Translational science fostering integration The predictive validity of the AEDI: Predicting later cognitive and behavioural outcomes. Assoc Prof Sally Brinkman ACER Conference August 2014

Presentation Structure Background. Predictive validity – 2 studies. Inequality in child development and predictive strength. Conclusions. International interlude (if time).

What is the AEDI? Teacher checklist, 5 Domains Triennial Census

Sensitive Periods in Early Brain Development Vision High Low Years Habitual ways of responding Emotional control Symbol Peer social skills Numbers Hearing Graph developed by Council for Early Child Development (ref: Nash, 1997; Early Years Study, 1999; Shonkoff, 2000.) Pre-school yearsSchool 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:

How does the AEDI predict outcomes through school?

Predictive Validity STUDY 1: LSAC – 2004 Wave 1 4year old cohort STUDY 2: NMHS – 2003 EDI cohort

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 data collection. AEDI – Nested Sample, children from WA, Vic and QLD 717 children with complete data in Wave children with complete teacher and parent data in Wave 3 (72.6%). 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 age AEDI MeasureSDQARS Language and Literacy ARS Mathematics Vulnerable on one or more of the AEDI Domains. (Australian National Progress Measure) Spec = 0.86 Sens = 0.34 NPV = 0.94 PPV = 0.20 Spec = 0.88 Sens = 0.65 NPV = 0.94 PPV = 0.48 Spec = 0.88 Sens = 0.65 NPV = 0.94 PPV = 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

Source: Brinkman et. al. in Child Indicators (2013) Predictive Validity – Study 2

NAPLAN Year 3 NAPLAN Year 5 NAPLAN Year 7 EDI DomainsNumeracyReadingNumeracyReadingNumeracyReading Physical well-being.23**.22**.25**.22**.24** Social competence.24**.22**.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

How do perinatal factors predict the AEDI?

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 AEDI Sensitivity: % 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

Relationship between the AEDI and Socio-Economic Position (SEP)

Social Inequality in Child Health and Development in South Australia 2009 Targeted Programs by high social disadvantage Proportionate Universal Programs that increasingly addresses barriers across the social gradient Targeted Programs by high developmental vulnerability Universal Programs Barriers to uptake Social Disadvantage Developmental vulnerability HighLow High Low

Social Disadvantage Developmental vulnerability HighLow High Low Changes in South Australian Community (LGA) AEDI results Vulnerable on 1 or more domain from

So - How does the AEDI predict school outcomes considering SEP?

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

Reflections

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

International Interlude Licensing Costs Protection’s around programing Vs Greater good / Public ownership Improving local systems Local capacity building International comparable and locally relevant

Tonga – locally mapped TeHCI