TRIAL OF A DEVELOPMENTAL SCREENING TOOL

Abstract

19 May 2011 Dear Editor, We write in response to the paper published in vol. 47 January–February 2011 Journal of Paediatrics and Child Health by D’Aprano and colleagues –‘Trial of a developmental screening tool in remote Australian Aboriginal communities: A cautionary tale’. The stated aim of the research was to ‘trial the Brigance developmental screening tool as an instrument for identifying Australian Aboriginal children at risk of developmental disability and requiring diagnostic developmental assistance’1 (p. 12). That is, the Brigance tool was on trial, not the Aboriginal children. The authors rightly concluded that ‘Language and cultural relevance, and the method of administration limit the use of this screening tool1 (p. 12). Our concern is that the results of the test have been reported as though they are actually a valid measure of these children's development. However, the limitations of both the tool and testing process reported in their paper clearly demonstrate that the test results cannot be considered valid for this population. The authors acknowledge that all the children speak a language other than Standard English as their first language and, not surprisingly, reported that ‘they struggled with the items requiring competent levels of expressive and receptive English’1 (p. 16). The authors also acknowledge limitations in cultural relevance stating that ‘some items were clearly not relevant’ and that: ‘the items therefore may not be testing skills that are a true reflection of the child's ability’1 (p. 16). Also, the authors identified a number of factors related to test administration which may have impacted negatively on results, for example, the influence of an examiner who is not known to the children and unfamiliarity with a process which requires responses to questions which seem irrelevant or to which the examiner already knows the answer1 (p. 15). While the authors argue that their ‘findings cannot be explained by the lack of culturally relevant items and language tasks alone’1 (p. 14), the reality is that the limitations related to culture and language are extremely serious. By reporting findings from a test that is clearly not valid for the target population, the authors perpetuate the interpretation of difference as deficit and do not in any way progress our understanding of the genuine needs of these children and their families or the most effective and appropriate way to work with them to address these needs. Also, administration of a test in a foreign language based on irrelevant cultural concepts renders invisible the developmental strengths of these children. The publication of results such as these derived from invalid tools contributes to a damaging misrepresentation characterized by lack of recognition of the developmental differences between Aboriginal and non-Aboriginal children, as well as Aboriginal children's unique strengths, capacities, knowledge and abilities that can be drawn and built upon in educational settings. There also seems little justification for a study to yet again ‘trial’ an approach that has been so thoroughly discredited in the past.2–7 However, there is an urgent need, as the authors suggest, for a collaborative and culturally-responsive approach which does have the potential to identify strengths, as well as the needs of Indigenous children who are genuinely experiencing developmental problems.