Protocol for validation of the Global Scales for Early Development (GSED) for children under 3 years of age in seven countries

Vanessa Cavallera, Gillian Lancaster, Melissa Gladstone, Maureen M. Black, Gareth McCray, Ambreen Nizar, Salahuddin Ahmed, Arup Dutta, Romuald Kouadio E. Anago, Alexandra Brentani, Fan Jiang, Yvonne Schönbeck, Dana C. McCoy, Patricia Kariger, Ann M. Weber, Abbie Raikes, Marcus Waldman, Stef Van Buuren, Raghbir Kaur, Michelle Pérez MaillardMuhammad Imran Nisar, Rasheda Khanam, Sunil Sazawal, Arsène Zongo, Mariana Pacifico Mercadante, Yunting Zhang, Arunangshu D. Roy, Katelyn Hepworth, Günther Fink, Marta Rubio-Codina, Fahmida Tofail, Iris Eekhout, Jonathan Seiden, Rebecca Norton, Abdullah H. Baqui, Jamila Khalfan Ali, Jin Zhao, Andreas Holzinger, Symone Detmar, Samuel Nzale Kembou, Farzana Begum, Said Mohammed Ali, Fyezah Jehan, Tarun Dua, Magdalena Janus

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Introduction Children's early development is affected by caregiving experiences, with lifelong health and well-being implications. Governments and civil societies need population-based measures to monitor children's early development and ensure that children receive the care needed to thrive. To this end, the WHO developed the Global Scales for Early Development (GSED) to measure children's early development up to 3 years of age. The GSED includes three measures for population and programmatic level measurement: (1) short form (SF) (caregiver report), (2) long form (LF) (direct administration) and (3) psychosocial form (PF) (caregiver report). The primary aim of this protocol is to validate the GSED SF and LF. Secondary aims are to create preliminary reference scores for the GSED SF and LF, validate an adaptive testing algorithm and assess the feasibility and preliminary validity of the GSED PF. Methods and analysis We will conduct the validation in seven countries (Bangladesh, Brazil, Côte d'Ivoire, Pakistan, The Netherlands, People's Republic of China, United Republic of Tanzania), varying in geography, language, culture and income through a 1-year prospective design, combining cross-sectional and longitudinal methods with 1248 children per site, stratified by age and sex. The GSED generates an innovative common metric (Developmental Score: D-score) using the Rasch model and a Development for Age Z-score (DAZ). We will evaluate six psychometric properties of the GSED SF and LF: concurrent validity, predictive validity at 6 months, convergent and discriminant validity, and test-retest and inter-rater reliability. We will evaluate measurement invariance by comparing differential item functioning and differential test functioning across sites. Ethics and dissemination This study has received ethical approval from the WHO (protocol GSED validation 004583 20.04.2020) and approval in each site. Study results will be disseminated through webinars and publications from WHO, international organisations, academic journals and conference proceedings. Registration details Open Science Framework on 19 November 2021 (DOI 10.17605/OSF.IO/KX5T7; identifier: osf-registrations-kx5t7-v1).

Original languageEnglish (US)
Article numbere062562
JournalBMJ open
Issue number1
StatePublished - Jan 24 2023


  • Developmental neurology & neurodisability
  • International health services
  • Paediatric neurology

ASJC Scopus subject areas

  • General Medicine


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