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A Toolkit for Measuring Early Childhood Development in Low- and Middle-Income Countries Lia C. H. Fernald, Elizabeth Prado, Patricia Kariger, Abbie Raikes Prepared for the Strategic Impact Evaluation Fund, the World Bank Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized © 2017 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the govern- ments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Rights and Permissions The material in this work is subject to copyright. Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: [email protected]. A Toolkit for Measuring Early Childhood Development in Low- and Middle-Income Countries Lia C. H. Fernald, Elizabeth Prado, Patricia Kariger and Abbie Raikes Prepared for the Strategic Impact Evaluation Fund, the World Bank Table of Contents Introduction . 9 Acknowledgements . .13 Acronyms and Abbreviations . 14 Chapter 1: Why Measure Early Childhood Development? . 17 Chapter 2: Early Childhood Development and Its Determinants . .21 Child development depends on the environment and care. 22 Continuity of development across childhood . .23 Poverty increases the risk of delayed development . .27 Norms for development can differ across cultures . 27 Chapter 3: Measurable Skills and Longer-Term Impact . 29 Predictive validity . .29 Cognitive skills . 31 Predictive validity of early cognitive assessments . 31 Self-regulation, effortful control and executive function . 33 Predictive validity of self-regulation, effortful control, and executive function assessments . 34 Language skills . .35 Predictive validity of language assessments . 35 Motor skills . 36 Predictive validity of early motor assessments . 36 Social and emotional development . .36 Predictive validity of early social and emotional assessments . 37 Pre- and early-academic skills . 38 Implications for impact evaluations . 39 Chapter 4: Assessment Tools and Their Uses . .41 Purpose of measurement . 41 PURPOSE 1: Population monitoring . 42 PURPOSE 2: Program evaluation . 45 PURPOSE 3: Hypothesis-driven or exploratory research . 45 PURPOSE 4: Screening children for further evaluation and diagnosis . 48 Types of child development measurements . 50 Direct tests . 50 Ratings and reports . 51 Observational measures . .53 Screening tests . .54 Ability tests . 55 Tools using rapidly developing technologies . 55 Electronic data collection and testing . .60 Chapter 5: Measure Selection . 62 Ideal characteristics of an assessment . 63 Ethical risks and responsibilities in assessing young children . 66 TABLE OF CONTENTS 5 Chapter 6: Adaptation and Standardization of Existing Tools . 67 Test fairness and bias across cultures . .68 Modification and adaption guide . 70 Evaluation of test scores: reliability, validity, and norms . 75 Ensuring quality in test administration . 77 Inter-rater reliability . 77 Rater accuracy . 79 Chapter 7: Creating New Assessments . 81 Recommendations for creating a new test . .82 The “standards” approach . 84 Chapter 8: Children’s Home and Early Learning Environments . 87 Measuring the home environment and family functioning . .87 The Home Observation for Measurement of the Environment (HOME) . 88 Tools derived from the HOME . .90 Tools for observing parent-child interactions . .92 Measuring the quality of early learning environments . .93 Chapter 9: Summary and Recommendations . 95 References . 99 Glossary . 121 List of Figures Figure 1.1 Three Primary Reasons for Assessing Child Outcomes . 18 Figure 1.2 Framework for Adapting Assessment Tools . 19 Figure 2.1 The Role of Context, Environment, and Caregiving in Child Development . 22 Figure 2.2 Intervention Options for Young Children and Families . 23 Figure 2.3 A Timeline for Human Brain Development . 24 Figure 2.4 Evidence-Based Interventions to Promote Care Across a Lifespan . .26 Figure 3.1 Correlations Between Early Developmental Scores and Later Performance . .32 Figure 3.2 Developmental Trajectories and the Impact of Intervention . .40 Figure 4.1 The Importance of Validity and Quality in Data Collection . 42 Figure 4.2 Taxonomy of Child Development Measures . 50 Figure 6.1 Reliability and Validity . 75 Figure 6.2 Figure 6.2 Assessing Inter-Rater Reliability. 79 Figure 6.3 Testing Accuracy . .80 Figure 8.1 Subscales of HOME Inventories for Use with Children Aged 0–8 Years . 89 Figure 9.1 Flowchart for Identifying a Suitable Assessment Tool . 97 List of Tables Table 1.1 Child Development Assessment: Ideal and Reality . 19 Table 3.1 Description of ECD Domains . 30 Table 4.1 Pros and Cons of Population Monitoring Tools . 45 Table 4.2 Direct Assessment Pros and Cons . 51 Table 4.3 Ratings and Reports Pros and Cons . 52 Table 4.4 Observational Measures Pros and Cons . 54 Table 4.5 Comparison of Devices for Measuring Brain and Behavioral Development. 59 Table 4.6 Pros and Cons of Using Computerized Testing . .60 Table 5.1 Ideal Traits of an ECD Assessment . .63 Table 6.1 Pros and Cons of Changing or Adding Assessment Items . 73 Table 6.2 Checklist for Test Adaptation . 77 6 A Toolkit for Measuring Early Childhood Development in Low- and Middle-Income Countries Table 6.3 Checklist for Ensuring Quality of Test Implementation . .80 Table 7.1 Examples of Parent Rating Items from EAP-ECDS. 84 Table 7.2 Pros and Cons of Standards Approach. 86 Table 8. Home Environment Questionnaires Derived from the HOME . .90 List of Sidebars Sidebar 2.1 The Impact of Adversity on Early Development. 25 Sidebar 4.1 EDI: Example of a Population-Based Assessment . 42 Sidebar 4.2 MICS Surveys: Efforts to Develop a Global Indicator . .44 Sidebar 4.3 Questions to Clarify Purpose of Measurement . 46 Sidebar 4.4 Tools Developed in Low- and Middle-Income Countries for Program Evaluation . 47 Sidebar 4.5 Tools Developed in High-Income Countries for Program Evaluation . 47 Sidebar 4.6 Screening Tools Developed in Low- and Middle-Income Countries . 49 Sidebar 4.7 Screening Tools Developed in High-Income Countries. 49 Sidebar 4.8 Examples of Computerized Tests . 61 Sidebar 6.1 How to Evaluate Reliability of Test-Retest . .76 Sidebar 6.2 How to Evaluate Validity of Ability Tests . 76 Sidebar 6.3 How to Evaluate Validity of Screening Tests . .76 Sidebar 6.4 Tips for Training . 78 Sidebar 7.1 Recommendations for Creating a New Test . 82 Sidebar 7.2 Examples of New, Country-Specific Tests by Region . 83 Sidebar 7.3 Examples of Standards.

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