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Measuring child development at the 2-21/2-year health and development review in England: a rapid scoping review of available tools

Por: Lysons · J. · Mendez Pineda · R. · Alarcon · G. · Aquino · M. R. J. · Cann · H. · Stoianov · D. · Fearon · P. · Kendall · S. · Kirman · J. · Gladstone · M. · Woodman · J.
Objective

All children in England should receive a health review at 2–21/2 years, with the Ages and Stages Questionnaire third edition (ASQ-3) used to collect public health surveillance data on child development. However, practitioners also value tools that assess individual children’s development—consistent with ASQ-3’s original purpose. Concerns about licensing costs and barriers to digitalisation have prompted interest in alternative tools to the ASQ-3 in England.

Design

To inform policy, we conducted a rapid scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify tools that can measure or assess early child development.

Data sources

Searched PubMed, PsycINFO and Web of Science from January 2012 to November 2022, with targeted search update November 2024.

Eligibility criteria

We included English-language studies published after January 2012 that described or evaluated tools in English which could measure or assess early child development in children

Data extraction

We extracted key features and reliability, validity, sensitivity and specificity of tools which could feasibly be implemented at the 2–21/2-year review (eg, including multiple age versions and

Results

We identified 112 unique publications describing 34 tools; six met our feasibility criteria for the 2–21/2-year review (reported in 53 studies). Only ASQ-3 and CREDI offer domain-specific scoring—a government priority. ASQ-3 moderately detects mild delays and performs better for severe delays in at-risk groups. Caregiver Reported Early Development Instruments (CREDI) was designed for public health surveillance, and we do not yet know how it performs for individual assessment.

Conclusions

ASQ-3 and CREDI are most promising for use at the 2–21/2-year review. However, we lack UK-based validation and norming studies, even for ASQ-3. Ultimately, careful implementation and integration into existing systems will determine a tool’s value for identifying developmental needs, supporting families and producing high quality data for public health surveillance.

Cohort profile: a prenatal birth cohort study of intergenerational risk and resilience after conflict and forced displacement

Por: Wuermli · A. · Hiott · M. C. · Ugarte · E. · Rahman · M. S. · Elahi · M. · Rahim · A. · Dutta · G. K. · Ahamed · M. S. · Roy · B. R. · Akhter · R. M. · Hossain · E. · Michael · D. · Ayrin · T. K. · Haseen · S. H. · Alam · R. B. · Ratul · T. I. · Horaira · M. A. · Gladstone · M. · Sanin · K.
Purpose

As of 2024, 123.2 million people had been forcibly displaced as a result of persecution, armed conflict or climate-related catastrophes, and these numbers are predicted to rise. There is a growing awareness of possible intergenerational effects of trauma on life-course health and well-being, however few studies have followed individuals longitudinally starting prenatally. This paper describes the first large prenatal birth cohort study in a refugee context in a lower middle-income country. This study aims to investigate the potential lifespan health and developmental implications of being born into a protracted humanitarian context, and what factors can buffer from the adversity posed by conflict and displacement.

Participants

We outline our approach of recruiting, consenting and gathering data from pregnant Rohingya refugee and host community women (N=2888; 80% Rohingya) over the course of 12 months in Cox’s Bazar, Bangladesh.

Findings to date

A fifth wave of data collection, when children were 6 months old, was completed in April 2025. Rohingya women were substantially less literate; were marrying and having children at slightly younger ages, were more likely to live in crowded, resource-limited households and exhibited higher rates of clinically significant post-traumatic stress disorder and anxiety than host community women.

Future plans

There is a critical need for research in displaced populations in order to elucidate potentially lasting transgenerational impacts of experiencing conflict and displacement trauma, and the prenatal and postnatal factors that support health and development across the life span. The next follow-up is planned when the children turn 36 months of age (starting March 2026).

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