Measuring children’s development in low and middle income countries: getting it right

Bernie Munoz, Julie Dockrell, Lynn Ang and Jessica Massonnié.

How do we measure young children’s development and the quality of their learning environments in low and middle income countries (LMICs)? This answer is key for researchers, practitioners, field workers and NGOs working with children as there is a pressing need to prevent childhood ‘stunting’ in these countries.

Childhood stunting is the impaired growth and development that children experience because of poor nutrition, repeated infection, and inadequate psychosocial stimulation.

Through a systematic review (SR) soon to be published in the Journal of Early Childhood Research, we identified 43 current tools: 34 for assessing children’s development across countries, five to measure the home environment and four to measure early childhood education settings to inform research and practice.

We conducted this review as part of a large-scale interdisciplinary study, UKRI GCRF Action Against Stunting Hub (2019-2024), working in India, Indonesia and Senegal. To inform this important research hub about education and cognition, we identified and evaluated measures to provide comparative robust data about children’s development and their learning contexts.

The Sustainable Development Goals state that by 2030 all children should have access to high quality early child development opportunities, healthcare and pre-primary education, so effective measurement of these outcomes is high on the global agenda.

A poorly chosen measure will significantly compromise the best research study. Reliable and valid measures provide opportunities to track children’s development, target their needs, evaluate the efficacy of interventions and capture the impact of challenges to development within the child and the environment.

However, the rarity of validated measures of early childhood development in emerging economies makes choosing the right ones easier said than done. Even in the global North – where a wide range of assessment tools have been developed and standardised – which measures to use, for which children, at which point of development, and in which settings are highly contested. In emerging economies, it is not only critical to identify reliable and valid tools, but culturally sensitive assessments are needed to profile children’s development and learning environments. Without such tools, conclusions about children and interventions to help them at scale across different contexts is likely to be misleading.

Along with each tool’s psychometric properties and cultural appropriateness, our review highlights the implementation challenges. Critical accessibility aspects (such as licenses and training) need to be considered when choosing a tool to successfully apply it to a new context. Measures which require professional training for example, can be extremally challenging in contexts where professionals – such as psychologists, speech and language therapists or occupational therapists – are scarce.

We have identified twelve considerations which can inform decisions about which tool(s) to use when carrying out studies in emerging economies. Seven dimensions (target age, administration method, domains, battery, accessibility, language and country/Institution) profile the tools’ characteristics. Five dimensions (study, population tested, validity, reliability and cultural adaptability/translation) capture previous applications of the tools in these countries. Together these dimensions illuminate the decision processes required in selecting assessment tools.

Overall, the twelve considerations look beyond tools’ psychometric properties to consider the wider social context in which children are developing and learning in different environments across Low and middle income countries. We hope that this review will support the rigor of developmental studies in LMICs and provide useful guidance for fellow researchers, practitioners, field workers and NGOs to select the most appropriate tools for their specific studies and contexts.

Photo: Children in Senegal by Carsten ten Brink via Creative Commons