Early Development Instrument Report: East Lothian Pilot 2012

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July 2012 Written by Dr Rosemary Geddes of the Scottish Collaboration for Public Health Research and Policy, Edinburgh, a research body of the Medical Research Council (MRC), and funded by the MRC and the Scottish Chief Scientist’s Office. This report expands on the shorter report available on the East Lothian EDI pilot. The Early Development Instrument used in this pilot is a measurement tool translated from the original version designed by McMaster University, Hamilton, Canada, and protected under copyright laws. You may not use or copy the questionnaire without prior written agreement with McMaster. Please contact Dr Magdalena Janus at janusm@mcmaster.ca for details. For more information about this report, please contact: Scottish Collaboration for Public Health Research and Policy (SCPHRP) 20 West Richmond Street Edinburgh EH8 9DX Tel +44 (0) 131 651 1597 www.scphrp.ac.uk

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CONTENTS Acknowledgements ................................................................................................................................................................ 5 Executive Summary ................................................................................................................................................................ 6 Introduction ............................................................................................................................................................................... 7 Background to the East Lothian pilot .................................................................................................................... 7 What is the Early Development Instrument? ..................................................................................................... 7 How can it be used?....................................................................................................................................................... 7 How are results reported? ......................................................................................................................................... 8 The East Lothian EDI Pilot ......................................................................................................................................... 9 Measuring inequalities in child development .................................................................................................. 10 Exclusions from the main analyses ................................................................................................................... 10 References....................................................................................................................................................................... 10 Profile of East Lothian’s P1 Children ............................................................................................................................. 12 Teacher characteristics ....................................................................................................................................................... 19 Conclusions .............................................................................................................................................................................. 20 Next Steps ................................................................................................................................................................................. 21 Appendices ............................................................................................................................................................................... 22 I Scottish Early Development Instrument Child Form ................................................................................. 22 II Scottish Early Development Instrument Teacher Form .......................................................................... 31

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ACKNOWLEDGEMENTS The Early Development Instrument (EDI) pilot project was led by principle investigator, Professor Lisa Woolfson from University of Strathclyde, and co-investigators Professor John Frank and Dr Rosemary Geddes from the Scottish Collaboration for Public Health Research and Policy (SCPHRP). The project was managed by Rosemary Geddes assisted by the EDI project implementation team consisting of: Karen Fleming (East Lothian Head Teacher representative), Mary Preston (Pre-school Education Officer, Department of Services for People – Education, East Lothian Council), Leisa Randall (Principal Educational Psychologist, East Lothian Council), Tara Shivaji (StR Public Health, NHS Highland), Marion Wood (Service Manager, Children and Families Practice Teams, East Lothian Council), and Steven Wray (Public Health Practitioner, NHS Lothian and lead officer - Support from the Start). The original EDI questionnaire was developed and designed by the Offord Centre for Child Studies at McMaster University, Canada. We thank, from McMaster University, Professor Magdalena Janus for her professional support, Eric Duku for analysis, and Cindy Walsh for administrative support. In addition, thanks go to Professor Clyde Hertzman (Human Early Learning Partnership, British Columbia, Canada) and Sally Brinkman (well known for spearheading the use of the EDI in Australia) for their guidance and support. The EDI project could not, of course, have been conducted without the participation of the East Lothian Primary 1 school teachers and head teachers of 2011/2012. We thank them for their time and effort. We also thank Don Ledingham, Executive Director of Services for People at East Lothian Council and Director of Education and Children’s Services for Midlothian Council, for his infectious enthusiasm and support for the project. Finally, we wish to thank: University of Strathclyde Research Assistants, Josephine Booth and Stephanie McNicol, for their substantial contributions to the data analysis; Andrew Gasiorowski, National Services Scotland, for assistance with mapping; and Samantha Bain and Renee Ingram (SCPHRP) for administrative support.

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EXECUTIVE SUMMARY The early childhood period is considered to be the most important developmental phase throughout the lifespan and can have immediate and longer term impacts on health and well-being. Currently there are few means in Scotland by which inequalities in child development during these early years can be assessed. Neither can the impact of government early years policies and programmes on child development be determined at local or national level. Our aim was to pilot an internationally validated tool, the Early Development Instrument (EDI), to assess global development in Scottish children at school entry. The phase 1 objective was to test and adapt the Canadian-designed EDI for the Scottish context. Phase 2 aimed to implement the EDI in one local authority to provide the community with information about their children’s strengths and vulnerabilities. In both phases, the psychometric and discriminatory properties of the EDI were tested. During phase 1 in March 2011, 14 P1 teachers assessed 154 P1 children using the 104-item EDI. Qualitative methods were used to gather feedback from teacher participants on the tool and the process. During January 2012, phase 2 was conducted with 68 P1 teachers and 1180 P1 children (4½ months after school entry) using a descriptive cross-sectional design. The average scores in each of the five developmental domains were linked to socioeconomic status. ‘Overall vulnerability’ was defined as scoring at or below the 10th percentile on at least one developmental domain. Results for geographic areas were mapped using GIS mapping. Cronbach’s α was used to determine internal consistency. The qualitative work during phase 1 demonstrated that the majority of teachers found the EDI to be easy to use, acceptable, feasible and appropriate to the Scottish context. Only minor adjustments in terminology were made to the Canadian EDI. On average, East Lothian P1 children, attending school without any additional support in class, are doing well in all areas of child development. Phase 2 analyses found the ‘overall vulnerability’ of the P1 children to be 27%. When compared with other English speaking Western countries that do the EDI at the same age, East Lothian falls in the middle with Australian children scoring slightly better and Canadian children scoring slightly worse on average. Across all socioeconomic status groups, East Lothian 5 year olds: do quite well in physical health and well-being and cognitive/language development domains; score ‘average’ in social competency; and score less well in emotional maturity and communications and general knowledge domains. A clear socioeconomic status gradient was observed across all five domains. ‘Overall vulnerability’ was higher in: boys (34%) compared with girls (20%), and younger children (34%) compared with older children (20%). The pilot results indicate that the EDI is appropriate and feasible for use in Scotland. During the next phase local community groups in East Lothian will utilise EDI findings for local decisionmaking around early years’ services, support and resources.

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INTRODUCTION BACKGROUND TO THE EAST LOTHIAN PILOT Currently there are few means in Scotland by which inequalities in child development, by geographic area or socioeconomic status, are universally measured. Neither is the impact on child development of national government early years policies and programmes assessed at regional or national level. As a result, the Scottish Collaboration for Public Health Research and Policy explored, with a number of health boards and local authorities, the possibility of developing an economical prototype system for monitoring early child development, particularly at school entry. Discussions between NHS Lothian, East Lothian Council, University of Strathclyde and the Scottish Collaboration for Public Health Research and Policy led to an agreement to pilot the Early Development Instrument (EDI) in East Lothian local authority, as part of an early years’ Equally Well test site. Ethical approval was granted by University of Strathclyde.

WHAT IS THE EARLY DEVELOPMENT INSTRUMENT? The EDI was developed in Canada by the Offord Centre for Child Studies, McMaster University and has been demonstrated to be an accurate and affordable method for measuring ‘developmental health’ (1). The instrument is now used in almost all provinces of Canada and, since 2009, in all of Australia. It is also being used in regional populations in the USA, Central and South America, Asia, the Middle East, Africa and four European countries. The EDI is completed by teachers for the children they teach, based on their knowledge of the children’s skills, competencies and behaviour. It has been used in populations of children aged 4–6 years and measures ‘school readiness’ in five domains of development:     

physical health and wellbeing social knowledge and competence emotional health/maturity language and cognitive development general knowledge and communication skills (2) .

HOW CAN IT BE USED? The instrument is intended for community-level monitoring and not for individual student assessment or for clinical diagnostic purposes. The results are fed back to local communities, schools, parents and teachers allowing stakeholders to judge how their local children entering school are doing in developmental terms. This also allows local partner agencies to reflect on services and programmes supporting 0-5 year olds and to geographically target services and implement early childhood interventions for infants, children, parents, families, and/or communities, all of which aim to address any ‘developmental vulnerabilities’ identified by the measurement (3, 4). We know from the evidence that children’s readiness to learn, and particularly the five domains included in the EDI instrument, all impact on the life course of an individual, their health and ability 7


to contribute positively to society (5). Indeed, the EDI predicts school success, which in turn is a powerful predictor of life success, which itself is strongly linked to lifelong health outcomes.

HOW ARE RESULTS REPORTED? Figure 1. The domains or areas of development assessed by the EDI

Once teachers have completed the EDI questionnaire for all their Primary 1 (P1) children, each child is scored (out of 10) for each domain of development. The whole range of scores for all the children in East Lothian is then considered, and the bottom 10% of scores in each domain is regarded as ‘low’. Children who score ‘low’ in one or more domains of development are regarded as ‘Overall Vulnerable’. Thus, in EDI terminology, ‘vulnerable’ does not have connotations with child protection or social services; it simply means that the group of children falls within the lowest 10% in terms of their development. The EDI is never interpreted or reported at the individual child level. There are three ways in which the results from the EDI are reported (table 1). The first is the percentage of children (in the whole local authority or a cluster or school) who are found to be ‘overall vulnerable’. In addition, we will report on the percentage of children scoring ‘low’ on two or more domains. The second way of reporting is the average scores (out of 10) in each domain. Again this can be done for the whole local authority or clusters or schools. Finally, for each of the five domains of development, the percentage of children in an area scoring in the bottom 10%, between 10 and 25%, and above 25% (regarded as ‘on track’ for development) are reported. This uses the 10% and 25% ‘cut-offs’ scored by the whole East Lothian local authority. A 50th percentile cut-off can also be used scoring above which is termed ‘On Track 2’.

Lowest 10% of all scores

Scores between 10 and 25%

Scores falling above 25% = ‘On Track’

ALL SCORES IN EACH DOMAIN OF DEVELOPMENT OF P1 CHILDREN IN EAST LOTHIAN

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Any area or subpopulation where either the numerator or denominator is 10 or less will not be reported on. This is to prevent ‘over-interpretation’ of results in areas where the assessment of individual children can cause large changes in group outcomes. These areas with small numbers will rather be merged with adjacent areas.

Measure

How expressed

Overall developmental vulnerability -‘low’ in one or more of the five domains of the EDI

Percentage

Average or Mean Domain Score – reports average scores in each area or domain of development

Score out of 10

For the 5 domains:

Percentage

Vulnerable (on or below 10th percentile) At risk (between 10th and 25th percentile) On track (above 25th percentile) – reports % in each domain For more detail ‘On track’ can be divided into: On track 1 (above 25th percentile to 50th percentile) On track 2 (above 50th percentile) Table 1. Three ways in which the results from the EDI are reported

THE EAST LOTHIAN EDI PILOT The pilot was conducted in two phases with the following objectives: Phase 1   

adapt the Canadian EDI to the Scottish context and school system test the feasibility of implementing it in Scotland assess the psychometric properties and discriminatory ability of the measure in Scotland

During phase 1, conducted in March 2011, 14 P1 teachers assessed 154 P1 children using the 104item EDI. Qualitative methods were used to gather feedback from teacher participants on the tool and the process. The Scottish Index of Multiple Deprivation (see below) was used to categorise levels of deprivation. Cronbach’s α was used to determine internal consistency. Phase 1 demonstrated that the majority of teachers in East Lothian found the Canadian-designed EDI to be easy to use, acceptable, feasible and appropriate to the Scottish context. Only minor adjustments to terminology were required to adapt the EDI for Scotland. The EDI performed well in 9


terms of its psychometric properties and was found to be appropriate for the P1 entry age group in Scotland. All five domains of the EDI exhibited good internal consistency (Cronbach’s α => .78). Phase 2   

implement the EDI in whole local authority provide the community with information about their children’s strengths and vulnerabilities conduct validity and reliability testing of the EDI measure for the Scottish context

Phase 2 data was collected during January 2012 with the participation of 68 P1 teachers and 1180 P1 children from 35 schools. The mean scores in each of the five developmental domains were linked to socioeconomic status based on Scottish Index of Multiple Deprivation data zones. Results for geographic areas were mapped using GIS mapping. Phase 2 results are presented in the next section. Validity testing will be reported on at a later date.

MEASURING INEQUALITIES IN CHILD DEVELOPMENT In order to measure inequalities in child development by socioeconomic status in an area, there needs to be a way of categorizing socioeconomic status. The Scottish Index of Multiple Deprivation (SIMD) ranks small areas (called data zones) from most deprived – ranked 1 – to least deprived – ranked 6,505. To assess deprivation in an area, it combines approximately 37 indicators across various measures, namely current income, employment, health, education, skills and training, housing, geographic access and crime. The data zones can be grouped into deciles (10 groups) or quintiles (5 groups). In the EDI pilot we have used SIMD quintiles. More information about SIMD can be obtained at http://www.scotland.gov.uk/Topics/Statistics/SIMD.

EXCLUSIONS FROM THE MAIN ANALYSES In total, 90 children had to be excluded from main analyses. These included: children with ‘additional support needs’ (defined on following page) or those where ‘Don’t know’ was marked for that question (n=42); parental refusals (n=18); children where there was too little information on the form(n=1)1; and those children who were in class for less than one month or where data missing for this question (30). Some children fell into more than one of these categories. The final sample included in the main analyses was 1090 children.

REFERENCES 1. Offord Centre for Child Studies. School readiness to learn project. Hamilton, Ontario: McMaster University; 2010 [updated 2010; cited 2010 August 31]; Available from: http://www.offordcentre.com/readiness/index.html. 2.

Hertzman C, Williams R. Making early childhood count. CMAJ. 2009 Jan 6;180(1):68-71.

If less than 30% of the questionnaire items were completed in 2 or more domains for a child, then that was regarded as too little information to assess that child 1

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3. Sayers M, Coutts M, Goldfield S, Oberklaid F, Brinkman S, Silburn S. Building Better Communities for Children: Community Implementation and Evaluation of the Australian Early Development Index. Early Education and Development. 2007;18(3):519-34. 4. Mort JN. The EDI (Early Development Instrument) Impact Study. Victoria, British Columbia: University of Victoria; 2004. 5. Irwin LG, Siddiqi A, Hertzman C. Early Child Development: A Powerful Equalizer. Vancouver: Human Early Learning Partnership; 2007.

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PROFILE OF EAST LOTHIAN’S P1 CHILDREN Age and gender Out of all the children assessed, 52% were male and 48% were female, with an average age of 5.5 years (range 4 y 5 m to 6 y 9 m). Language 97% of children spoke ‘English only’ as their first language whilst 2% spoke ‘English and another’ as their first language. Only 0.6% of children had ‘other language only’ (these were Polish and Urdu) as first language. Teachers assessed that 97.5% could communicate adequately in their own language. Main other languages spoken in order of frequency Polish, German, Spanish, Punjabi, Japanese, Mandarin, Indonesian/Malay, French, Italian, Dutch/Flemish, Urdu, Thai, Turkish, Romanian

Socioeconomic status The majority of P1 children in East Lothian fall into the middle quintiles (2, 3 and 4) with only 4% of children falling into the lowest, and 17% in the most affluent quintiles.

Quintiles based on SIMD

1 (lowest)

2

3

4

5 (highest)

Total

% P1 children

4

23

20

36

17

99

Number of P1 children

41

270

238

426

197

1172#

Table 2. Socioeconomic status “quintiles” of East Lothian P1 children (full cohort) based on the Scottish Index of Multiple Deprivation categories. #Total sample – unclassified postcodes = 1180 – 8 = 1172. Additional support needs and ‘areas of concern’ The EDI definition of a child with additional support needs is ‘a child already identified as needing additional support due to a chronic medical, physical or mental disabling condition and which results in the child needing extra support in the classroom’. 42 out of 1180 (4%) children were already identified as having additional needs. These children were analysed separately. The most common problem areas in order of frequency were: (1)speech impairment (2)behavioural problem (3)learning disability (4)emotional problem (5)home environment 12


(problems at home) (6)physical disability (7)chronic medical problem. The most common diagnoses were: speech and language disorder and developmental/global delay. Out of the remaining children who were not already identified or diagnosed, a further 9.5% were thought to have ‘a problem influencing his/her ability to do work in regular classroom’ and required further assessment, based on the judgement of either the teacher, another professional or the parents. The most common problems amongst these children were, in order: (1)speech impairment (2)behavioural problem (3)home environment (4)learning disability (5)visual impairment. School and preschool attendance Average absenteeism since the beginning of the year was 5½ sessions (half days). 99% of the children attended preschool nursery and just 1.2% were repeating the Primary 1 year. Overall developmental vulnerability Out of all East Lothian children included in the main analysis, 27.3% were low on at least 1 domain and 15.4% were low on at least 2 domains of development. Girls were less likely to be developmentally vulnerable than boys (consistent with other research), with 19.8% of girls, versus 34.3% of boys, scoring low on one or more domains of development. Older children were less likely to be developmentally vulnerable than younger children, with 20.2% of those older than or equal to 5.2 years, versus 34% of those younger than 5.2 years, scoring low on one or more domains of development. Figure 2. ‘Overall developmental vulnerability’ of East Lothian P1 children January 2012

% overall vulnerability

40 35 30 25 20 15 10 5 0

All children

male

female Sex

13

<5.2 years >=5.2 years Age


Overall developmental vulnerability in East Lothian of 27.3% is similar to other populations e.g. Canada 27.9%, the province of British Columbia 29%, and Australia 23.5%. Overall developmental inequalities by socioeconomic status There was a clear gradient in the ‘overall developmental vulnerability’ when plotted against socioeconomic status (figure 3). The most affluent quintiles were likely to be less developmentally vulnerable than the least affluent quintiles. Quintiles 1 and 2, however, had little difference between them (bearing in mind that Quintile 1 had a very small number of pupils). It should be noted that despite Quintile 5 being the most affluent, and the fact that those with already diagnosed additional support needs were removed, there was still 17% developmental vulnerability in that group. Figure 3. ‘Overall developmental vulnerability’ (% children low on at least one/two domains of development) of East Lothian P1 children by postcode (SIMD) quintile in January 2012 45 38.5

40

38.4 % Vulnerable in 1 or more Domains

35 30.5

Percentage

30

27.3

25.6

25

23.7

20

23.2 16.7

16.4

15.4 15

12.8

10

7.2

% Vulnerable in Two or more Domains

5 0 East Lothian

1

2

3

4

5

Quintile How did they do in each ‘domain’ of development? On average, East Lothian P1 children, attending school without any additional support in class, scored relatively high in all areas of child development. There were no domains of development with average scores under 8 out of 10 (figure 4). When compared with other English speaking Western countries that do the EDI at the same age, East Lothian falls in the middle with Australian children scoring slightly better and Canadian children scoring slightly worse on average (figure 5). Across all SES groups, East Lothian 5 year olds do quite well in physical health and well-being and cognitive/language development domains, score ‘average’ in social competency, and score less well in emotional maturity and communications and general knowledge domains. It is also noteworthy, when comparing the Scottish children in our sample with those from Canada and Australia, that the scores in the different domains of child development follow a similar pattern suggesting that perhaps English speaking Western children of similar descent have similar shortfalls and strengths 14


in their development at age five. Unfortunately, EDI scores from very different cultures are not publicly available for comparison. Figure 4. Average scores in domains of development for East Lothian P1 children in January 2012

East Lothian 10

8.89

8.64

8.31

Physical health & wellbeing

Social competency

Emotional maturity

Mean domain score

9

8.89

8.39

Language & cognitive development

Communication & general knowledge

8 7 6 5 4 3 2 1 0

Figure 5. East Lothian P1 child development average scores in January 2012 compared with most recent available results for Canada and Australia

Mean domain score

10 9.5

Canada

9 8.5 8 7.5 7

East Lothian, Scotland Australia

NOTE: In figure 5, scores 0 to 7 have been removed from the vertical axis for ease of comparison. 15


Girls scored higher, on average, than boys in all domains of development (figure 6). Those children who could ‘communicate adequately in their own language’ scored higher, on average in all domains, than those who could not (figure 7). Figure 6. EDI domain scores in P1 pupils by gender, East Lothian January 2012 9.4 9.2 9 Mean Score

8.8 8.6 8.4 8.2

Female

8

Male

7.8 7.6 7.4 Physical Health Social and Well Being Competence

Emotional Maturity

Language and Communication Cognitive and General Development Knowledge

Domains

Mean Score

Figure 7. EDI domain scores in P1 pupils by ‘Communicates Adequately in First Language’, East Lothian January 2012 10 9 8 7 6 5 4 3 2 1 0

Yes No Don't Know

Domains

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Socioeconomic status and different domains of child development Figure 8: Graphs A – E Domain: Percentage of P1 children “Vulnerable, At Risk or On Track” for development by each quintile, East Lothian January 2012 A. Physical Health & Well Being 120

PHWB

100 80 60

On Track 2 (Score above 50%) On Track 1 (26th - 50th) At Risk (11th 25th)

40 20

Vulnerable (Score in lowest 10%)

0 1

2

3

4

EM

100

120

80

80 60

At Risk (11th 25th)

40 20

Vulnerable (score in lowest 10%)

0 1

2

3

120 On Track 2 (above 50%)

At Risk (11th 25th)

40

On Track 2 (score above 50%) On Track 1 (26th - 50th)

4

5

E. Language & Cognitive Development

On Track 1 (26th 50th)

60

SC

100

5

B. Emotional Maturity 120

D. Social Competence

20

LC

100 80

On Track 2

60

On Track 1

40

At Risk Vulnerable

20 Vulnerable (score in lowest 10%)

0 1

2

3

4

5

0 1

2

3

4

5

C. Communication & General Knowledge 120

C&GK

100 80 60 40 20 0 1

17

2

3

4

5

On Track 2 (above 50%) On Track 1 (26th 50th) At Risk (11th 25th) Vulnerable (score in lowest 10%)

NOTE: In the Communications and General Knowledge domain, no children scored above the 50th percentile - it was not possible since the 50th percentile cut-off was 10/10 (100%).


Figure 8 shows the percentage of East Lothian P1 children ‘Vulnerable, At Risk, and On Track’ by socioeconomic status quintiles. On Track 1 and On Track 2 are displayed. The greatest ‘gaps’ between the most and least affluent groups were in the Communication and general knowledge, and the Language and cognitive development domains (figure 9). However, this should be seen in perspective – all the average scores displayed in Figure 9 are above 7.5 out of 10. Figure 9. Average scores (out of 10) in each domain of child development for each socioeconomic status ‘quintile’ in East Lothian P1 children in January 2012 9.5

Physical health and well being 9

Social competence Emotional Maturity

Mean Domain Score

8.5

Language and cognitive development Communication and general knowledge

8

7.5

The flatter the line, the more equal the society is

7 Quintile 1

Quintile 2

Quintile 3

Quintile 4

Quintile 5

NOTE: In figure 9, scores 0 to 7, and above 9.5, have been removed from the vertical axis for ease of comparison. Geographic area differences For practical purposes (e.g. high school catchments), East Lothian is divided into six areas or ‘clusters’. Relatively large differences were found between the different cluster areas in terms of ‘overall developmental vulnerability’ and average scores in each domain of development. This can, however, be partly explained by socioeconomic status. East Lothian leaders in local areas and schools in have received detailed results and maps for their areas.

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TEACHER CHARACTERISTICS Sixty eight different teachers completed the EDI, 66 females and two male. Figure 14 shows the age groupings and figure 15 the qualifications of the teachers.

Frequency

Figure 14. East Lothian P1 teacher’s age categories with frequencies, January 2012 20 18 16 14 12 10 8 6 4 2 0

20 - 29

30 - 39

40 - 49

50 - 59

Teacher Age Groupings

Figure 15. East Lothian P1 teacher’s qualifications, January 2012

Other undergraduate degree Doctorate Some coursework towards doctorate Qualification Type

Postgraduate masters degree Some coursework towards… Professional graduate diploma in… Postgraduate certificate in education… Other undergraduate degree

Bachelor of education degree A teaching certificate of diploma Some coursework towards a bachelors…

0

5

10

15

20

25

Frequency

19

30

35

40


CONCLUSIONS We piloted an internationally validated tool which monitors global child development at school entry, the EDI, in Scotland with the ultimate goal of providing communities with a way of assessing the impact of early childhood interventions. Our initial results have shown that the EDI is an acceptable, feasible and appropriate measurement instrument for the Scottish context. Developmental differences between socioeconomic and geographic groups can be detected with the EDI in Scotland. On average, East Lothian P1 children, attending school without any additional support in class, are doing well in all areas of child development. Our analyses found that 27% of P1 children scored ‘low’ on at least one domain of development whilst 15% scored ‘low’ on two or more domains of development. When compared with other English speaking Western countries that do the EDI at the same age, East Lothian falls in the middle with Australian children scoring slightly better and Canadian children scoring slightly worse on average. Across all socioeconomic status groups, East Lothian school enterers: do well in physical health and well-being, and cognitive/language development domains; score ‘average’ in social competency; and score less well in emotional maturity, and communications and general knowledge domains. A clear socioeconomic status gradient was observed across all five domains. The most affluent quintiles were less likely to be ‘developmentally vulnerable’ than the least affluent quintiles. Girls were less likely to be ‘developmentally vulnerable’ than boys (consistent with other research), with 20% of girls, versus 34% of boys, scoring low on one or more domains of development. Older children were less likely to be ‘developmentally vulnerable’ than younger children, with 20% of those older than or equal to 5.2 years, versus 34% of those younger than 5.2 years, scoring low on one or more domains of development. In order for changes and trends to be observed over time, the EDI should be repeated at three year intervals. When presented and interpreted with other local data, the EDI results should provide useful information on children’s school readiness and inspire collaborative action to address challenges and celebrate strengths.

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NEXT STEPS During the next phase of the EDI pilot, local ‘champions groups’ for Support from the Start and East Lothian early years partnership will utilise EDI findings, with other outcome data, for local decision-making around early years’ services and resources. Local stakeholders will be encouraged to take stock of their early childhood education and development services and programmes, including parenting programmes, to see how accessible and well-used they are. In addition, broader issues such as poverty, the environment (built and natural), culture and attitudes towards children and child-rearing, adolescent preparation for parenthood, and parental skills and employment, should be considered. If communities can be profiled in this way and a joint and informed understanding can be reached on the factors influencing child development, then stakeholders can seek to improve these circumstances and the EDI can be used to monitor changes over time. The EDI pilot in Scotland, the first that we are aware of in UK, was funded through SCPHRP as research work. The authors will be presenting these pilot results to wider Scottish audiences and should further roll-out be desired, it is suggested that funding come from sustainable sources (such as the Scottish Government). SCPHRP’s funders are unable to finance replication or extension of the pilot to other local authorities.

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APPENDICES I SCOTTISH EARLY DEVELOPMENT INSTRUMENT CHILD FORM

Note: This cover page with names is removed, stored securely by a third party and only accessed for data linkage purposes.

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II SCOTTISH EARLY DEVELOPMENT INSTRUMENT TEACHER FORM

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