those involving both parents’ report and professionals’ observations (n=3). Two parent completed measures, Ages and Stages (ASQ-3) and Parents’ Evaluation of Developmental Status (PEDS) meet most of the criteria laid out by DH, and have significant advantages over using a measure that is completed by professionals. Although they are currently being used in many parts of England in the 2-2½ years HCP review, we could not locate formal peer reviewed evaluations of these measures, and only limited evidence of parental acceptability of PEDS. Importantly neither measure appears to have been validated or standardised for use in the UK. CONCLUSIONS AND RECOMMENDATIONS: ASQ and PEDS best satisfy the requirements for a population measure of children’s development at 2-2½ years to be incorporated into the HCP review, but both measures require proper evaluation in a representative UK population. As PEDS is basically a pass/fail screening test it would not be as useful as ASQ in providing a more detailed view of the population year on year. It is suggested that both PEDS and ASQ are tested on different cohorts of children to assess their reliability and acceptability. A subset of each should also be assessed using an appropriate gold standard test to establish the validity in a representative UK population. Following this, one measure should be chosen for national use as a population measure. By their nature, if the two measures are in use, it will not be possible to aggregate the data from each into one outcome measure to provide informative data on the development of 2 year old children.

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