# Advancing Equity in Early Childhood Developmental Screening Through Item Response Theory and User-Centered Design

> **NIH AHRQ K01** · SEATTLE CHILDREN'S HOSPITAL · 2024 · $145,081

## Abstract

Project Summary
Over one-third of all U.S. children are at-risk for negative long-term health, behavioral and emotional
outcomes, due to circumstances of poverty. Beginning in early childhood, children living in low-income
circumstances are twice as likely to experience developmental delay in one or more developmental domains
including: 1) motor, 2) cognitive, 3) communication, and 4) social-emotional. For Black and Latino children this
risk is compounded due to structural racism. Specifically, racial and ethnic minority children and children
living in low-income circumstances experience severe inequities in access to appropriate
developmental screening and support. These inequities result in missed opportunities to intervene at critical
developmental periods, contributing to economic and racial disparities in school readiness and long-term
cognitive and behavioral disabilities. A report by the American Academy of Pediatrics identified two key
barriers to enhancing screening and referral practices: 1) lack of provider time to carry out more frequent
screenings, and 2) difficulty accessing services once families are referred. To address these barriers, I will
design specifications of a computer adaptive developmental assessment that includes contextually
and culturally appropriate items, to be used by parents, clinicians, and community health workers to
improve developmental assessment in primary care settings. Informed by principles of patient-centered
measurement and user-centered design I will carry out the following specific aims of this project: Aim 1:
Identify optimal items in English and Spanish to include in a new developmental assessment –
computer adaptive test; Aim 2: Develop a prototype for a new developmental assessment – computer
adaptive test informing a primary care based developmental support intervention. This project will result
in 1) culturally and contextually appropriate developmental assessment items in English and Spanish ready for
standardization to nationally representative samples, and 2) design specifications to inform building a high-
fidelity developmental assessment - computer adaptive test for clinical integration. This research plan is part of
a K01 proposal designed to provide me with scholarly training, mentorship, and support to gain skills and
experience needed to be an independent investigator, conducting community-engaged research to design
effective developmental assessment and response practices, to address economic and racial disparities in
child development outcomes. To achieve this objective, I will pursue training in: (1) advanced Item Response
Theory, (2) user centered design, (3) clinical effectiveness research.

## Key facts

- **NIH application ID:** 10927407
- **Project number:** 5K01HS029428-02
- **Recipient organization:** SEATTLE CHILDREN'S HOSPITAL
- **Principal Investigator:** Kendra Liljenquist
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $145,081
- **Award type:** 5
- **Project period:** 2023-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10927407

## Citation

> US National Institutes of Health, RePORTER application 10927407, Advancing Equity in Early Childhood Developmental Screening Through Item Response Theory and User-Centered Design (5K01HS029428-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10927407. Licensed CC0.

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