Individual or Group-based Approach to the Assessment of Preschool Children: A Comparison using the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA)
Introduction: It is unclear if the assessment of early child development can be carried out using a group approach, as opposed to individually.
Objective: To compare scores obtained from children aged 22 to 26 months assessed either in small groups or individually using the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA), which measures cognition, language, motor skills, behavior, attention and socio-emotional reactivity.
Methods: A small group based strategy for administering and scoring the INTER-NDA was developed. Thirty-six preschool children attending four Centros de Cuidado y Atención Infantil of the Sistema Nacional para el Desarrollo Integral de la Familia (DIF) of Mexico were assessed in small groups of three children by a teacher specifically trained in the INTER-NDA. A second teacher, unaware of the group results, assessed the children individually on a different day. The sex, age, weight, length and head circumference of the children at the time of assessment were recorded.
Results: INTER-NDA domain scores for group and individual assessments were statistically significantly correlated (range r=0.35 to r=1.00) for all domains except receptive language (r=0.25, p=0.14). Bland-Altman analysis showed agreement between group and individual scores for the language, behavior, attention and socio-emotional reactivity domains, and consistency (but not agreement) between group and individual scores for the cognitive and motor domains. None of the differences between group and individual scores examined were statistically significant, even after adjusting for the children’s age, sex, nutritional status and location of the preschool.
Conclusion: INTER-NDA domain specific scores obtained following group and individual assessment of children aged 22 to 26 months are consistent. It is feasible for trained preschool teachers to administer INTER-NDA at both group and individual level.