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J Pediatr (Rio J). 2018 Aug 11. pii: S0021-7557(18)30367-X. doi: 10.1016/j.jped.2018.07.008. [Epub ahead of print]

Measuring early childhood development in Brazil: validation of the Caregiver Reported Early Development Instruments (CREDI).

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Instituto para a Valorização da Educação e da Pesquisa no Estado de São Paulo (IVEPESP), São Paulo, SP, Brazil. Electronic address:
Harvard University, Graduate School of Education, Cambridge, United States.
Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Pediatria, São Paulo, SP, Brazil.
Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.



The present study aims to analyze the psychometric properties and general validity of the Caregiver Reported Early Development Instruments (CREDI) short form for the population-level assessment of early childhood development for Brazilian children under age 3.


The study analyzed the acceptability, test-retest reliability, internal consistency and discriminant validity of the CREDI short-form tool. The study also analyzed the concurrent validity of the CREDI with a direct observational measure (Inter-American Development Bank's Regional Project on Child Development Indicators; PRIDI). The full sample includes 1,265 Brazilian caregivers of children from 0 to 35 months (678 of which comprising an in-person sample and 587 an online sample).


Results from qualitative interviews suggest overall high rates of acceptability. Most of the items showed adequate test-retest reliability, with an average agreement of 84%. Cronbach's alpha suggested adequate internal consistency/inter-item reliability (α>0.80) for the CREDI within each of the six age groups (0-5, 6-11, 12-17, 18-23, 24-29 and 30-35 months of age). Multivariate analyses of construct validity showed that a significant proportion of the variance in CREDI scores could be explained by child gender and family characteristics, most importantly caregiver-reported cognitive stimulation in the home (p<0.0001). Regarding concurrent validity, scores on the CREDI were significantly correlated with overall PRIDI scores within the in-person sample at r=0.46 (p<0.001).


The results suggested that the CREDI short form is a valid, reliable, and acceptable measure of early childhood development for children under the age of 3 years in Brazil.


Avaliação da população; Brasil; Brazil; Child development; Desenvolvimento infantil; Estudos de validação; Measurement; Medicação; Population assessment; Validation studies

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