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Abstract:
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"More than 40% of children under 5-years-old in middle-low income countries are under risk of not
reaching developmental potential for causes associated with poverty and psychosocial
deprivation. The reason for that is probably associated with a low relevance of development as a
biological decline more than an increasing process. A way to improve the life chances and
opportunities of low-income children, families, and communities is described in a model of
extinction and interoperability characteristics.
An original model for interoperability considers three levels of data exchange: facility-to-facility
(macrotier), intra-facility (meso-tier), and at the point of care (micro-tier). Focused in
developmental-care, the model needs a transformation toward parent-child interaction-driven and
institutional support in Children’s Centres (CCs). To optimize our model, we use information from
multiple sources, devices, and organizations across the development-care continuum.
A short-scaled interoperability model was designed and probed in Colombia. First components of
this model include a baseline with previous measurement of developmental outcomes in children
of two major geopolitical regions in a middle-low income country (n=1177), and the use of a tool
administrated by parents to report different items related to sociocognitive milestones. First
analysis within a regression model founded 14 variables significant associated with a
sociocognitive development index.
Second component is related to results obtained in a specific CC, where developmental screening
indicates the effect of intra-facility activities as a positive factor that avoids the loss of development
potential that can be expected in uncontrolled environments or institutions, such as those in the
first sample (t(207)=-2.026, p=0.044). Finally, at the point of care, the use of a tool administrated
by parents, a compilation of activities to report enhanced development (CARE®), denotes optimal
psychometric properties for child development screening (Sensitivity = .80, Specificity = .76, LR
+ = 3.8, LR- = .26) and significant changes in the risk indexes for a control group of children
(Delayed items: Avr.= 4.5 , SD = 3.8) compared with those who used the booklet with their parents
or caregivers (Avr.= 1.2, SD = 1.1); t (17) = -2.82, p = 0.012)."
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