Validation, and utility for intervention, of a parentally-completed developmental screen for use by low-income families with children at risk of failure to reach their developmental potential

Giraldo-Huertas, J. J. (2022) Validation, and utility for intervention, of a parentally-completed developmental screen for use by low-income families with children at risk of failure to reach their developmental potential. PhD thesis, University of Reading. doi: 10.48683/1926.00127887

Abstract/Summary

Early childhood poverty and scarcity of resources put children in low-and-middle-income countries at risk of not reaching their developmental potential. However, despite a near-universal interest in risk reduction, effective interventions for developmental delay remain elusive for most vulnerable families. Here, we report four studies, including data from a previous two-year research programme in Colombia, evaluating the quality and design of the CARE instrument. CARE involves the use of parental scaffolding for developmental screening of 24- to 59-month-old children. Our initial study (Study 1) measure different health, wellbeing, and demographic dimensions for the whole sample (N = 1177) through a previous research programme called Inicio Parejo de la Vida (‘Equal Start in Life’). In this study, we found a correlation between the reading frequency reported at home and developmental-screening risk status for a subsample of children (24- to 36-month-old; n = 116). In Study 2, we undertook a reliability and agreement study for CARE’s congruence and diagnostic properties, comparing direct observation using a screening instrument (the Haizea-Llevant) and the parental report. The two further studies presented effects on children’s outcomes when parents received CARE (Study 3) and specific interventions with CARE and a dialogical book-sharing protocol in Spanish (Study 4). All participants lived in exclusively Spanish-speaking vulnerable neighbourhoods in Colombia. The results of the aforementioned studies indicate differences in children evaluated as “At risk” or “Not at risk” based on frequency of reading habits as measured by parents (Study 1). Also, for the “At risk” and “Not at risk” classifications, CARE had good psychometric properties and high congruence between the direct screening observation and parental reports (Study 2). The third study indicated the non-significant and limited benefits of no-intervention-delivery of CARE for general risk results between pre-and post-assessments. However, the interventions reported in the fourth study positively affected children’s developmental status and language-related skills and will be used as a strong benchmark for sample size calculation in subsequent trials. Finally, it should be noted that the research programme was compromised by measures taken against the COVID-19 pandemic (e.g., closure of day care centres), with several resulting limitations (e.g., sample size) for each study, and possible effects on the analysis of children’s developmental potential to consider in future research.

Item Type	Thesis (PhD)
URI	https://centaur.reading.ac.uk/id/eprint/127887
Identification Number/DOI	10.48683/1926.00127887
Divisions	Life Sciences > School of Psychology and Clinical Language Sciences
Uncontrolled Keywords	Early childhood poverty, Developmental potential, Scaffolding, Developmental Screening, Parent–child interactions, Dialogical book sharing
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