Measuring Early Child Development in Scotland:

Introducing the Early Development Instrument

Dr Rosemary GeddesCareer Development Fellow, MRC Human Genetics Unit, Scottish Collaboration for Public Health Research and Policy

Professor John Frank

Director, Scottish Collaboration for Public Health Research and Policy

Professor and Chair, Public Health Research and Policy, University of Edinburgh

Today’s presentation

• Early child development• Health inequalities• Measuring child development• Early Development Instrument• Tool for community change• How other countries do this• Our project• Timescales and steps involved

EARLY YEARS MATTER:

They set the stage for further development

`Sensitive periods’ in early brain development

Vision

0 1 2 3 7654

High

Low

Years

Habitual ways of responding

Language

Emotional control

Conceptualization

Peer social skills`Numbers’

Hearing

Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.)

“Pre-school” years

School years

What determines early child development?

• Genetics• Environmental factors – the world around

BreastfeedingSensitive nurturingReading and activitiesHealthy dietBeing treated with care and respect by those

around youGood parental role models

Life Course Problems Related to Early Life

2nd Decade

3rd/4th Decade

5th/6th

Decade Old Age

• School Failure

• Teen Pregnancy

• Criminality

• Obesity

• Elevated Blood Pressure

• Depression

• Addictions

• Coronary Heart Disease

• Diabetes

•Premature Aging

• Memory Loss

Source: Clyde Hertzman, Early Child Development: A powerful equalizer.

Outcome Most deprived Least deprived

Smoking during pregnancy¹ 38% 13%

Stillbirth 5.9/1000 live births 3.8/1000 live births

46m

Language development concerns² 26% 12%

Behaviour to other children 24% 10%

Total difficulties (on SDQ) 20% 7%

Dental caries age 5 years³ (odds) 4.6 1

Teenage pregnancy⁴ 3 x higher

Death in 15-44 year olds⁵ 5 x higher

45-74 year olds

Death due to CHD 3.8 x more likely

Death due to cancer 2.3 x more likely

Alcohol deaths 12.3 x more likely

Under-75 year old deaths 3.6 x more likely

Health inequalities in Scotland

Sources : 1. Gray R, Bonellie SR, Chalmers J, Greer I, Jarvis S, Kurinczuk JJ, et al. 2009. 2. Scottish Government. Growing Up in Scotland: Health inequalities in the early years. 2010. 3. Levin KA, Davies CA, Topping GV, Assaf AV, Pitts NB. 2009. 4. Scottish Government 2003. 5. Scottish Government Health Analytical Services Division 2008.

In Scotland babies born into these circumstances live, on average, 12 years less than …

… babies born into these circumstances.

Measuring child development

• No standardized way of measuring child development

• Health Visitor 6-8 weeks, next stop is school• School measures - height, weight, vision• No idea if children are ready for school• No idea if the 0-5 year old environments are

providing children with the support and stimulation they need to be ready for school

What is the EDI?

• The EDI is teacher-completed (20 minutes) checklist that assesses children’s readiness to learn when they enter school.

• It measures the outcomes of children’s pre-school (0-5 years) experiences as they influence their readiness to learn at school.

• As a result, the EDI is able to predict how children will do in primary school.

• The EDI does not report information about individual children’s development, rather groups of children.

What Does the EDI Measure?

1) Physical Health and Well-Being

Physical readiness for school day- e.g., arriving to school hungry

Physical independence- e.g., having well-coordinated movements

Gross and fine motor skills- e.g., being able to manipulate objects

turity

2) Social Competence

3) Emotional Maturity

Overall social competence- e.g., ability to get along with other childrenResponsibility and respect- e.g., accept responsibility for actionsApproaches to learning- e.g., working independentlyReadiness to explore new things- e.g., eager to explore new items

Pro-social and helping behaviour- e.g., helps other children in distressAnxious and fearful behaviour- e.g., appears unhappy or sadAggressive behaviour- e.g., gets into physical fightsHyperactivity and inattention- e.g., is restless

3) Emotional Maturity

4) Language & Cognitive DevelopmentBasic literacy- e.g., able to write own nameInterest in literacy/numeracy and memory- e.g., interested in games involving numbersAdvanced literacy- e.g., able to read sentencesBasic numeracy- e.g., able to count to 20

5) Communication Skills and General Knowledge

(No subdomains)- Ability to clearly communicate one’s own needs and understand others- Clear articulation- Active participation in story-telling (not necessarily with good grammar and syntax)- Interest in general knowledge about the world

Purposes of the EDI• Tells us what % of children are “vulnerable” in our

communities and in which development areas • Provides picture of what early learning looks like at

the community level• Reports on populations of children in different

communities over time• Identifies strengths and where the needs are greatest• One predictor of how children will do in primary

school• Identifies gaps in programmes and services

Benefits of EDI• paints a picture - EDI results yield neighbourhood profiles of early childhood for

every community in the district

• building more bridges – agencies that serve infants, toddlers & preschoolers have an opportunity to plan and enhance their services including parenting programmes

• planning – assists principals, schools and school boards to look forward to adjust school programmes to meet the needs of incoming students

• takes a village – emphasizes the role of the community before the child reaches school

• teachers tell us – doing the EDI helps focus their thoughts for report card writing, parent/teacher meetings and programme planning

• Look forward – adjust school programmes to meet the current needs of incoming students (schools).

• Look backward – adjust early childhood programmes to help ensure children are ready to learn and make it easier for them to make the transition to school (community).

Early experiences

Developmental outcomes

Success in school

EDI results

PredictInform

In terms of what we can influence

Example of community action from down under

Asset Mapping Perth East Metropolitan region, Proportion of children vulnerable on one or more domains

Prepared by: AEDI National Support CentreSource: AEDI Communities Data 2004/05

MucheaMucheaMucheaMucheaMucheaMucheaMucheaMucheaMuchea

Sawyers ValleySawyers ValleySawyers ValleySawyers ValleySawyers ValleySawyers ValleySawyers ValleySawyers ValleySawyers Valley

MidlandMidlandMidlandMidlandMidlandMidlandMidlandMidlandMidland

WoodbridgeWoodbridgeWoodbridgeWoodbridgeWoodbridgeWoodbridgeWoodbridgeWoodbridgeWoodbridge

Middle SwanMiddle SwanMiddle SwanMiddle SwanMiddle SwanMiddle SwanMiddle SwanMiddle SwanMiddle Swan

Swan ViewSwan ViewSwan ViewSwan ViewSwan ViewSwan ViewSwan ViewSwan ViewSwan View

Jane BrookJane BrookJane BrookJane BrookJane BrookJane BrookJane BrookJane BrookJane Brook

StrattonStrattonStrattonStrattonStrattonStrattonStrattonStrattonStratton

North PerthNorth PerthNorth PerthNorth PerthNorth PerthNorth PerthNorth PerthNorth PerthNorth Perth

Mount HawthornMount HawthornMount HawthornMount HawthornMount HawthornMount HawthornMount HawthornMount HawthornMount Hawthorn

MarangarooMarangarooMarangarooMarangarooMarangarooMarangarooMarangarooMarangarooMarangarooGirrawheenGirrawheenGirrawheenGirrawheenGirrawheenGirrawheenGirrawheenGirrawheenGirrawheen

KoondoolaKoondoolaKoondoolaKoondoolaKoondoolaKoondoolaKoondoolaKoondoolaKoondoolaBallajuraBallajuraBallajuraBallajuraBallajuraBallajuraBallajuraBallajuraBallajura

MirrabookaMirrabookaMirrabookaMirrabookaMirrabookaMirrabookaMirrabookaMirrabookaMirrabookaWestminsterWestminsterWestminsterWestminsterWestminsterWestminsterWestminsterWestminsterWestminster

BeechboroBeechboroBeechboroBeechboroBeechboroBeechboroBeechboroBeechboroBeechboro

BalgaBalgaBalgaBalgaBalgaBalgaBalgaBalgaBalga

Alexander HeightsAlexander HeightsAlexander HeightsAlexander HeightsAlexander HeightsAlexander HeightsAlexander HeightsAlexander HeightsAlexander Heights

DarchDarchDarchDarchDarchDarchDarchDarchDarch

GuildfordGuildfordGuildfordGuildfordGuildfordGuildfordGuildfordGuildfordGuildford

CavershamCavershamCavershamCavershamCavershamCavershamCavershamCavershamCaversham

GreenmountGreenmountGreenmountGreenmountGreenmountGreenmountGreenmountGreenmountGreenmount

LockridgeLockridgeLockridgeLockridgeLockridgeLockridgeLockridgeLockridgeLockridge

Helena ValleyHelena ValleyHelena ValleyHelena ValleyHelena ValleyHelena ValleyHelena ValleyHelena ValleyHelena Valley

Eden HillEden HillEden HillEden HillEden HillEden HillEden HillEden HillEden Hill

South GuildfordSouth GuildfordSouth GuildfordSouth GuildfordSouth GuildfordSouth GuildfordSouth GuildfordSouth GuildfordSouth Guildford

DarlingtonDarlingtonDarlingtonDarlingtonDarlingtonDarlingtonDarlingtonDarlingtonDarlington

Glen ForrestGlen ForrestGlen ForrestGlen ForrestGlen ForrestGlen ForrestGlen ForrestGlen ForrestGlen Forrest MundaringMundaringMundaringMundaringMundaringMundaringMundaringMundaringMundaring

Mahogany CreekMahogany CreekMahogany CreekMahogany CreekMahogany CreekMahogany CreekMahogany CreekMahogany CreekMahogany Creek

HoveaHoveaHoveaHoveaHoveaHoveaHoveaHoveaHovea

StonevilleStonevilleStonevilleStonevilleStonevilleStonevilleStonevilleStonevilleStoneville

ParkervilleParkervilleParkervilleParkervilleParkervilleParkervilleParkervilleParkervilleParkerville

Henley BrookHenley BrookHenley BrookHenley BrookHenley BrookHenley BrookHenley BrookHenley BrookHenley Brook

Herne HillHerne HillHerne HillHerne HillHerne HillHerne HillHerne HillHerne HillHerne Hill

West SwanWest SwanWest SwanWest SwanWest SwanWest SwanWest SwanWest SwanWest Swan

MorleyMorleyMorleyMorleyMorleyMorleyMorleyMorleyMorley

HighgateHighgateHighgateHighgateHighgateHighgateHighgateHighgateHighgate

ChidlowChidlowChidlowChidlowChidlowChidlowChidlowChidlowChidlow

Upper SwanUpper SwanUpper SwanUpper SwanUpper SwanUpper SwanUpper SwanUpper SwanUpper Swan

EllenbrookEllenbrookEllenbrookEllenbrookEllenbrookEllenbrookEllenbrookEllenbrookEllenbrook

BelhusBelhusBelhusBelhusBelhusBelhusBelhusBelhusBelhus

The VinesThe VinesThe VinesThe VinesThe VinesThe VinesThe VinesThe VinesThe Vines

Mount HelenaMount HelenaMount HelenaMount HelenaMount HelenaMount HelenaMount HelenaMount HelenaMount Helena

GidgegannupGidgegannupGidgegannupGidgegannupGidgegannupGidgegannupGidgegannupGidgegannupGidgegannup

BullsbrookBullsbrookBullsbrookBullsbrookBullsbrookBullsbrookBullsbrookBullsbrookBullsbrook

Proportion of children vulnerableN=Percent

34.4 to 63.924.5 to 34.318.5 to 24.410.5 to 18.4

0 to 10.4

East Metropolitan Perth, WA

3. Community asset mapping

The AEDI community planning process

1. Identifying areas of particular need

e.g. Mission Australia funds 3 year play group, language program & mums group at school

4. Mobilising community action

2. Assessing the local distribution of children’s

developmental vulnerability

Mirrabooka C4C - Change in AEDI Results from 2003-2009

0

10

20

30

40

50

60

2003 (n=538) 2004 (n=354) 2008 (n=228) 2009 (n=589)

Year

Pro

po

rtio

n o

f C

hild

ren

Vu

lne

rab

le

Phys

Soc

Emot

Lang

Comm

Low 1+

WHO IS USING IT?

Conclusion• EDI provides communities with the opportunity

to better understand how they can allocate resources & concentrate their efforts to work towards improving outcomes for children.

• EDI is inexpensive & has been well-validated and used internationally with success

• EDI covers more domains of child development than most other similar instruments

• This ‘joined-up’ standardized holistic measurement of child outcomes provides an opportunity for information sharing and subsequent planning by all stakeholders in a local authority

EDI pilot project: East Lothian

• Preschool nursery schools• Assess children at end of nursery• Phase 1: smaller group of 20 teachers

assessing 220 children – test the Canadian-EDI for language, content, user-friendliness

• Adapt Canadian-EDI to a Scottish-EDI• Phase 2: larger pilot which assesses all

(approximately 1000) preschool nursery children in the year before P1

Logistics

Timelines• Phase 1: Dec 2010 to March

2011• Phase 2: June 2011• Reporting back to

stakeholders: October 2011

Stakeholders• Community leaders• Parent representatives• Local authority leaders• Preschool and school

representatives• Education authorities• Health authorities• Voluntary organisations

operating in East Lothian