Child Assessment Tool for Use in Resource Limited Settings

Neurodevelopmental assessments of young children can be complex and difficult to use by untrainednon clinical staff in low resourced settingsAdditionallyfew instruments have been developed or tested for use with culturally diverse samples of children living in povertyIn family homeless shelters in the United Statesdevelopmental assessment of the children is especially raredespite their high risk statusFifty one percent of homeless children are under age five and a disproportionate number are from African American or Latino familiesand most are exposed to multiple adverse early life experiencesEnvironmental and family factorse gpoverty and racismmaternal depressionadversely impact the developmental trajectories of homeless childrenTo address these concernsthe Center for Social InnovationCwill develop the Vulnerable Child Assessment ToolVCATAn Instrument for Use in Resource Limited SettingsNormed on a diverse sample of homeless children ages three to five and based in an ecological frameworkthe VCAT will make neurodevelopmental assessment accessible to vulnerable children and families in low resource settingsPhases 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 experiencesrisk and protective factorsand developmental delaysDuring Phase Ia set item pool for each domain will be developed in conjunction with the expert panel and vetted for cognitive burdencultural responsivenessand ease of administrationPhase I families will be recruited through Housing Familiesa local homeless program serving up tohomeless children a dayWe will test the pool of items in a small sample ofparents andprogram staff using cognitive interviews and psychometric testsincluding Item Response TheoryIRTand internal consistency reliabilityConcurrentlywe will develop a prototype online platform and pilot its use for feasibility with the initial items on a sample ofchildrenIn Phase IIwe will test the validity and reliability of the instruments using a larger sample ofhomeless children recruited from programs around the countryand will assess the validity of the instrument by correlating results with gold standardclinically administeredinstruments on a subsample ofhomeless childrenWe will further the refine the web based platformdevelop a scoring algorithmand incorporate a recommendations system for service interventions to address identified concernsThis project will build upon on Cs innovative platform used to create the first psychometrically validated instrument to measure trauma informed careUsing the same back end technologythe VCAT will enable direct service staff to target limited resources to the most needed areas for intervention at the childparentand environmental levelsThe instrument will fill a significant gap in the field making valid and reliable assessment of low incomeracially diverse children exposed to multiple risk factors more accessibleand serve as a model to develop tools for use with infants or school aged childrenand those in other low resourced environments