Assessing Childhood Development: Systematic Review and Meta-Analysis on the Validation of Local Assessment Tools in the Context of Developing Countries

Background: Accurate child development assessment is crucial, particularly in developing countries where access to validated tools remains limited. Many assessment tools are adapted for local contexts, but their psychometric properties require evaluation. Objective: This systematic review examines the reliability, validity, and overall psychometric properties of new and adapted child development assessment tools used in developing countries. The focus on these settings stems from the need to assess tools that are culturally appropriate, feasible, and accurate in resource-constrained environments, where early identification of developmental delays can significantly impact long-term child outcomes. Methods: Descriptive and meta-analyses were conducted to synthesize findings from eligible studies. Psychometric properties such as internal consistency, inter-rater reliability, construct validity, sensitivity and specificity were assessed. This review is registered on Open Science Framework (OSF) doi:10.17605/OSF.IO/GU28K. Results: The findings indicate that although some adapted tools demonstrate strong reliability and validity, others exhibit inconsistencies, highlighting challenges in adaptation. The meta-analysis provided pooled estimates of key psychometric properties with a net sensitivity and specificity of 0.859 and 0.805, respectively, illustrating the validity of these local tools but also variability in performance across different tools. Conclusion: The results emphasize the need for rigorous validation processes to ensure that adapted tools maintain their psychometric integrity. Future research should focus on refining these measures to improve their applicability in diverse cultural and socioeconomic settings.