Comparing Two Early Child Development Assessment Tools in Rural Limpopo, South Africa

BACKGROUND: Providing increased cognitive stimulation or learning opportunities to young children significantly increases cognitive and social-emotional competence later in life. This study aims to determine the acceptability of a pediatric assessment tool to track early child development (ECD) in a rural health district in Limpopo, South Africa. METHODS: A total of 11 primary health nurses from the region in two focus groups were selected to learn and compare two ECD assessment tools: the Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) and Ages and Stages Questionnaire (ASQ). Data were analyzed using versus coding to compare between the two focus groups and between ASQ and CAT/CLAMS. RESULTS: The major categories that emerged from the discussion were current practice, usability, resource management, cultural adaptation, patient and parent factors, and new knowledge. CONCLUSIONS: This study illustrates the challenges related to adapting and implementing ECD assessment in an environment where ECD is largely unknown by local residents, and differs from the environment in which the tool was initially developed. Further work is needed to develop new tools or alter existing tools that can be adapted to diverse settings and cultures.