Table 2 Strengths and Weaknesses of implementing the CAT/CLAMS and ASQ child development tool in Limpopo, South Africaa
From: Comparing Two Early Child Development Assessment Tools in Rural Limpopo, South Africa
| Â | CAT/CLAMS | ASQ | ||
|---|---|---|---|---|
Strengths | Weaknesses | Strengths | Weaknesses | |
Usability | - Calculates developmental score - Well suited for hospital or school environment - Feasible for use in clinic work flow | - Described as costly, time consuming, and difficult to calculate - Score calculation is moderately challenging - Better suited for low-volume days | - Described as easy, practical, uncomplicated, and simple - Uncomplicated administration - Visual graph to show where a child falls in relation to “cut off” scores - Identified as primary assessment tool - Feasible for use in clinic work flow | - Requires assessor to be literate - Score calculation is mildly challenging |
Resource Management | None identified | - High cost of toys - Long administration time | - Low cost - Utilization of CHW - Minimal time commitment for nurses | - Cost of copying assessment surveys - Insufficient numbers of CHW to complete home assessments |
Cultural Adaptations | None identified | - Moderate amount of translating needed - Expensive toys which are not all culturally appropriate | None identified | - Substantial amount of translating needed - Poor access to copiers and printers - Requires cultural modification of survey assessment questions |
Patient and Parent Factors | - Direct observation of child’s abilities - Can use toys to teach mothers about meaningful play - Spend more time with patients - Nurses want to assess their own children using the tool | - Parents may not understand the importance of “play” during assessment and become impatient and leave - Child may be afraid of the nurse and underperform | - Assessment done in-home - Nurse can teach parents about results when they score the assessment tool | - Nurses distrust accuracy of information reported by parents |