Population-Level Data on Child Development at School Entry Reflecting Social Determinants of Health: A Narrative Review of Studies Using the Early Development Instrument

Abstract

Background: The Early Development Instrument (EDI) was developed as a population-level assessment of children’s developmental health at school entry. EDI data collection has created unprecedented opportunities for population-level studies on children’s developmental outcomes. The goal of this narrative review was to synthesize research using the EDI to describe how it contributes to expanding the understanding of the impacts of social determinants on child development and how it applies to special populations. Methods: Select studies published in peer-reviewed scientific journals between 2015 and 2020 and incorporating the social determinants of health perspectives were chosen to highlight the capability of the EDI to monitor children’s developmental health and contribute knowledge in the area of early childhood development. Results: A number of studies have examined the association between several social determinants of health and children’s developmental outcomes, including hard-to-reach and low-frequency populations of children. The EDI has also been used to evaluate programs and interventions in different countries. Conclusions: The ability of the EDI to monitor children’s developmental outcomes in various populations has been consistently demonstrated. The EDI, by virtue of its comprehensive breadth and census-like collection, widens the scope of research relating to early childhood development and its social determinants of health.

Re-Envisioning an Early Years System of Care towards Equity in Canada: A Critical, Rapid Review

“…Moreover, from an equity perspective, health promotion is not merely about educating people to change their behavior but of equal importance is changing the conditions under which families can lead healthy and fulfilling lives [ 85 ]. A comprehensive early years system would thus provide holistic, intersectoral and wrap-around support for communities and families who are experiencing health-promoting challenges such as food or housing insecurity, parental mental health problems, violence, structural racism and discrimination [ 14 , 16 , 86 , 87 ]. Health promotion strategies and initiatives would also be targeted and tailored in response to unique family contexts, including the social, economic, cultural and historical determinants that may limit or prevent access for newcomer and racialized families from effectively accessing early years services, resources and supports [ 18 ].…”

“…By employing intersectionality, the authors view children’s early health and well-being as complex, multidimensional and embedded in and shaped by multiple and inter-related social and structural factors and systems of power. In the Canadian context, intersectional analysis is inclusive of how broader social relations of power, including ongoing colonialism and systemic racism, shape communities and families’ everyday lives, their quality of life and their children’s chances of optimal health and well-being [ 14 , 15 ]. From this critical viewpoint, children are not inherently “vulnerable” to health inequities but rather their vulnerability is created by structural inequities and structural violence that result in particular child populations having a greater risk of health inequities.…”

“…UNICEF ranks Canada lowest in “child survival” [ 14 ]. A high prevalence of infant mortality stems from inequities in the social determinants of health and the impact of systemic discrimination [ 22 ].…”

COVID‐19 school closures and educational achievement gaps in Canada: Lessons from Ontario summer learning research

“…Gaps in readiness have been traced to systematic differences in children's early environments (Hertzman, 2009). 4 Low SES children are more likely to start school with lower levels of reading and math skills (Duncan et al, 2014) and are less "school ready" in the areas of physical health, social confidence, emotional maturity, and language, cognitive, and communication skills (Janus & Duku, 2007;Janus & Offord, 2007;Janus et al, 2021). Longitudinal studies find that early gaps in school readiness tend to persist as children progress through school, generating not only unequal outcomes in education, but also inequalities in health, employment, and judicial involvement (Duncan et al, 2007(Duncan et al, , 2014Perry, Braren & Blair, 2018).…”

Introduction to the Special Issue on Early Child Development: From Measurement to Optimal Functioning and Evidence-Based Policy

“…Early child development measurement tools and their association with long-term outcomes were covered by many papers included in this issue [ 1 , 2 , 3 , 4 , 5 ]. Janus et al [ 1 ] synthesized research using the Early Development Instrument (EDI), which was developed in Canada as a population-level assessment of children’s developmental health at school entry. This narrative review shows the ability of the EDI to monitor children’s developmental outcomes in various populations, how the EDI contributes to expanding the understanding of the impacts of social determinants on child development, and how it applies to special populations.…”