Pre-testing a culturally adapted developmental outcome measure for Aboriginal and Torres Strait Islander children

Purpose

Early childhood is of critical importance in building a foundation for children’s lifelong development. Developmental outcome measures used within dominant Western cultures lack cultural appropriateness and validity in the Australian Aboriginal and Torres Strait Islander population. The Ages & Stages Questionnaire-STEPS for Measuring Aboriginal Child Development (ASQ-STEPS) is a culturally adapted developmental outcome measure that is being developed for Australian Aboriginal and Torres Strait Islander children aged one to four years. This paper aimed to describe the pre-testing process for the ASQ-STEPS prototype; the functionality of the ASQ-STEPS prototype in practice; and the acceptability of the culturally adapted Ages & Stages Questionnaires, Third Edition (ASQ-3) items and accompanying illustrations for caregivers and practitioners in two Australian Aboriginal and Torres Strait Islander communities.

Methods

The study was conducted in partnership with two Aboriginal community-controlled health services. Participants included practitioners who would administer the ASQ-STEPS, caregivers and their children aged 1 to 48 months. Study measures included the ASQ-STEPS pre-testing prototype, observation record, post-administration meeting record and focus group/semi-structured interviews.

Main findings

Three practitioners and 18 caregivers participated. Of the 18 caregivers, 15 provided feedback through focus groups or interviews. The findings showed that the ASQ-STEPS was acceptable to caregivers and practitioners. They reported that the ASQ-STEPS items were clear and easy to understand. The caregivers and practitioners made several important recommendations for modifications to the culturally adapted ASQ-STEPS. This has led to an improved prototype ready for validation.

Principal conclusions

This pre-testing study found that caregivers and practitioners made several important recommendations for modifications to the culturally adapted ASQ-STEPS. This step has led to an improved prototype that is ready for validation and highlights the value of engaging and consulting with partners in the pre-testing phase, to better understand the community needs and co-create the final tool. To date, there has been a scarcity of literature providing detailed accounts of the pre-testing process in the cultural adaptation of a child development screening tool or outcome measure. While some studies outside this area have provided a more detailed framework to follow, this study includes a detailed account of the pre-testing process in the Aboriginal and Torres Strait Islander context, incorporating strong Aboriginal and Torres Strait Islander governance, which can be used as an example for future research projects.