Table 1.
Summary of test-specific information, training required and key issues for developmental screening tests and comprehensive or specific neurodevelopmental tests assessed in LMIC
| Measure | LMIC for which the test has been adapted | Test-specific information | Extensive training required? | Comments |
|---|---|---|---|---|
| Screening Measures | ||||
| Abbreviated Developmental Scale (van Meerbeke et al., 2007) | Colombia | Used as a primary tool in Colombia to evaluate developmental delays | No | No reliability and validity published |
| ACCESS Portfolio Wirz et al., 2005) | Uganda, Sri Lanka | Administered by public health officers | No | Reliability and validity not reported. Parent and medical officers reported the questionnaire was useful. |
| A not B test (Diamond, 1990) | Kenya | An (Tombokan-Runtukau & Nitko, 1992)object is hidden in front of the child in one of 2 locations; after short delay child is asked to find the item; location is changed between trials | No | Limited psychometric properties for LMIC countries—well-established findings in HIC |
| Ages and Stages Questionnaire - Third Edition (Squires, 2009) | Korea, Thailand, Ecuador | Screening instrument for developmental delays 4 to 60 months of age | No | No norms, validity and reliability are reasonable, parent questionnaire |
| Angkor Hospital for Children Developmental Milestone Assessment Tool (Ngoun, Stoey, Van’t Ende, & Kumar, 2012) | Cambodia | Measure of fine and gross motor, and social emotional development | No | Adapted from Denver Developmental Test; added 43% of items based on expert opinion; reliability and validity being established |
| Australian Early Development Index (Sayers, 2004) | Indigenous children in Australia (rch.org.au/aedi) | Teacher completed | No | Used to collect data as to community functioning—does not provide individual scores |
| Baroda Development Screening Test (Phatak & Khurana, 1991) | India | Child Administered | Some | Adapted from the BSID; 54 items (22 motor; 32 mental) Designed to be used by health care workers going door to door |
| Denver Prescreening Developmental Questionnaire (Denver II PDQ) (Frankenburk et al., 1990) | Brazil, Arab countries not specified, Armenia, Malawi, Sri Lanka, Egypt, China, Philipines, Singapore, Turkey, United Arab Emirates, Zaire | Parent Questionnaire of developmental skills expected at certain ages | No | Children with more than 2 delays or 3 items that were not performed totally should be referred for a further assessment to determine needs |
| Developmental Assessment Tool for Anganwadis (Nair et al., 1991) | India | Child Administered | Minimal | Designed to test children 2 ½ years old for developmental delays—quick and inexpensive. Anganwadis are government sponsored childcare and mother care centers in India |
| Developmental Milestones Checklist (Prado et al., 2013) | Kenya, Burkina Faso, Cambodia | Evaluates motor, language and personal-social skills | No | Good internal and test-retest reliability; validity established by correlations with play materials in home and activities |
| Disability Screening Test (Chopra et al., 1999) | India | Parental reports, observation of the child, direct assessment | Minimal | Obtains information on prenatal and birth history, physical and sensory functions, and direct developmental assessment |
| ICMR Psychosocial Development Screening Test (India) (Malik, Pradhan, & Prasuna, 2007) | India, Indonesia, Thailand | Screens for developmental delays | No | Administered by community health care workers Can be used for screening |
| Infant Neurological International Battery Test (Soleimani & Dadkhah, 2006) | Iran | Screens for developmental delays particularly in the areas of motor: does not test for cognitive delay | Designed for professionals with some level of medical training | Not designed for use by low-level workers for administration |
| Lucknow Development Screen for Indian Children (Bhave et al., 2010) | India | Administered to the main caregiver | Minimal | 27 milestones in motor, language and social domains. Validated against the Developmental Assessment Scale |
| Monitoring Child Development (Lansdown et al., 1996) | China, India, and Thailand | Child administered | Minimal | Multicenter study in collaboration with WHO. Purpose was to identify a small number of key milestones to be placed in child’s medical record |
| Screening Test Battery for Assessment of Psychosocial Development (Vazir et al., 1994) | India (particularly rural India) | Child administered | Yes | 66 items in 5 areas: gross motor, vision and fine motor, hearing and language and concept development, self-help skills, and social skills. Found to be culturally appropriate by the users |
| Strengths and Difficulties Questionnaire (1997) http://www.sdqinfo.com/b1.html | Bangladesh China, Iran, Malawi, Brazil, Pakistan, Yemen, Democratic Republic of Congo | Brief behavioral screening questionnaire for ages 3 to 16 years | No | Free and in the public domain |
| Ten Questions Questionnaire (Durkin, Hasan, & Hasan, 1995) | Sub-Saharan Africa, Asia, Caribbean, India, Jamaica, Pakistan, Bangladesh | Used to detect severe neurological impairment in children in resource poor countries | No | Good sensitivity rates ranging from 87.4% for hearing, 70% for cognitive, and 100% for epilepsy with specificity rates at 96% or higher (Mung’ala-Odera et al., 2004) |
| Test de Desarrollo Psicomotor (TEPSI) (Haussler & Marchant, 1980) | Chile | Evaluates motor function, coordination and language | Minimal training needed | Tester observes the child doing selected tasks |
| Comprehensive Neurodevelopmental Measures | ||||
| Bayley Scales of Infant Development-III (Bayley, 2005) | Bosnia, Argentina, Bangladesh, Brazil, Chile, China, Costa Rica, Czech Republic, Guatemala, Indonesia, Jamaica, Kenya, Lithuania, Malaysia, Mexico, Nicaragua, Nigeria, Phillipines, Poland, Romania, Seychelles, South Africa, Tanzania, Turkey, Thailand, Viet Nam, Zimbabwe | Major measure of development including fine and gross motor, language, social skills, and reasoning. | Yes | Most research completed on BSID II; BSID III now used and does not have the language scale factored into the composite |
| Cambridge Neuropsychological Testing Automated Battery (CNTAB) | Used with children whose first language is German, Russian, Spanish, Middle-eastern, Indian, African, Ethiopian, Asian | Computerized measure of visual memory, reaction time, processing speed, working memory, planning | No | Some familiarity required for computer use. |
| Cogstate (Westerman, Darby, Maruff, & Collie, 2001) | Jamaica, Uganda, China, Hungary, India, South Africa and Lithuania. | Computerized measure of thinking, memory and reasoning with no language component | No | *“None of the CogState tasks are language dependent, so they are adaptable cross-culturally” (Boivin et al., 2010) |
| Escala Argentina de Inteligencia Sensorimotriz (Oiberman, Orellana, & Mansilla, 2006) | Argentina, Chile | Uses direct observation of children completing Piagetian tasks | Need experience in child development | No studies for the validity and reliability of this screening measure |
| Escala de Evaluacion del Desarrollo Psicomotor (de Andraca, P., de La Parra, & Rivera y Marcwla, 1998 Schonhaut, Rojas, & Kaempffer, 2005) | Argentina, Chile | Observation and report | Need experience in child development | Used to identify risk factors for developmental delay—found to be useful particularly with low-income children |
| Griffiths Mental Development Scales (Griffiths, 1984) | South Africa, Pakistan | Measure of overall ability; measures gross motor, activities of daily living, interaction with others, language, eye hand coordination and visuospatial skills as well as practical reasoning | Requires training and certification | Older version well validated—newer version published in 2006 is not as well studied |
| Grover-Counter Scale of Cognitive Development (South Africa) (Grover & Sebate, 2005) | South Africa | Based on Piagetian theory—designed to be used for children and adults as well as those with hearing impairments—mostly nonverbal | Yes | Only provisional norms are provided-obtained from sample of normal children, mentally handicapped children, and normal African-speaking children |
| IEA Preprimary Program Assessments (Multi-national) (jmontie@highscope.org) | Guinea, Cape Verde, Bangladesh, Indonesia, Thailand | Documents how a child is performing in a given setting through observation | Need extensive training, | Is observation system for children 4 to 7 years |
| Intergrowth 21st Neurodevelopment Package (Fernandes et al., 2014) | India, Italy, Brazil, Kenya | Cognition, language, motor, behavior, attention | Yes | New measure being used—validity to be established |
| Kaufman Assessment Battery for Children-II (Kaufman & Kaufman, 2004) | Sub-Saharan Africa, India, Uganda, Romania, Benin, Laos, China, Senegal, Zaire | Tests general cognitive ability, and skills in visual spatial reasoning, sequential thinking, planning, learning, and memory | Yes | It maintained its factor structure in Ugandan children. |
| Kilifi Developmental Inventory (Abubakar, Holding, Van Baar, Newton, & van de Vijver, 2008) | Kenya Nigeria |
69 items that are explained and demonstrated prior to the child attempting the task | Yes | Found high community acceptability of the measure in Kenya |
| Leiter International Performance Scale-Revised (1997) (Roid & Miller, 1997) | Saudia Arabia, Taiwan | Nonverbal measure | Training is needed for administration | Language is not involved but is not a culture free measures |
| MacArthur-Bates Communicative Development Inventory (1993) (Fenson et al., 2007) | Sign language adaptation Hungary | Completed by the parent—parent asked about whether child understands words from a list and then is asked to fill in a vocabulary production checklist | Some training required. | Norms are developed in Britain. Unclear how would be adapted in other countries. |
| Malawi Developmental Assessment Tool (Gladstone et al., 2010) | Malawi | Direct assessment of the child as well as observation | Some training required | Sensitivity found to be around 97% and specificity at 82% |
| Mullen Early Developmental Scales (Mullen, 1995) | South Africa, Sub-Saharan Africa | Evaluates language (expressive, receptive), fine and gross motor skills, and social ability | Yes | Community Mental Health workers can administer |
| NEPSY II (2007) (Korkman, Kirk, & Kirk, 2007) |
Zambia, Indonesia, South Africa |
Measure of executive functions, memory, as well as language and reasoning |
Requires extensive training |
Limited use in LMIC; unclear as to reliability and validity |
| Rapid Neurodevelopmental Assessment Tool (Kahn et al., 2010) |
Bangladesh |
8 age related forms from ages 0 to 24 months; Measures reflexes, motor, vision, hearing, speech, cognition, behavior, and seizures |
Partially; need experience in child development |
Reliability and validity indices found to be good to excellent; Correlated strongly with BSID III |
| Shoklo Neurological Test (Thailand) (Haataja et al., 2002) |
Thailand |
No norms, assesses motor, cognition, social-emotional behavior, and speech |
Yes |
Must be administered by health care worker Uses observation and parental report Does not provide age norms |
| Stanford Binet Intelligence Scale, 5th edition (2003) (Roid, 2003) | India, Japan, China, Taiwan, Thailand, Turkey | Child is directly evaluated on verbal reasoning, abstract visual reasoning, quantitative comprehension, and short-term memory | Yes | Previous version validated—new version has not been evaluated |
| Wechsler Preschool and Primary Scale of Intelligence-third edition and Wechsler Intelligence Scales for Children (WISC) (Wechsler, 2003) | Brazil, Chile, South Korea, Bangladesh, China, Colombia, Ecuador, India Indonesia, Iran, Mexico, Peru, Thailand, Turkey, Taiwan, Venezuela, Pakistan, Yugoslavia, |
Measures of IQ; verbal comprehension, perceptual reasoning, processing speed, working memory |
Need extensive training |
Reliability and validity well established in HIC but not in LMIC |
| Yoruba Mental Subscale (Ogunnaike & Houser, 2002) | Yoruba, Nigeria (urban, semi-urban, and rural communities) | Based on the Bayley Scales from 1969 | Requires extensive training | Out of date norms—needs to be rescaled for BSID III |
| Rating Scales | ||||
| Behavior Rating Inventory of Executive Function (Gioia, Isquith, Guy, & Kenworthy, 2000) |
Malawi, Uganda |
Caregiver completed—may need to be read to parent |
No |
Rating scale; Just beginning to be used in Sub-Saharan Africa—appropriateness is currently unknown |
| CBCL/1.5–5 (Achenbach Child Behavior Checklist) (Achenbach & McConaughy, 2003) | Ethiopia, Bulgaria, China, Taiwan, Hong Hong, Croatia, Czech Republic, Estonia, Iran, India, Hungary, Lithuania, Malaysia, Poland, Brazil, Romania, Serbia, Slovenia, Philippines, Tamil, Thailand, Turkey, Ukraine, Pakistan, Viet Nam | Parent questionnaire—can also use a teacher form. Provides information about internalizing, externalizing and social behaviors | No | *The CBCL is translated into over 80 languages/not all forms available in all languages. *There are over 7,000 published studies on the CBCL tests (for multiple ages) multiple forms) |
| Early Childhood Care and Development Checklist (Armecin et al., 2007) | Phillipines | Checklist of items presented to parent and to child to evaluate general development | Requires experience in child development | Skills are either present or not present; Also has a semi-structured parent interview |
| Molteno Scale Cited in (Laughton, 2010) | South Africa | Measures overall developmental skills | Yes | Screening tool; weakly correlated with Griffiths Mental Development Scales |
| Academic, Attention, Visual-Motor, and Motor Measures | ||||
| Beery Visual Motor Integration Test-6th edition (Beery & Buktenica, 1997) | Recommended for use but not well documented as to countries | Nonverbal measure | No | Found to correlate significantly with academic achievement in South Africa |
| Bracken Basic Concept Scale-Revised (Bracken, 2008) | China | Academic measure including knowledge of letters, numbers, shapes, and pre academic skills | No | Measure of readiness—directly administered to child |
| Bruininks-Osteresky Test of Motor Proficiency | South Africa, South America, Sub-saharan Africa | Measure of motor dexterity, fine motor skills, and gross motor (balance, running, gait, etc) | Yes | Measure of motor skills—directly administered to the child as well as a rating scale for caregivers |
| Color Object Association Test (Jordan, Johnson, Hughes, & Shapiro, 2008) | Sub-Saharan Africa | Mostly nonverbal measure—can use materials commonly used in country of study | Yes | *Very little information found on this instrument |
| Early Childhood Vigilance Test (Shapiro, 2010) | Sub-Sahara Africa | Child watches a video and examiner codes where the child is viewing | Administration does not require extensive training. Scoring of this measure does | No published studies at this time |
| Early Development Instrument (EDI) (Brinkman et al., 2007) | Jamaica | Administered as a questionnaire for teachers | No | Measures school readiness |
| Motor Assessment Battery for Children-2 | Sub-Saharan Africa, Asia, Pacific Islanders | Administered directly to the child | Requires some training | Significant revision from initial battery |
| Parental Report Scales (kvalsvig@gmail.com) |
Tanzania, Nepal |
Assesses language and motor skills through parent questionnaire | Requires some training | Psychometric properties being established but as of yet unpublished. |
| Peabody Picture Vocabulary Test-4th edition (2010) (Dunn & Dunn, 2007) | China, Jamaica, South Africa, Translated and adapted in Peru, Viet Nam, India, Ethiopia, West Indies | Measure of receptive vocabulary and screening test for verbal ability | No | Some words do not translate well; Spanish version normed on small and high SES children |
| Test of Variables of Attention (Greenberg, 1989) | Malawi, Uganda | Computerized measure of attention. Provides scores for attention, impulsivity, reaction time, and variability | Little training needed for administration—training needed for interpretation | Child needs some initial exposure to computers |
| Woodcock-Johnson Third edition (Woodcock, McGrew, & Mather, 2001a, 2001b) |
Costa Rica, Seychelles |
Measure of cognitive and academic functioning |
Need extensive training |
Not validated in LMIC; Not clear how useful in many countries |
| Adaptive Behavior/Activities | ||||
| Children’s Assessment of Participation and Enjoyment (Cape)/Preferences for Activities of Children (PAC) (King, Law, King et al., 2004) | Beginning to be used in South Africa—no published data at this time | Self-report of a child on levels of participation and enjoyment in formal and informal activities | No | Construct validity established in Canada. Intensity enjoyment and preference were correlated with environmental, family and child variables |
| Independent Behavior Assessment Scale (Munir, Zaman, & McConachie, 1999) | Bangladesh, Jamaica, Pakistan | Four scales: motor, socialization, communication and daily living skills | No | Test-retest reliability and inter-rater reliability ranged from .71 to .98 and judged to be excellent |
| Indian Adaptation of the Vineland Adaptive Behavior Scales (Mahli & Singi, 2002) | India | Same scales at Vineland | No | Authors indicate needs additional validation. Initial findings were of similar structure to the VABS |
| Indonesian Adaptation of the Vineland Adaptive Behavior Scales (Tombokan-Runtukahu & Nitko, 1992) | Indonesia | Same scales as Vineland—254 questions | No | Authors indicate needs more validation before it is used widely in Indonesia |
| Vineland Adaptive Behavior Scales second edition (Sparrow, Cicchetti, & Balla, 2005) | Uganda, Kenya; Indonesia, also translated into Spanish |
Parent Interview |
Need training |
Generally administered by community health workers |
Tombokan-Runtukau, J., & Nitko, A. J. (1992). Translation, cultural adjustment, and validation of a measure of adaptive behavior. Research in Developmental Disabilities, 13, 481–501.