Integrating health, education and culture in predicting Pacific children's English receptive vocabulary at 6 years: A classification tree approach

J Paediatr Child Health. 2019 Oct;55(10):1251-1260. doi: 10.1111/jpc.14397. Epub 2019 Feb 12.

Abstract

Aim: Pacific children fare poorly on health and educational outcomes, including literacy. Early interventions are considered critical in reducing educational disparities. A prediction model was constructed to analyse the factors associated with Pacific children's English receptive vocabulary, an important component of English language development.

Methods: A birth cohort study of Pacific children was used to construct a classification tree model and predict the proportions of Pacific children who performed strongly in a standardised test of English receptive vocabulary at 6 years of age (n = 1019). Classification trees were constructed using 10-fold cross-validation (CV) and pruned using the one-standard-error rule. Prediction errors were directly estimated using leave-one-out CV.

Results: Analyses of misclassification errors from the pruned model gave false negative and positive rates of 19 and 19% from re-substitution and 54 and 21% from leave-one-out CV estimation, respectively. Of the predictors, maternal acculturation, small birthweight and performance in early developmental screening test at 4 years of age were found to have the highest goodness of split.

Conclusions: The cultural environment to which Pacific children were exposed in early childhood, indicated by the maternal acculturation, was more crucial in distinguishing children with strong English-receptive vocabulary skills than socio-economic or prenatal conditions. This highlights the importance of integrating the cultural environment into designing measures for facilitating Pacific children's language development.

Keywords: Pacific people; acculturation; decision trees; forecasting; vocabulary.

MeSH terms

  • Acculturation*
  • Adult
  • Child
  • Decision Trees
  • Education
  • Forecasting
  • Health Status Disparities*
  • Humans
  • Native Hawaiian or Other Pacific Islander*
  • New Zealand
  • Retrospective Studies
  • Vocabulary*
  • Young Adult