Psychometric properties of the REACh developmental screening tool for preschool children in Sri Lanka

Globally, over 53 million children have developmental disabilities, with 95% living in low- and middle-income countries (LMICs). While early detection and intervention are critical during early childhood, LMICs often lack reliable, culturally appropriate screening tools for detection of these children. Because most children attend preschools, training preschool teachers to screen for developmental delays offers an ideal way to connect children to early intervention services. Therefore, a group of researchers from the University of Kelaniya together with officials of the children's secretariat and preschool educators refined and evaluated the REACh (Ragama Early Assessment of Children) tool—a locally developed, low-cost developmental screening tool tailored for preschoolers aged 3 to 5 years. Based on feedback the tool was updated to assess cognitive, receptive language, expressive language, fine motor, gross motor, social–emotional, and pre-academic skills. This tool is available in Sinhala, Tamil, and English languages and assess children in four settings: tabletop activities, story book reading, playground, and classroom interactions. Twenty-eight trained preschool teachers evaluated 597 children using activity-based tasks and classroom observations over 2 weeks. To test accuracy, results were compared against observations by trained research assistants and comprehensive clinical assessments conducted by developmental pediatricians. Significance and impact