ArticlePLOS global public health2025
Adaptation and pilot testing of the Early Learning Outcome Measure (ELOM) (4&5) Years Assessment tool in South African Sign Language.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Early Childhood Development is a key national priority in South Africa which has developed the Early Learning Outcome Measure (ELOM 4&5) specifically designed to measure the progress of 4- and 5-year-old children across 5 domains of early childhood development. This age-validated, population-standardised instrument has been shown to have measurement equivalence and lack of bias across South Africa's 11 official spoken languages. In 2023, South African Sign Language was formally recognised as 12th official language of South Africa, but no ELOM (4&5) exists in SASL despite over 6,000 deaf children being born annually. This study reports the methods used to adapt the ELOM (4&5) into SASL and establish its face validity, preliminary results from its pilot implementation with 29 deaf children and initial evaluation of its test-retest reliability and internal consistency. The small sample limits the implications that can be drawn from the results, but we report the sample performing below the Q1 marginal mean for 50-59 months olds established in the national standardisation study on all domains apart from Fine Motor Skills and Visual Motor Integration in the 60-69 months old group where the children are reaching the Q2/3 mean (12.87 ± 0.25). Seventy two percent of the sample scored in the 'falling far behind' category in comparison with 28% of children overall in South Africa. Although the ELOM (4&5)-D meets the acceptable test-retest reliability coefficient, it does not do so in all domains with wide variation between the two testing points indicating instability. Internal consistency was found not to be satisfactory. The extent to which these results are a reflection of the children's true ability, or an artefact of an underpowered sample are discussed with reference to the implications for deaf children of language deprivation in the first three years of life experienced by many deaf children in South Africa.
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