Translational science fostering integration
The predictive validity of the AEDI: Predicting later cognitive
and behavioural outcomes.
Assoc Prof Sally BrinkmanACER Conference August 2014
Presentation Structure
• Background.• Predictive validity – 2 studies.• Inequality in child development
and predictive strength.• Conclusions.• International interlude (if time).
Sensitive Periods in Early Brain Development
Vision
0 1 2 3 7654
High
Low
Years
Habitual ways of respondingEmotional
control
Symbol
Peer social skillsNumbers
Hearing
Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.)
Pre-school years School years
Language
EDI
Past reliability and validity studies• Teacher to parent inter rater reliability• Teacher to teacher inter rater reliability• Repeat testing intra rater reliability• Construct and concurrent validity• Rasch psychometric property analyses• Indigenous and minority culture validation studies• Schools and the AEDI study
• Publications downloadable from: www.aedc.gov.au, www.offordcentre.com/readiness
Predictive Validity – Study 1
Longitudinal Study of Australian Children• nationally representative sample • two cohorts of Australian children: 5,104 infants
and 4,976 four year olds • first wave of the LSAC commenced in May 2004• face-to-face interviews with parents, parent self-
completed questionnaires, interviewer observation, direct child assessment, and teacher completed questionnaires
• Of the original 4948 children participating in the 2004 Wave 1 (4 year old cohort), information was obtained for 89.7% (n=4332) in the Wave 3 2008 data collection.
• AEDI – Nested Sample, children from WA, Vic and QLD
• 717 children with complete data in Wave 1
• 523 children with complete teacher and parent data in Wave 3 (72.6%).
Predictive Validity – Study 1
Predictive Validity – Study 1
• Even gender divide,• 5.7% of children had ESL,• 1.1% of children were of Aboriginal descent,• 4% with medically diagnosed SN status,• Age gap between Wave 1 and Wave 3 ranges
from 3yr 4mths through to 4yr 5mths (avg gap 3yr 8 mths).
Predictive Validity – Study 1
Instruments collected at ~4 years during Wave 1– AEDI– SDQ– PPVT– WAI– PEDS– PedsQL– Global Health
Predictive Validity – Study 1
Teacher completed instruments collected at ~8 years during Wave 3
–SDQ –Academic Rating Scale (literacy)
• Sensitivity the percentage of sick people who were correctly identified as having the condition.
• Specificity the percentage of healthy people who were correctly identified as not having the condition.
Sensitivity & Specificity (looking backwards)
Best predictors:• AEDI (all domains)• WAI
Worst predictors:• PEDS• SDQ
Predictive Validity: Outcome is Literacy
Best predictors:• WAI• AEDI (all domains)
Worst predictors:• PEDS• SDQ
Predictive Validity: Outcome is Maths
Best predictors:• WAI• AEDI (all domains)
Worst predictors:• PEDS• SEIFA
Predictive Validity: Outcome is Behaviour
Outcome Measures at ~ 8 years of ageAEDI Measure SDQ ARS
Language and Literacy
ARSMathematics
Vulnerable on one or more of the AEDI Domains. (Australian National Progress Measure)
Spec = 0.86Sens = 0.34NPV = 0.94PPV = 0.20
Spec = 0.88Sens = 0.65NPV = 0.94PPV = 0.48
Spec = 0.88Sens = 0.65NPV = 0.94PPV = 0.45
Predictive Validity – Study 1
Predictive Validity – Study 2• North Metro Health Service
– Population wide– Pre-primary (avg 5.6 years)– 2003– Original EDI
• Individually data linked to education records (DET WA)– Govt schools only– Biased (transience)– WALNA yr3, NAPLAN yr5 and NAPLAN yr7
0
10
20
30
40
50
60
70
None One Two Three Four Five
% p
erfo
rmin
g po
orly
on
NA
PLA
N i
n yr
7
Number of AEDI domains vulnerable on in first year of school
NAPLAN Reading yr 7
NAPLAN Numeracy yr 7
Source: Brinkman et. al. in Child Indicators (2013)
Predictive Validity – Study 2
NAPLANYear 3
NAPLANYear 5
NAPLANYear 7
EDI Domains Numeracy Reading Numeracy Reading Numeracy Reading
Physical well-being .23** .22** .25** .22** .24** .24**
Social competence .24** .24** .22** .24** .24** .27**
Emotional maturity .17** .16** .12** .16** .15** .19**
Language and cognitive development
.42** .40** .37** .40** .39** .40**
Communication skills and general knowledge
.36** .34** .30** .34** .28** .39**
Total Score .36** .35** .32** .35** .32** .38**
Predictive Validity – Study 2
Predictive Validity – Perinatal onto the AEDI
• SA Linked Data set at the individual level– 2003 to 2004 birth population– Developmentally vulnerable on the 2009 AEDI
• Strongest predictors at birth:– Childs gender– Gestational age– Mothers occupational status (ASCO)– Fathers occupational status (ASCO)– Mothers smoking status
AUC=0.72
Predictive Validity – Perinatal onto the AEDISensitivity: % of cases of poor development identified according to the number of risk
factors present perinatally
% of total population of children according to the number of risk factors they have
Social Inequality in Child Health and Development in South Australia2009
Targeted Programsby high social disadvantage
Proportionate Universal Programsthat increasingly addresses barriers across the social gradient
Targeted Programsby high developmental
vulnerabilityUniversal Programs
Barriers to uptake
Social Disadvantage
Dev
elop
men
tal v
ulne
rabi
lity
High Low
High
Low
Social Disadvantage
Dev
elop
men
tal v
ulne
rabi
lity
High Low
High
Low
Changes in South Australian Community (LGA) AEDI results Vulnerable on 1 or more domain from 2009 - 2012
WHAT WE PREDICTED TO SEE.The famous Feinstein graph – 1970 British Birth Cohort
Feinstein, L. (2003). Inequality in the Early Cognitive Development of British Children in the 1970 Cohort. Economica, 70 (73–97)
WHAT DO WE SEE?Feinstein Replication with Australian Data – 2003 Perth AEDI Cohort
Source: Brinkman, Sincovich, Gregory 2013
The pertinent questions to ask
• What has happened differently to the cohort born in 2003/2004 to the cohort born in 2006/2007 to the cohort born in 2009/2010?
• How do we reduce inequality in child development?
Translational science, fostering integration.
Conclusions:
• The AEDI has shown to be a moderate to strong predictor of school based outcomes
• Take away message – improve school readiness for all with a progressive universalist approach from birth to school age.
International Interlude
• Licensing• Costs• Protection’s around programing
Vs• Greater good / Public ownership• Improving local systems• Local capacity building• International comparable and locally relevant