G437 Validity of the washington group module on child functioning in 2-year-old children; disability outcome of the shine trial

Abstract

Introduction The WHO estimate that 1 billion people live with disability, with 80% living in developing countries. For children, this is associated with increased mortality, risk of becoming a victim of violence and decreased school attendance. Through identifying these children early, actions can be taken to improve their quality of life. Global childhood disability data collection to date has used various tools and methodologies, affecting comparability. In 2016, the Washington Group and UNICEF developed the child functioning module (WGCFM) to identify functional difficulty (FD) in children aged 2–17, for use in census and surveys. Field testing has highlighted a need for further validation. This study aims to identify prevalence of disability according to the WGCFM in over 1500 2-year-old children from the Sanitation Hygiene Infant Nutrition Study (SHINE) trial in 2 districts of Zimbabwe, and to assess concurrent validity with the Malawi Developmental Assessment Tool (MDAT). Methods All consenting pregnant females aged 15–49 were followed up throughout pregnancy and infancy. At age 2, their child was assessed for disability by one of 11 local research nurses using both the WGCFM and MDAT (a culturally appropriate tool for developmental assessment in rural Africa – adapted, translated and back translated for use in Zimbabwe). Quality control and reliability tests were performed on all measures between research nurses. Other measures included anthropometry (e.g. height, weight), maternal HIV status and behavioural measures. Results 1606 (49.9% female) participants from SHINE were eligible for disability follow-up. FD was identified in 4.17%, severe FD in 0.68%. MDAT and WGCFM scores showed a significant negative correlation, P Conclusions Following removal of the ‘controlling behaviour’ domain, prevalence of FD by WGCFM in rural Zimbabwe is comparable to that in field testing in Mexico, Samoa and Serbia. These results demonstrate that the WGCFM has concurrent validity for use within a population of 2-year-old children in Zimbabwe.