A Systematic Review of Measurement Instruments to Assess Cognition and Language Development at 24 Months of Age, for Use in Effectiveness Trials of Nurse-Home Visitation Programs

This systematic review evaluates cognitive and language measurement instruments for use at 24 months of age in effectiveness trials of nurse-home visitation programs. In particular, this review aims to identify and recommend potential instruments for the British Columbia Healthy Connections Project, a scientific evaluation of the Nurse Family Partnership, a nurse-home visitation program, in Canada. Although there is an overlap in child cognitive and language development in young children, the extent of the overlap is unclear, and hence it is recommended that instruments designed to separately assess cognition and language be used if feasible. A general search of potential instruments was completed, in addition to searches pertaining to instruments that have been used in home visitation interventions designed to improve language and cognition in young children. Detailed components are reported for 6 instruments: the Bayley Scales of Infant and Toddler Development –Third Edition (Bayley-III), the Battelle Developmental Inventory –Second Edition (BDI-2), the Preschool Language Scale –Fifth Edition (PLS-5), the MacArthur-Bates Communicative Development Inventory (CDI), the Language Development Survey (LDS), and the Language Use Inventory for Young Children (LUI). All 6 instruments were considered as acceptable for reliability and validity (r > 0.70). Although the Bayley-III is considered the gold standard, without adequate resources and planning, it presents challenges in training and administration. The BDI-2 is a suitable substitute for the Bayley-III in lower resource situations. More research is required to draw conclusions on the reliability and validity of the PLS-5. Selection between the CDI, LDS, and LUI depends on what aspect of language development is to be evaluated. Child cognitive and language instruments administered at 24 months of age have limitations in their predictive validity and use in populations speaking English as a second language. Further research and longitudinal studies in these areas are warranted.