Young children from impoverished backgrounds experience high levels of family and environmental stress, adversely impacting developmental functioning. Early identification provides a pathway to solutions, but many children are never evaluated. In addition, the child-serving workforce lacks resources and expertise to use traditional measures. Furthermore, existing measures do not account for the substantial influence of a child's ecology. To bridge these gaps, we developed the Neurodevelopmental Ecological Screening Tool (NEST) and conducted a pilot study (n = 60) to test its feasibility for use with caregivers of children 3–5 years of age in low-resource settings. We developed an item pool across 3 domains (child, caregiver, and environment), vetted it with experts, and conducted cognitive interviewing with parents (n = 15) and case managers (n = 10). Simultaneously, we built an online, user-friendly delivery platform. We used a one-parameter Item Response Model and a Rasch-based Rating Scale Model and fit confirmatory factor analytical models to test for unidimensional and construct validity. The results support the feasibility of screening children from low socioeconomic status populations within low-resource settings using an ecological perspective and support the work of child-serving paraprofessionals in identifying and addressing risks in the lives of young children.

中文翻译：

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使用生态框架开发幼儿筛查工具

来自贫困家庭的幼儿承受着较高的家庭和环境压力，对发育功能产生不利影响。早期识别提供了解决问题的途径，但许多儿童从未接受过评估。此外，儿童服务劳动力缺乏使用传统措施的资源和专业知识。此外，现有的措施没有考虑到儿童生态的实质性影响。为了弥补这些差距，我们开发了神经发育生态筛查工具 (NEST) 并进行了一项试点研究 (n = 60)，以测试其在资源匮乏地区 3-5 岁儿童的照顾者中使用的可行性。我们开发了一个跨 3 个领域（儿童、看护者和环境）的项目库，由专家对其进行审查，并对家长 (n = 15) 和个案经理 (n = 10) 进行认知访谈。同时，我们建立了一个在线、用户友好的交付平台。我们使用单参数项目响应模型和基于 Rasch 的评级量表模型并拟合验证性因子分析模型来测试一维和构造有效性。研究结果支持从生态角度对资源匮乏地区的低社会经济地位人群中的儿童进行筛查的可行性，并支持儿童服务辅助专业人员在识别和解决幼儿生活风险方面的工作。