Early Child Development on a Global Scale

A new tool that allows for large-scale monitoring of children’s early development across diverse cultures could have broad implications in research and policy around the globe, according to its co-creator, Assistant Professor Dana McCoy. The tool, whose promising early uses were recently summarized in the Early Childhood Research Quarterly, provides scalable, comparable data on the motor, language, cognitive, and social-emotional skills of young children (ages 0 to 3) around the world. McCoy worked with Günther Fink, associate professor at the Swiss TPH in Basel and adjunct professor at the Harvard T.H. Chan School of Public Health, and HGSE doctoral candidate Marcus Waldman to develop and validate the first-of-its-kind measure, an open-source platform called the Caregiver Reported Early Development Instruments (CREDI).

“The CREDI has filled a gap — not only from a policy perspective but also a research perspective, to have tools to use in program evaluation globally,” McCoy says. “Early childhood has increasingly been recognized by governments and nongovernmental organizations (NGOs) as a window of opportunity for improving not only the developmental outcomes of individual children, but also the social and economic wellbeing of society as a whole.”

The CREDI helps provide policymakers and NGOs a snapshot of how children are developing globally, and can inform conversations about how best to allocate resources or make decisions in policies and programming related to children.

McCoy first realized there was almost no evidence-based, large-scale literature on child development beyond high-income countries five years ago, when she was trying to understand major risk factors for children in Tanzania. Part of the many challenges in researching early childhood development globally is a lack of measurement tools that work in a non-Western cultural setting, she says. To date, most research and evaluation tools have been developed for children living in high-income countries such as the United States, then applied to research on children living in low- and middle-income countries with minimal success.

“Sometimes that works, but sometimes that really doesn’t work,” McCoy says. “What we are likely doing by administering U.S.-based assessments is underestimating the actual ability levels of kids in low-resourced communities because we are using the wrong tools, the wrong questions. You really need tools and solutions developed locally. You can’t ask a child in Tanzania to describe a picture of a snowman. She’s bound to get that wrong.” The need is important, McCoy says, considering that 90 percent of children under the age of 5 live in developing countries.

McCoy, Fink, and Waldman developed the CREDI in order to find a better way to understand and measure child development on a global scale. The tool is unique in that it is both open source and based on caregiver reports that are focused on milestones and behaviors that are common across cultures, rather than objects or resources that may be culturally specific.

Researchers and policymakers can access CREDI in two versions: a short form, which has exactly 20 questions for each child and is geared toward large scale surveys and monitoring effects, and a more detailed long form, which has up to 100 questions per child and can be beneficial for research and evaluation projects.

The CREDI is already being used in 20 countries by local researchers and the nonprofit, Save the Children. Parts of it are also being considered for use by organizations like WHO and UNICEF, where, if incorporated into data collection efforts, it has the potential to reach hundreds of thousands of children, McCoy says.

“It’s an exciting time for the field. Early childhood has had a lot of momentum in the United States for a long time but it’s starting to pick up steam internationally,” McCoy says. “There’s a ton of work to be done and a ton of need. Children in low- and middle-income countries face stress and adversity that is substantially more challenging and dramatic than what kids in high-income countries are experiencing, and we need to do more.”