Concept: Early Development Instrument (EDI) Outcomes
Last Updated: 2022-09-28
1. Socio-economic Status (SES) and EDI Outcomes
Across income quintiles, the prevalence of children's vulnerability at age five is considerable, ranging from 21% to nearly 40% of children in a given income quintile and representing thousands of Manitoban children at the crucial developmental transition from the early years into school at Kindergarten.
EDI outcomes as a function of SES can be further broken down into the percent of children not ready (vulnerable) at age five by urban or rural income quintile, age, gender, RHA of residence or Winnipeg community of residence.
For more information see:
- Chapter 2: Socioeconomic Adversity and Children's Vulnerability at Age Five in Santos et al. (2012).
- Table 2.2: Number of Children Not Ready at Age 5 by Urban and Rural Income Quintiles, Manitoba in Santos et al. (2012).
2. Early Life Health and EDI Outcomes
Early life health includes children's health at birth (gestational age, birth weight, preterm birth, long intensive care unit (ICU) stay, long hospital stay) up until their EDI outcomes at age five. This also includes children's major and minor illness in early childhood to age four.
In summary, in the context of socioeconomic adversity, the five EDI outcomes all share a common pathway originating from biological vulnerability at birth.
For more information see:
- Chapter 3: Biological Vulnerability at Birth and Children's Vulnerability at Age Five in Santos et al. (2012).
- Figure 3.5: Birth Measures by Urban and Rural Income Quintiles, Manitoba in Santos et al. (2012).
- This figure details the measures of biological vulnerability at birth that also exhibit SES gradients, including, long ICU stay, preterm birth, and long hospital stay.
3. Children "At-Risk"
Researchers have identified three "at-risk" groups of children when implementing the EDI. That is, three groups which are more likely to have a higher prevalence of children that fall into the "Not Ready" category or the MCI. These groups are:
- children born to mothers who were teenagers at their first childbirth (see Teen (Mother) at First Birth);
- children in families that were ever on Income Assistance (IA); and
- children in the care of Child and Family Services (CFS).
For more information, please see:
- Chapter 4: Children's Vulnerability at Age Five in At-Risk Groups in Santos et al. (2012).
- Figure 4.5: Percent Not Ready at Age 5 by Number of Risk Factors, Winnipeg in Santos et al. (2012).
- This figure details the prevalence of children's vulnerability at age five for each of the at-risk groups and their combinations.
- Figure 4.7: Odds Ratios for At-Risk Groups for Outcomes from Age 5 to Adulthood, Winnipeg in Santos et al. (2012)
- This figure details the odds ratios for children's vulnerability at age five for each of the varying combinations of the three at-risk groups, in comparison to the findings of Brownell et al. (2010) for poor outcomes in youth and early adulthood (not completing eight credits by the end of Grade 9, not completing high school, becoming a teen mom, receiving income assistance as a young adult).
4. Epigenetics: What Causes the Biology of Adversity in EDI Outcomes
Epigenetics is the study of changes in gene activity without any change in the structure of the DNA where the genes reside. In other words, epigenetics refers to how the environment interacts with the genome. Depending on the environmental circumstances, the expression of a gene can be activated or inhibited (turned "on" or "off"), causing different visible effects. Such changes are most profound in early development.
To read more about epigenetics and EDI outcomes see Chapter 5: Linking Biological Vulnerability and Socioeconomic Adversity in Santos et al. (2012).
1. Santos et al. (2012)
In the deliverable, The Early Development Instrument (EDI) by Santos et al. (2012), there was a focus on the socioeconomic inequities in health, learning, and behavior, as well as the early life (in utero and at birth) of children and its significance for children's early developmental outcomes at age five. Santos et al. also categorized and examined the three at-risk groups of children that were especially vulnerable in early development.
For more information on the key findings in this report please see Chapter 7: Summary and Conclusion.
2. Brownell et al. (2012)
In the deliverable, How are Manitoba's Children Doing? by Brownell et al. (2012), they investigated the relationship between level of EDI vulnerability and Grade 3 vulnerability and found an association with both reading and numeracy assessments. Figure 5.74: Grade 3 Students Not Meeting or Approaching Reading and Numeracy Assessment Expectations by Number of Vulnerabilities on EDI in Kindergarten shows that with each increase in EDI vulnerability, there was an increase in the percent of students who were vulnerable on both the Grade 3 reading and numeracy assessments.
They further elaborate on the factors associated with EDI outcomes and the complex inter-relationship of these factors. It is possible for some variables to be both an outcome as well as a predictor of subsequent outcomes. These variables cannot be measured directly and therefore must be estimated by related variables known as "latent constructs".
For more information, see the section titled Factors Associated with Outcomes in Chapter 5 of this deliverable.
3. Chartier et al. (2012)
In the deliverable, Health and Healthcare Utilization of Francophones in Manitoba by Chartier et al. (2012), they investigated EDI outcomes comparing a Francophone cohort and a matched cohort. Overall, they found that children in the Francophone Cohort had a higher "not ready for school" rate. The groups were similar for the domains physical health & well-being and social competence, but Francophone children scored less in the emotional maturity, language & cognitive development, and communication skills & general knowledge domains.
For more information, see section 16.1 Early Development Instrument in this deliverable.
4. Smith et al. (2013)
In the deliverable, Social Housing in Manitoba. Part II: Social Housing and Health in Manitoba: A First Look by Smith et al. (2013), they investigated the percent of children classified as being "not ready" in at least one EDI domain over two school years: 2005-06 and 2006-07, comparing a Social Housing cohort to All Other Manitobans.
They found the provincial percentage of Kindergarten students not ready for school was higher in the Social Housing cohort (44.6%) than in the All Other Manitobans cohort (26.4%). In Winnipeg, the percentage of Kindergarten students not ready for school was higher in the Social Housing cohort (45.8%) than in the All Other Manitobans cohort (26.1%).
For more information, see the section titled Children Not Ready for School (in One or More Early Development Instrument (EDI) Domains) in the deliverable.
5. Brownell et al. (2015)
In the deliverable, The Educational Outcomes of Children in Care in Manitoba by Brownell et al. (2015), they investigated the educational outcomes of children in care, including the EDI. They looked at the percent of children who were not ready in one or more domains and not ready in two or more domains.
The proportions of children deemed not ready in one or more domains were 53.1% who were ever in care, 43.5% who were never in care but whose families had received services from CFS, and 23.8% who were never in care or never received services from CFS. The proportions of children deemed not ready in two or more domains were 36.3% who were ever in care, 26.1% who were never in care but whose family had received services from CFS, and 12.0% who were never in care or never received services from CFS.
For more information:
- on the EDI outcomes of children in care, see the section titled Early Development Instrument (EDI) in Chapter 4 of the deliverable.
- on the use of statistical modeling to identify the factors associated EDI outcomes of children in care, see the section titled Early Development Instrument (EDI) in Chapter 5 of the deliverable.
Developmental Vulnerability / Not Ready:The EDI SAS macro that is used at MCHP has been updated to reflect this change in calculating pprob and cprob values. If you do not use the EDI macro, then make sure to manually add these two conditions into your code. Please check with your data analyst to ensure you are using the updated macro/code.
Physical Health & Well-Being
*if phys>=0 & phys<6.9232 pprob=1.
*above was incorrect below is correct.
if phys>=0 & phys<7.0833 pprob=1.
Communication & General Knowledge
*if comgen>=0 & comgen<4 cprob=1.
*above was incorrect below is correct.
if comgen>=0 & comgen<4.3750 cprob=1.