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Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries

Mohammed Ali, S; Jehan, F; Dua, T; Janus, M; Khalfan Ali, J; Zhao, J; Norton, R; Baqui, AH; Holzinger, A; Detmar, S; Kembou, SN; Begum, F; Tofail, F; Eekhout, I; Seiden, J; Cavallera, V; Lancaster, GA; Gladstone, M; Black, MM; McCray, G; Nizar, A; Ahmed, S; Dutta, A; Anago, RKE; Brentani, A; Jiang, F; Schönbeck, Y; McCoy, DC; Kariger, P; Weber, AM; Raikes, A; Waldman, M; van Buuren, S; Kaur, R; Pérez Maillard, M; Nisar, MI; Khanam, R; Sazawal, S; Zongo, A; Pacifico Mercadante, M; Zhang, Y; Roy, AD; Hepworth, K; Fink, G; Rubio-Codina, M

Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries Thumbnail


S Mohammed Ali

F Jehan

T Dua

M Janus

J Khalfan Ali

J Zhao

R Norton

AH Baqui

A Holzinger

S Detmar

SN Kembou

F Begum

F Tofail

I Eekhout

J Seiden

V Cavallera

GA Lancaster

M Gladstone

MM Black

A Nizar

S Ahmed

A Dutta

RKE Anago

A Brentani

F Jiang

Y Schönbeck

DC McCoy

P Kariger

AM Weber

A Raikes

M Waldman

S van Buuren

R Kaur

M Pérez Maillard

MI Nisar

R Khanam

S Sazawal

A Zongo

M Pacifico Mercadante

Y Zhang

AD Roy

K Hepworth

G Fink

M Rubio-Codina


<jats:sec><jats:title>Introduction</jats:title><jats:p>Children’s early development is affected by caregiving experiences, with lifelong health and well-being implications. Governments and civil societies need population-based measures to monitor children’s early development and ensure that children receive the care needed to thrive. To this end, the WHO developed the Global Scales for Early Development (GSED) to measure children’s early development up to 3 years of age. The GSED includes three measures for population and programmatic level measurement: (1) short form (SF) (caregiver report), (2) long form (LF) (direct administration) and (3) psychosocial form (PF) (caregiver report). The primary aim of this protocol is to validate the GSED SF and LF. Secondary aims are to create preliminary reference scores for the GSED SF and LF, validate an adaptive testing algorithm and assess the feasibility and preliminary validity of the GSED PF.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>We will conduct the validation in seven countries (Bangladesh, Brazil, Côte d’Ivoire, Pakistan, The Netherlands, People's Republic of China, United Republic of Tanzania), varying in geography, language, culture and income through a 1-year prospective design, combining cross-sectional and longitudinal methods with 1248 children per site, stratified by age and sex. The GSED generates an innovative common metric (Developmental Score: D-score) using the Rasch model and a Development for Age Z-score (DAZ). We will evaluate six psychometric properties of the GSED SF and LF: concurrent validity, predictive validity at 6?months, convergent and discriminant validity, and test–retest and inter-rater reliability. We will evaluate measurement invariance by comparing differential item functioning and differential test functioning across sites.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>This study has received ethical approval from the WHO (protocol GSED validation 004583 20.04.2020) and approval in each site. Study results will be disseminated through webinars and publications from WHO, international organisations, academic journals and conference proceedings.</jats:p></jats:sec><jats:sec><jats:title>Registration details</jats:title><jats:p>Open Science Framework<jats:ext-link xmlns:xlink="" ext-link-type="uri" xlink:href=""></jats:ext-link>on 19 November 2021 (DOI 10.17605/OSF.IO/KX5T7; identifier: osf-registrations-kx5t7-v1).</jats:p></jats:sec>

Acceptance Date Oct 26, 2022
Publication Date Jan 24, 2023
Journal BMJ Open
Publisher BMJ Publishing Group
Pages e062562 - e062562
Publisher URL


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