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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

Cavallera, Vanessa; Lancaster, Gillian; Gladstone, Melissa; Black, Maureen; McCray, Gareth; Nizar, Ambreen; Ahmed, Salahuddin; Dutta, Arup; Kouadio E Anago, Romuald; Brentani, Alexandra; Jiang, Fan; Schönbeck, Yvonne; C McCoy, Dana; Kariger, Patricia; Weber, Ann M.; Raikes, Abbie; Waldman, Marcus; van Buuren, Stef; Kaur, Raghbir; Pérez Maillard, Michelle; Nisar, Muhammad Imran; Khanam, Rasheda; Sazawal, Sunil; Zongo, Arsène; Pacifico Mercadante, Mariana; Zhang, Yunting; Roy, Arunangshu; Hepworth, Katelyn; Fink, Günther; Rubio-Codina, Marta; Tofail, Fahmida; Eekhout, Iris; Seiden, Jonathan; Norton, Rebecca; H Baqui, Abdullah H; Khalfan Ali, Jamila; Zhao, Jin; Holzinger, Andreas; Detmar, Symone; Kembou, Samuel Nzale; Begum Chandio, Farzana; Mohammed Ali, Said; Jehan, Fyezah; Dua, Tarun; Janus, Magdalena

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


Vanessa Cavallera

Gillian Lancaster

Melissa Gladstone

Maureen Black

Ambreen Nizar

Salahuddin Ahmed

Arup Dutta

Romuald Kouadio E Anago

Alexandra Brentani

Fan Jiang

Yvonne Schönbeck

Dana C McCoy

Patricia Kariger

Ann M. Weber

Abbie Raikes

Marcus Waldman

Stef van Buuren

Raghbir Kaur

Michelle Pérez Maillard

Muhammad Imran Nisar

Rasheda Khanam

Sunil Sazawal

Arsène Zongo

Mariana Pacifico Mercadante

Yunting Zhang

Arunangshu Roy

Katelyn Hepworth

Günther Fink

Marta Rubio-Codina

Fahmida Tofail

Iris Eekhout

Jonathan Seiden

Rebecca Norton

Abdullah H H Baqui

Jamila Khalfan Ali

Jin Zhao

Andreas Holzinger

Symone Detmar

Samuel Nzale Kembou

Farzana Begum Chandio

Said Mohammed Ali

Fyezah Jehan

Tarun Dua

Magdalena Janus


Introduction: 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.

Methods and analysis: 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.

Ethics and dissemination: 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.

Journal Article Type Article
Acceptance Date Oct 26, 2022
Publication Date 2023-01
Publicly Available Date May 30, 2023
Journal BMJ Open
Publisher BMJ Publishing Group
Volume 13
Issue 1
Article Number e062562
Keywords MENTAL HEALTH; Paediatric neurology; Developmental neurology & neurodisability; PUBLIC HEALTH; EPIDEMIOLOGY; International health services
Publisher URL


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