Psychometric Evaluation of the Teacher’s Evaluation of Neurodevelopmental Delays (TEDD) Tool Among Indian Preschoolers: Reliability Analysis Using Cronbach’s Alpha

Abstract

Background – Early detection of developmental delays in children can significantly help them realize their full potential. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is currently used to identify neurodevelopmental delays among children worldwide. However, due to cultural differences, there is a pertinent need for a content-validated screening tool in the context of low- and middle-income countries, including India.

Purpose – To examine reliability and validity of the TEDD (Teacher’s Evaluation of Neurodevelopmental Delays) screening tool in measuring neurodevelopmental delays among Indian preschool children aged 3 years to 6 years. The TEDD tool was developed to be administered by preschool teachers or early childhood educators. It can be used as a focused screening tool or a mass-level screening tool. The items were developed in accordance with the theoretical framework, aligning with the criteria and definitions of neurodevelopmental disorders outlined in the DSM-V, and were subsequently integrated with the developmental milestones described in the International Classification of Diseases, 10th version (ICD-10) AND Early Childhood Care and Education (ECCE)/New York City Early Education Centre (NYCE) framework. The items were then worded in behavioral terms.

Methodology – The TEDD was administered by preschool teachers. A total of 381 preschoolers participated in the study. There were 96 items spread across five domains, namely, Cognitive, Sensory Motor, Social-Emotional, Language Speech and Communication and Daily Living, which measure Neuro developmental milestones. Exploratory factor analysis (EFA) and confirmatory composite analysis were used to establish the structural validity of the TEDD. The reliability of the instrument was evaluated using Cronbach’s alpha and composite reliability scores. To determine its validity, both convergent and discriminant validity assessments were conducted. The structural validity of the TEDD scale was assessed using exploratory factor analysis (EFA) followed by confirmatory composite analysis (CCA). The study sample consisted of 381 preschool children aged 3-6 years, recruited from 6 preschools in Bangalore. Reliability was evaluated using Cronbach’s alpha and composite reliability scores, with values ≥0.70 considered acceptable. Convergent validity was assessed through average variance extracted (AVE > 0.50), and discriminant validity was evaluated using the Fornell–Larcker criterion. All analyses were performed using SPSS-24 , with a significance level set at p < 0.05

Results – The EFA and CFA results confirmed the measurement structure of the TEDD tool. Cronbach’s alpha analyses indicated high internal consistency for the TEDD. Discriminant validity was established, which revealed that the TEDD accurately measures neurodevelopment delays in preschool children.

Conclusion – The TEDD is a valid and reliable instrument for assessing neurodevelopmental delays in Indian preschoolers across five key developmental domains.

Implications – The TEDD has significant implications for educational and clinical settings. The TEDD has proven to be a culturally sensitive tool for early childhood educators as well as practitioners and researchers to assess and support the process of early identification and diagnosis of neurodevelopmental disorders in children aged 3 years to 6 years.