Child Assessment Tool for Use in Resource Limited Settings

适用于资源有限环境的儿童评估工具

• 批准号: 9144188
• 负责人: Carmela DeCandia
• 金额: $ 14.98万
• 依托单位: C4 INNOVATIONS, LLC
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9144188
• 关键词: 5 year old; Accounting; Address; African American; Age; Algorithms; American; Area; Assessment tool; Awareness; Back; Caregivers; Caring; Child; Child Development; Child Rearing; Childhood; Cognitive; Communication; Communities; Complex; Country; Data; Development; Developmental Delay Disorders; Effectiveness; Ensure; Environment; Environmental Risk Factor; Evidence based practice; Face; Factor Analysis; Family; Feedback; Future; Goals; Gold; Homeless Youth; Homelessness; Housing; Hunger; Individual; Infant; Intervention; Interview; Knowledge; Latino; Life; Life Experience; Link; Low income; Measures; Mental Depression; Mental Health; Modeling; Mothers; Online Systems; Parents; Participant; Peer Review; Phase; Pilot Projects; Poverty; Process; Property; Provider; Psychometrics; Publications; Recommendation; Recruitment Activity; Resources; Risk; Risk Factors; Sampling; School-Age Population; Schools; Secure; Services; Shapes; Shelter facility; System; Technology; Testing; Time; Training; Trauma; United States; Validity and Reliability; Violence; base; cognitive load; community setting; design; experience; high risk; innovation; instrument; journal article; maternal depression; meetings; outreach; peer; phase 2 study; post-traumatic stress; programs; prototype; public health relevance; racial diversity; racism; research and development; research in practice; resilience; response; service intervention; social; social media; standard measure; theories; tool; usability; user-friendly

 DESCRIPTION (provided by applicant): Neurodevelopmental assessments of young children can be complex and difficult to use by untrained, non-clinical staff in low resourced settings. Additionally, few instruments have been developed or tested for use with culturally diverse samples of children living in poverty. In family homeless shelters in the United States, developmental assessment of the children is especially rare, despite their high risk status. Fifty one percent of homeless children are under age five and a disproportionate number are from African-American or Latino families, and most are exposed to multiple adverse early life experiences. Environmental and family factors (e.g., poverty and racism, maternal depression) adversely impact the developmental trajectories of homeless children. To address these concerns, the Center for Social Innovation (C4) will develop the Vulnerable Child Assessment Tool (VCAT): An Instrument for Use in Resource Limited Settings. Normed on a diverse sample of homeless children ages three to five and based in an ecological framework, the VCAT will make neurodevelopmental assessment accessible to vulnerable children and families in low resource settings. Phases I and II of this study will use a rigorous psychometric approach to develop an ecologically aware instrument with low cognitive burden to measure adverse childhood experiences, risk and protective factors, and developmental delays. During Phase I, a set item pool for each domain will be developed in conjunction with the expert panel and vetted for cognitive burden, cultural responsiveness, and ease of administration. Phase I families will be recruited through Housing Families, a local homeless program serving up to 150 homeless children a day. We will test the pool of items in a small sample of 20 parents and 10 program staff using cognitive interviews and psychometric tests, including Item Response Theory (IRT) and internal consistency reliability. Concurrently, we will develop a prototype online platform and pilot its use for feasibility with the initial items on a sample of 60 children. In Phase II, we wil test the validity and reliability of the instruments using a larger sample of 300 homeless children recruited from programs around the country, and will assess the validity of the instrument by correlating results with gold standard, clinically administered, instruments on a subsample of 50 homeless children. We will further the refine the web based platform, develop a scoring algorithm, and incorporate a recommendations system for service interventions to address identified concerns. This project will build upon on C4's innovative platform used to create the first psychometrically validated instrument to measure trauma-informed care. Using the same back-end technology, the VCAT will enable direct service staff to target limited resources to the most needed areas for intervention at the child, parent, and environmental levels. The instrument will fill a significant gap in the field making valid and reliable assessment of low income; racially diverse children exposed to multiple risk factors more accessible, and serve as a model to develop tools for use with infants or school aged children, and those in other low resourced environments.

 描述（由申请人提供）：幼儿的神经发育评估可能是复杂的，难以由未经培训的非临床工作人员在低资源环境中使用。此外，很少有工具被开发或测试用于不同文化背景的贫困儿童样本。在美国的家庭无家可归者收容所，对儿童的发展评估特别罕见，尽管他们的高风险状态。51%的无家可归儿童年龄在5岁以下，来自非洲裔美国人或拉丁裔家庭的儿童比例过高，大多数儿童在早期生活中有多种不良经历。环境和家庭因素（例如，贫困和种族主义、产妇抑郁症）对无家可归儿童的发展轨迹产生不利影响。为了解决这些问题，社会创新中心（C4）将开发弱势儿童评估工具（VCAT）：在资源有限的情况下使用的工具。VCAT以3至5岁无家可归儿童的多样化样本为标准，并以生态框架为基础，将使低资源环境中的弱势儿童和家庭能够获得神经发育评估。本研究的第一阶段和第二阶段将采用严格的心理测量方法，开发一种具有低认知负担的生态意识工具，以测量不良的童年经历、风险和保护因素以及发育迟缓。在第一阶段，将与专家小组一起为每个领域开发一套项目库，并对认知负担、文化反应和管理便利性进行审查。第一阶段的家庭将通过住房家庭招募，这是一个当地的无家可归者计划，每天最多为150名无家可归的儿童提供服务。我们将使用认知访谈和心理测量测试，包括项目反应理论（IRT）和内部一致性信度，在20名家长和10名项目工作人员的小样本中测试项目池。同时，我们将开发一个原型在线平台， 在60名儿童的样本中试用初步项目，以确定其可行性。在第二阶段，我们将测试的有效性和可靠性的工具，使用更大的样本300名无家可归的儿童从全国各地的方案招募，并将评估工具的有效性，通过相关的结果与金标准，临床管理，工具的子样本50名无家可归的儿童。我们将进一步完善网上平台，开发评分算法，并纳入服务干预的建议系统，以解决确定的问题。该项目将建立在C4的创新平台上，该平台用于创建第一个经心理测量验证的工具来测量创伤知情护理。使用相同的后端技术，VCAT将使直接服务人员能够将有限的资源用于儿童、父母和环境层面最需要干预的领域。该工具将填补这一领域的一个重大空白，使人们更容易获得对低收入、面临多种风险因素的不同种族儿童的有效和可靠评估，并作为一个模式，开发用于婴儿或学龄儿童以及其他资源匮乏环境中儿童的工具。