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ISCI conference York July 27-29, 2011 Sanober Nadeem , Bilal Iqbal Avan , Ghazala Rafique ,

Development and inter-rater reliability of the "Care for Development - appraisal tool“(CDA): Assessment and monitoring of child development during first three years . ISCI conference York July 27-29, 2011 Sanober Nadeem , Bilal Iqbal Avan , Ghazala Rafique , Aga Khan University - Pakistan.

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ISCI conference York July 27-29, 2011 Sanober Nadeem , Bilal Iqbal Avan , Ghazala Rafique ,

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  1. Development and inter-rater reliability of the "Care for Development - appraisal tool“(CDA): Assessment and monitoring of child development during first three years ISCI conference York July 27-29, 2011 SanoberNadeem, BilalIqbalAvan,GhazalaRafique, Aga Khan University - Pakistan

  2. Assessment of the needs of young children • Developmental assessmentof children is very important for the identification of developmental delays and disability • A child's development during the early years consists of: • physical (both health and nutritional status) • motor development (gross and fine motor skills), • psycho-social and emotional development (in terms of social relationships, culturally appropriate behavior, values, and self-esteem), and • cognitive and language development.

  3. Child Development Indicators • Measuring the status of children requires indicators that capture the different aspects of Early Child Development • International agreement has been reached only for indicators of health and nutritional status. • Many instruments exist to assess development of young children, however, none of them is accepted as a universal standard. • Mainly developed by the western world and not always appropriate because of cultural differences.

  4. Care for Development - appraisal tool(CDA): First three years • CDA simultaneously: • monitors child growth and development during the first three years; • advises parents on how to enhance their nurturing skills; and • can be used by community based workers after appropriate training

  5. CDA Manual and Tool

  6. Introduction • Developmental assessment of children is primarily done by trained professionals in health care settings and high correlation is found amongst them • However, there is a scarcity of child development screening tools that could be used by community based workers with reliability

  7. Aims and Objectives • The current study was undertaken to determine the Inter- rater reliability of the CDA tool when used by trained community workers as compared to Experts (psychologists)

  8. Methods • A cross sectional survey was conducted in the AKU-HDP field site in Tando Jam, Sindh on 277 children aged less than three years • For inter observer reliability measures, each ECDWs pair and one expert assessed children independently in the home setting

  9. Results • Very high inter-rater correlation was observed in the paired assessments (r = .951 to .995, p<.001) on all developmental domains of the CDA tool • There is no significance difference in the distribution of mean difference (95% CI) among the experts and ECDWs observer rating for all developmental domains of the CDA tool

  10. Graph 1: Degree of Agreement on Gross Motor (GM) among Expert and ECDWs

  11. Conclusion • This study concludes that CDA …… is a reliable tool for use in community settings by trained community based workers

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