اعتباریابی روانسنجی مقیاس رشدی نیوشا در کودکان پیش دبستانی

Introduction

The second childhood period (3–6 years), commonly referred to as the preschool years, is the most critical phase for physical, sensory-motor, cognitive, emotional, social, and moral development [1]. During this stage, children exhibit remarkable progress in their motor repertoire, acquiring fundamental movement skills such as balance, locomotion, and object control. These skills serve as prerequisites for mastering complex motor tasks essential for daily living and physical activity [2]. Motor developmental problems are relatively prevalent in this population, with underlying etiologies including developmental coordination disorder, cerebral palsy, autism spectrum disorder, attention-deficit/hyperactivity disorder, and limited opportunities for motor skills practice [3]. Motor developmental problems can lead to adverse consequences, including academic, emotional, and behavioral difficulties [4]. Early intervention has been shown to enhance motor performance and mitigate negative outcomes [5]. Early identification and intervention are thus vital for optimizing language, cognitive, motor, and socio-emotional development, as well as academic success [6]. Early identification of motor developmental problems requires a screening tool with adequate sensitivity, specificity, and criterion validity, benchmarked against standardized diagnostic instruments, while remaining feasible in terms of cost, administration time, and training requirements [3].

A variety of assessment tools are available to screen distinct domains of development, or specifically motor development in children, such as the checklist of Movement Assessment Battery for Children (MABC-2-C), Ages and Stages Questionnaire (ASQ-3), and DCD Questionnaire [3]. However, the validity of these instruments is influenced by language and culture [7], and standardized motor assessment tools may lack cross-cultural validity [8]. Consequently, locally-developed tests with robust psychometric properties are preferred.

Among the few Iranian developmental tools designed for Persian-speaking children is the Newsha Developmental Scale. Jafari and Asad-Malayeri developed the preliminary version of Newsha Developmental Scale to assess seven domains—hearing, speech, receptive language, expressive language, cognition, social communication, and motor skills—in children aged 0–72 months [9]. After content validation by 10 pediatric development experts and a pilot study (n=75) and revisions, the scale was administered to 593 typically developing children in Tehran. Test-retest and inter-rater reliability exceeded 95% (p<0.001), with significant age effect (p<0.001) but significant gender effect only 6/646 items (p<0.02). They concluded that Newsha Developmental Scale is a valid and reliable tool for assessment and identification of developmental delays in Persian-speaking children under six years.

Limited psychometric studies have focused on the motor subscale of Newsha developmental scale. Soleimani [10] examined concurrent validity of the motor subscale of Newsha developmental scale with MABC-2 in 50 five-year-olds from Pardis, Tehran, reporting a moderate positive correlation (r=0.42, p=0.003). Other studies evaluated Newsha non-motor subscales. For instance, Dashtaki et al. [11] examined the convergent validity of the Newsha cognitive and social skills subscales in preschool children from Tehran. They found a very weak negative correlation between Newsha cognitive skills subscale and the Behavior Rating Inventory of Executive Function (BRIEF) (r_s=−0.013), as well as between the Newsha social skills subscale and Vineland Social Maturity Scale (r_s=−0.1). Consequently, they concluded that the Newsha developmental scale lacks adequate convergent validity for assessing cognitive and social skills in Tehran preschoolers. In contrast, Nakhshab et al. [12] evaluated the convergent validity of the Language Use Inventory (LUI) with the social communication skills subscale of the Newsha developmental scale in a sample of 144 Persian-speaking children aged 18 to 47 months. Their analysis revealed a moderate positive correlation (r=0.54, p=0.01).

Given the limited psychometric research on the Newsha Developmental Scale—particularly its motor subscale—the present study aimed to examine the concurrent and construct validity of the Newsha motor development subscale in preschool children.

Method:

Participants. This cross-sectional study enrolled 80 healthy preschool children (46 boys, 34 girls), recruited through cluster random sampling from three kindergartens in Bajestan, Iran.

Inclusion criteria were as follows:

• Chronological age between 3 and 6 years;
• Absence of physical disabilities or congenital impairments, as confirmed by parental report and teacher observation.

Sample size calculation was conducted using G*Power software (version 3.1.9.7) [13]. For concurrent validity analysis with a correlation coefficient, the minimum required sample size was estimated at 46 participants, assuming a power of 0.95, a significance level (α) of 0.05, and a strong correlation (r=0.5) [14]. To account for potential attrition and improve statistical robustness, the final sample size was increased to 80, approximately double the calculated minimum.

Materials. The main measurement tool in the present study was the Newsha developmental scale [9]. The Newsha developmental scale is an integrated scale designed to assess developmental skills in Persian-speaking children from birth to six years of age. It evaluates seven developmental skills—hearing, speech, receptive language, expressive language, cognition, social communication, and motor skills—across 13 developmental levels. In the present study, the motor subscale was administered for age groups ranging from 31 to 72 months. The number of motor skill items varies across these five age groups, ranging from 5 to 12 items. Each item is scored dichotomously (yes/no), and the child’s score for each skill is calculated based on the sum of "yes" responses. A child’s performance is considered developmentally normal if they meet or exceed the expected milestones for their age. The content validity, construct validity (based on age differences), and test-retest reliability of the Newsha Developmental Scale were confirmed by Jafari and Asad-Malayeri in a sample of 593 Tehran children [9].

The Ages and Stages Questionnaire, third edition (ASQ-3) was used to assess concurrent validity. This tool consists of 21 age-appropriate questionnaires assessing five developmental domains: communication, problem-solving, personal-social skills, gross motor skills, and fine motor skills in children aged 1 to 66 months [15]. In the present study, only the gross and fine motor skill questions were used. ASQ-3 has been translated, culturally adapted, and validated in multiple languages [16]. In Iran, Shariatpanahi et al. [17] conducted translation, cultural adaptation, and standardization of the ASQ-3 in 11,740 Iranian children (1–66 months). They confirmed its face validity, content validity, internal consistency (Cronbach’s alpha), and established age-specific cut-off points, concluding that the ASQ-3 is a reliable and valid tool for screening developmental delays in Iranian children.

Procedure. Prior to obtaining informed consent from parents, detailed information concerning the study's objectives, methodology, and ethical protocols—including stringent measures to ensure the confidentiality of child-specific data and the anonymized, aggregate-level reporting of results—were explicitly communicated. Data collection was conducted via interviews with parent's/kindergarten teachers. Hard-copy questionnaires were administered in person, with the researcher available throughout the process to provide clarifications, address queries, and ensure the precise completion of all instruments in alignment with the study’s standardized procedures. To assess concurrent validity, the correlation between the Newsha motor skills score and the total score, as well as the gross and fine motor skills scores of the ASQ-3, was calculated. Additionally, construct validity was examined by analyzing the correlation between age and the Newsha motor skills score.

Statistical analysis: In addition to descriptive statistics, the Kolmogorov-Smirnov test was used to assess the assumption of normality, and Spearman’s correlation coefficient was applied to examine relationships between two tools at a significance level of p<0.05. All analyses were conducted using IBM SPSS Statistics (Version 26).

Results: Table 1 presents the descriptive statistics of demographic variables and scores from the ASQ-3 (gross and fine motor skills, and total score of motor development) and Newsha motor developmental subscale. The Kolmogorov-Smirnov test failed to confirm the normality of data distribution, even after logarithmic and Box-Cox transformations (p<0.0001). Consequently, Spearman’s correlation coefficient was employed to examine the concurrent and construct validity.

Table 2 presents the Spearman’s correlation coefficients (rₛ) between the two assessment tools. The coefficients ranged from –0.039 to 0.234. In accordance with Hopkins et al.’s [18] guidelines for interpreting correlation coefficients, the concurrent validity of the Newsha motor development subscale demonstrated the following relationships with the ASQ-3 subscales:

• A weak association with the gross motor skills subscale of ASQ-3 (rₛ(78)=0.234, p=0.037) and the total score of motor skills of ASQ-3 (rₛ(78)=0.11, p=0.333).
• No meaningful correlation with the fine motor skills subscale of ASQ-3 (rₛ(78)=–0.039, p=0.73), suggesting unacceptable concurrent validity.

A

Spearman’s correlation was conducted to evaluate the relationship between age and Newsha motor skills scores. The results revealed a significant positive correlation between these variables, r_s(78)=0.67, p<0.001, indicating moderate construct validity [19].

Discussion:

The presets study aimed to examine the concurrent and construct validity of the Newsha motor development subscale in preschool children. The results indicated poor concurrent validity between the Newsha motor development subscale and the total ASQ-3 motor score (rₛ=0.11), as well as gross motor subscale of ASQ-3 (rₛ=0.234) and the unacceptable validity with the ASQ-3 fine motor subscale (rₛ=-0.039). Concurrent validity pertains to the development of a new assessment instrument. To establish concurrent validity, researchers evaluate the degree of correlation between the new measure and an existing, validated test [20]. A strong correlation between a new locally-developed tool and valid and standardized tests may justify its substitution. Our findings contradict those of Soleimani [10], who reported moderate concurrent validity for the Newsha motor development subscale in 5-year-old children from Pardis, Tehran. Soleimani evaluated concurrent validity using the Movement Assessment Battery for Children-2 (MABC-2), a gold standard performance-based test, whereas the present study employed the parent-reported ASQ-3. Although the ASQ-3 demonstrates good sensitivity (86%) and specificity (85%) [21] and a moderate correlation with the MABC-2 [22], screening tools inherently have lower precision than diagnostic tests. Moreover, the present study examined a broader age range compared to Soleimani's research, which may account for the divergent findings. While Soleimani exclusively assessed 5-year-old children [10], our study included participants aged 3 to 6 years, likely yielding more comprehensive and precise results due to the wider developmental spectrum evaluated.

One notable limitation of the Newsha motor development subscale, which may contribute to its low concurrent validity, is the lack of differentiation between gross and fine motor skills. Additionally, the uneven distribution of items of gross and fine skills across age-specific questionnaires undermines its developmental appropriateness for distinct age groups. For instance, in the 43–48-month questionnaire, all six items assess gross motor skills, whereas in the 49–60-month and 61–72-month questionnaires, only 2 from 6 items and 3 from 12 items, respectively, evaluate gross motor skills. Therefore, future studies should critically evaluate the item structure of the Newsha motor development subscale to ensure balanced representation of gross and fine motor skill items within each age cohort. Such revisions would enhance the scale’s construct validity and developmental appropriateness for diverse pediatric populations.

Among the key findings of the present study was the moderate construct validity of the Newsha motor development subscale. The results demonstrated a significant positive correlation between age and Newsha motor skills scores (r_s(78)=0.67). This finding aligns with Jafari and Asad-Malayeri's construct validation study [9], which evaluated age effect on Newsha developmental scale scores in 30 children aged 0-6 years. Their hypothesis posited that typically developing children should achieve age-appropriate scores, with either maximal or minimal/no scores when tested outside their age boundaries. They observed that all 30 children obtained maximal scores when assessed below their age threshold, while scoring minimally or zero when tested above their age range. These results suggest this subscale can reflect age-related differences in preschool children's motor competence. Although demonstrating age-dependent variation is fundamental for any developmental assessment tool, further investigation of additional construct validity types in more diverse and scattered samples is warranted to strengthen these conclusions. Future studies should incorporate comprehensive validity analyses to establish robust psychometric properties.

Conclusion: The present study revealed that the Newsha motor development subscale for children aged 3–6 years exhibits weak concurrent validity with the ASQ-3 motor skills scores (weak correlation with gross motor skills and negligible correlation with fine motor skills) and moderate construct validity based on the correlation between Newsha motor skills scores and age. Consequently, utilizing this tool for motor development screening in preschool children warrants caution. A critical revision of the motor skills questionnaire content is recommended, alongside standardization of the item distribution for gross and fine motor skills across age-specific questionnaires to enhance measurement precision.

Keywords: child development; motor skills; psychometrics; reproducibility of results

Ethical Considerations

Compliance with ethical guidelines

All ethical principles, such as the informed consent of the participants, the confidentiality of information, the permission of the participants to cancel their participation in the research, are considered in this article.

Funding

This study was extracted from the MSc thesis of first author at Department of motor behavior of Alzahra University, utilizing secondary data analysis. The research was conducted as a research project endorsed by the Student Scientific Association of Motor Behavior at Alzahra University.

This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contribution

Authors contributed equally in preparing this article.

Conflict of interest

The authors declared no conflict of interest.

Acknowledgements

The authors extend their gratitude to the kindergarten teachers, the participating children, and their parents for their invaluable contributions to this study.