Box 1.

Identification of children with developmental disabilities

In order to meaningfully measure thriving and well-being of children globally, developmental assessment tools need to be culturally relevant and age appropriate and cover the spectrum of developmental domains, including sensory impairments and educational outcomes. Examples of tools with high validity and reliability to measure several developmental domains include the Bayley Scales of Infant and Toddler Development (BSID II or Bayley-III).22 Regionally developed instruments include the Malawi Development Assessment Tool23 and the Kilifi Developmental Inventory.24 However, a recent review found variability in translation, adaptation, piloting and standardisation of tools, with important domains such as vision, hearing, functioning and disability often omitted, which limits holistic understanding of a child's progress.25 In addition, no tool covers all domains of development and is accurate and feasible in all contexts.26