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The Life Skills Assessment Scale: Norms for young people aged 17-19 and 20-22 years

  • National Health Service, Isle of Wight, UK & Dream A Dream NGO Bengaluru India

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Severe poverty, adversity, and malnutrition have irrefutable negative effects on the development and mental health of children and young people. The Life Skills Assessment Scale (LSAS), is a 5-item impact assessment scale developed in India, that provides a simple, yet valid and reliable, instrument to assess life skills of disadvantaged children and young people, with age norms of 8–16 years. In the present study, in Bengaluru, India, we used observational data obtained from 656 disadvantaged young people to extend the LSAS age norms to 17–19 and 20–22 years age groups, resulting in a simple, valid, and reliable assessment tool for children and young people aged from 8 to 22 years.
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Social Behavior and Personality, Volume 48, Issue 4, e8938
The Life Skills Assessment Scale: Norms for young people aged 17–19
and 20–22 years
David Pearson1, Fiona Kennedy1, Vishal Talreja2, Suchetha Bhat2, Katherine Newman-Taylor3
1National Health Service, United Kingdom
2Dream A Dream Nongovernmental Organization, Bengaluru, India
3Psychology Department, University of Southampton, United Kingdom
How to cite: Pearson, D., Kennedy, F., Talreja, V., Bhat, S., & Newman-Taylor, K. (2020). The Life Skills Assessment Scale: Norms for
young people aged 17–19 and 20–22 years. Social Behavior and Personality: An international journal, 48(4), e8938
Severe poverty, adversity, and malnutrition have irrefutable negative
effects on the development and mental health of children and young
people. The Life Skills Assessment Scale (LSAS), is a 5-item impact
assessment scale developed in India, that provides a simple, yet valid
and reliable, instrument to assess life skills of disadvantaged children
and young people, with age norms of 8–16 years. In the present study,
in Bengaluru, India, we used observational data obtained from 656
disadvantaged young people to extend the LSAS age norms to 17–19
and 20–22 years age groups, resulting in a simple, valid, and reliable
assessment tool for children and young people aged from 8 to 22 years.
life skills; failure to thrive;
extreme poverty; severe
adversity; disadvantaged
young people; Life Skills
Assessment Scale;
developing countries;
The global levels of extreme child poverty are not precisely known, as there is no standard definition of
poverty nor is there a consistent approach to the collection of data. However, available figures show that,
globally, from approximately 40% to 47% of children live with the effects of extreme poverty, surviving on
less than US$2 per day: This percentage equates to hundreds of millions of children, of whom 30% are in
India (Olinto, Beegle, Sobrado, & Uematsu, 2013; United Nations International Children’s Emergency
Fund/World Bank, 2016; World Bank, 2018) where the current study took place. A key indication of
extreme poverty is failure to thrive, commonly observed as stunted growth. Failure to thrive is associated
with a wide range of long-term mental health and developmental issues. For example, it was estimated in
the HUNGaMa Survey Report (Naandi Foundation, 2011) that in India the growth of up to 59% of all
children under 5 years of age was stunted. Further, it was stated in the Indian government’s Children in
India 2012 Statistical Appraisal (Ministry of Statistics and Programme Implication, 2012) that 48% of
children in India under 5 years of age were affected by this condition. More recently, it was reported in the
National Family Health Survey-4 in India (NFHS-4; International Institute for Population Sciences, 2017)
that the 2015/2016 survey figures recorded that the growth of 38% of children under 5 years of age was
stunted. NFHS-4 also stated that this rapid decline over the last decade appears to have stalled. However,
globally both the World Bank (2018) and Geoghegan (2017) in a report for the Save the Children
organization have stated that the number of children experiencing severe adversity is increasing as they are
living in conflict areas and as members of displaced populations.
It is important to recognize that failure to thrive can happen in all stages of development and is associated
with long-term or lifelong effects (Homan, 2016; Martorell, Rivera, Kaplowitz, & Pollitt, 1992). Stunted
growth at 5 years of age will generally lead to problems in later development. Research examples include
findings that stunted growth at 2 years of age can be linked to cognitive deficits at 9 years of age (Berkman,
Lescano, Gilman, Lopez, & Black, 2002) and at 8 years and 11 years of age (Daniels & Adair, 2004; Mendez
CORRESPONDENCE David Pearson, The Boulders, Quarr Road, Ryde PO33 4EL, UK. Email:
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
& Adair, 1999). Hoddinott et al. (2013) found in their longitudinal research that stunted growth at 72
months was associated with cognitive deficits in people aged from 25 to 42 years. Even if failure to thrive is
completely remediated at a young age, the effects can continue for a generation as those 5-year-olds develop
into adulthood. Although failure to thrive mostly comes about because of poor nutrition, even if adequate
nutrition is available, adversity can also cause failure to thrive. Severe adversity for a child can involve
being a refugee, living in a war zone, being abandoned, receiving institutional care, or having poor care
Thousands of nongovernmental organizations (NGOs) provide interventions designed to ameliorate the
negative effects of severe adversity, ranging from large multinational organizations to small local shelters
caring for a handful of children or young people. Interventions to address malnutrition include
supplementary feeding, and health- and social-improvement programs. Common life-skills interventions to
address developmental and psychological needs include the teaching of life skills, programs in sports,
creative arts, computer skills, and language skills, provision of camps, and mentoring. These interventions
are designed to enhance development by facilitating young people’s ability to interact with others, by
building up their skills, and enabling them to recognize and manage their emotions. A workable way to
measure the outcome of interventions has been problematic. Although the physical measurement of weight
and height is straightforward, it is much more difficult to measure developmental or psychological change.
Staff in most NGOs use nonstandardized common sense measures (e.g., how many times does a young
person attend programs or go to school), personal judgments, or just assume that interventions have
worked. The Life Skills Assessment Scale (LSAS) is a simple, reliable, and valid measure of life skills
interventions, which is currently in use in numerous developing countries (Kennedy, Pearson, Brett-Taylor,
& Talreja, 2014). This study took place in India, but as the LSAS construction was based on child and
adolescent development, it is culture and intervention generalizable. The LSAS does not assess any given
activity but uses the notion of age-appropriate behavior in any activity or situation. As the LSAS is
development-centered and culture and intervention free, it is generalizable to disadvantaged children and
young people in developing countries outside India. NGO staff and facilitators have reported that young
people aged up to about 22 years are using the programs, but the LSAS only had norms for those up to 16
years, so standardized assessments were not possible. Thus, in the current study we have added norms for
the 17–19 and 20–22 years age groups.
Effects of Severe Childhood Adversity and Failure to Thrive
The terms extreme adversity, extreme poverty, and failure to thrive can be confusing. Extreme adversity can
be experienced in many ways, and extreme poverty is an example of extreme adversity and can also cause
failure to thrive or stunted growth. The probability of malnutrition being experienced by children and young
people living in severe poverty is, of course, very high.
Failure to thrive isdefinedasachildnotgrowingatapredeterminedrateasmeasuredbyagrowthchart.
Growth charts cover development from birth to approximately 20 years of age (Centers for Disease Control
and Prevention, 2000). Normally, children and young people grow in a set pattern, and growth charts are
used to plot individual height, weight, and head circumference against a set standard. Stunted growth is
used as a key indicator of failure to thrive as it is apparent and easy to measure using a standardized growth
chart. Many disadvantaged children’s and young people’s growth patterns are abnormal in that they show
changes in, or deviations from, the expected patterns of growth shown on the chart (e.g., below the 3rd or
5th percentile on a growth chart or crossing major percentiles), and these changes and/or deviations
generally indicate failure to thrive. Although organic failure to thrive is most often caused by malnutrition
(Homan, 2016), nonorganic failure to thrive can be caused by a range of severe adverse experiences.
Nonorganic failure to thrive is defined as a failure of growth with no organic reason, for example,
abandonment, trauma, or abuse. However, the damaging effects of failure to thrive on development are the
same whether the cause of the failure is organic or nonorganic. The effects of experiencing severe adversity
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Social Behavior and Personality: an international journal
and failure to thrive have been recognized for over a century (Holt, 1897) and have been irrefutably linked to
attachment disorders, cognitive impairment, emotional and behavioral issues, neuropsychological
abnormalities, and diagnoses of physical and mental-health disorders (see examples in Table 1). In the
1960s, failure to thrive was linked to a reactive attachment disorder that is included in the fifth edition of the
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (2013), which
reflected its connection with developmental delay and mental health problems (Schwartz, 2000).
Depending on the prevailing culture in which such issues occur, they may be described as symptoms of
disorder or illness or as life-skills problems. The description/diagnosis may also depend on the services
available in that location, that society’s perceptions, and the strength of the medical model. We conducted
the current study in India where these issues are perceived as life-skills problems.
As cognitive impairment (see Table 1) describes an impact on areas such as children’s attention, memory,
and information processing, it becomes very difficult, if not impossible, for children or young people whose
growth is stunted or who have failed to thrive to reach individual capacity in learning, education, or
vocational skills. United Nations International Children’s Emergency Fund (2009) described this situation
as one of diminished learning capacity and poor school performance and Geoghegan (2017) of Save the
Children described it as a lifetime of lost opportunities in education. Attachment disorder difficulties are
associated with individuals being unable to tolerate closeness, attaching quickly to possibly inappropriate
others, being unable to assert themselves, and experiencing emotion regulation difficulties, such as, being
highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing extreme
inappropriate emotions. High anxiety levels may be interpreted as aggression, social withdrawal, avoidance,
and absconding. At best, these issues make it difficult for the child or young person to thrive in the context
of 21st century demands and, at worst, they establish the key foundations of future mental health issues.
Table 1. Examples of the Effects of Severe Childhood Adversity and Failure to Thrive
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
Life Skills Assessment Scale
A simple, valid, reliable, and accessible assessment instrument is needed for staff in NGOs to use to
determine if their programs are effective in combating the effects of adversity. The LSAS 8–16 is currently in
use in developing countries. However, NGO personnel have recognized that young people stay in programs
and need care and support beyond 16 years of age, as they attempt to thrive. Thus, our aim was to construct
norms of 17–19 and 20–22 years age groups.
The LSAS is a five item, 5-point impact scale based on the World Health Organization’s (1997) definition of
life skills (see Kennedy et al., 2014 for a full description) as follows: “Psychosocial competence is a person’s
ability to deal effectively with the demands and challenges of everyday life. It is a person’s ability to maintain
a state of mental well-being and to demonstrate this in adaptive positive behavior while interacting with
others, his/her culture and environment.” The five life skills that the LSAS is designed to assess are:
interacting with others, overcoming difficulties and solving problems, taking initiative, managing conflict,
and understanding and following instructions.
Data based on observers’ responses to items concerning these five simple skills can provide a wide range of
information, in a similar way to children’s developmental milestone assessments. They should not be seen
as five discrete assessments but rather as indicators of areas of competence. For example, an observer can
carry out a simple milestone assessment by asking a child to build a column of four play bricks. This is not
intended as an assessment of the child’s play-brick-column-building ability but rather to enable the observer
to assess the child’s fine motor skills and perception. The LSAS statements are often described as tips of the
iceberg indicating broader areas of competence. Each item (dimension) is assessed on a 5-point Likert scale:
1=does not yet do,2=does with lots of help,3=does with some help,4=does with a little help,5=does
independently. Numbers can be attached to the Likert points, as shown above, for processing. However,
when a simple scoring sheet is used, or when young people are assessed, we found it more effective not to
have the numbers on the sheet as this could create an examination or pass/fail perception (see Appendix).
As the LSAS was based on child and adolescent development together with age-appropriate life skills, it is
culture and program free.
Uses of the Life Skills Assessment Scale
The LSAS has multiple uses depending on the type of assessment that is required by the user. It can be used
to assess individual children, groups of children, and overall performance of programs or interventions. This
means that the most effective programs can be identified and offered to individuals or groups of children
and young people.
Individual young person assessment. An individual’s score can be compared to a normative score to
ascertain if she or he is functioning in line with the population norm, or below (one standard deviation or
more below the mean), or doing well (one standard deviation or more above the mean) in comparison with
young people of the same age.
Life skills profiles can be produced to assess current strengths and development needs, for example, a young
person may be able to take the initiative without help, but may need a lot of help in managing conflict
without becoming aggressive. The assessment can be used interactively as appropriate with that young
person individually and/or with carers, parents, teachers, and NGO staff to provide a program or
intervention designed specifically to improve that young person’s management of conflict without becoming
The effects of life skills programs or interventions on an individual can be assessed using the LSAS.
Individual scores at Time A can be compared with scores at Times B or C, to assess progress on one of the
five skills individually or on overall life skills. These results can be used to provide empirical evidence of
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Social Behavior and Personality: an international journal
progress and the assessor can then congratulate the individual on that progress, and/or can be used to
choose further interventions/programs to build on this achievement. Alternatively, reductions in scores at
Times B or C can be used as alerts that the current program or intervention is not meeting the needs of the
young person and the individual who is working with the young person needs to give further attention to
program/intervention selection.
An assessment based on the LSAS can be simply completed with a pen or pencil and the scoring sheet (see
Appendix). If computing facilities are available graph-type representations are easily produced. A sample
graph for an individual young person is shown in Figure 1.
Groups of young people or population assessment. The assessment can be used in a similar way for
groups of young people or for populations by combining scores as in the above description. Graph
representations can also be produced.
Outcome assessment and program comparison. A program or intervention can be evaluated through a
comparison of the progress of groups of young people over time to assess if their life skills have improved
and if the program or intervention is effective or ineffective.
The effects of the different programs on individual life skills can be assessed. In this assessment, programs’
strengths are highlighted and this enables the assessor to offer the most effective program according to the
needs of the young people. For example, a computer-skills program may encourage the young person’s
development of the life skill of taking initiative and solving problems, but may not contribute to the
development of conflict-management skills.
A comparison of available programs with each other is useful to assess which type of program is the most
effective for an individual young person in development both of overall life skills and of each specific life
skill. This may be particularly useful when programs are being set up and developed to ensure that
individual needs are met.
Who can use the Life Skills Assessment Scale?
Because of the simplicity of the assessment procedure, it can be used at various levels by any person
individually or by staff in organizations that provide interventions to disadvantaged young people. The data
can provide feedback to the young people themselves, and to their families. Other stakeholders who benefit
from feedback may include teachers, researchers, funding bodies, partner organizations, and policymaking
Impact of a Program on an Individual Young Person
The progress of Saanvi, who lived in institutional care is shown in Figure 1, at the time of entry into the
program (Time 1) and after attendance at daily evening sessions (Time 2). At Time 1, Saanvi scored poorly
for overall life skills compared with her peer group. After 6 weeks (Time 2), Saanvi showed an overall
significant increase in the score for life skills (1.4–2.6). However, Saanvi’s life-skill in interaction with others
had not changed, according to the LSAS. The staff member working with Saanvi arranged for her to attend a
program that had been shown by increases in the score for this skill in the LSAS to be successful at
improving the ability of the individual to interact with others. As similar graphs can be produced to
illustrate the impact and efficacy of whole programs, this can be valuable when a decision is being made
about which program(s) would meet specific needs of individuals or groups of young people.
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
Figure 1. Preprogram and postprogram scores of Saanvi, a young woman.
Ethical Considerations
All data collection took place during induction sessions that are a part of NGOs’ normal activities. Three of
the observers/raters were paid an honorarium of Rs1,000 (approximately £10/US$12) per day to cover
personal expenses.
Participants were 656 young people in two age groups 17, 18, and 19 years (n=378)and20,21,and22years
(n= 278), approximately equally gender divided (see Table 2). The makeup of the participant group was
designed to reflect the general population of disadvantaged young people in India. Although the majority of
participants were selected from an urban area, there was a mixture of rural and urban families, as rural
families are rapidly migrating to formal (buildings) and informal (tents, temporary shelters) urban
developments. Participants were from three groups: in formal education, not in a system, and in shelter
care. Formal education is a wide description that includes preuniversity college through to part-time
vocational training. Participants were in low cost or free courses, and came from poor socioeconomic areas,
including slums. The term not in a system refers to young people who are not registered as being in
education or formal employment, and includes young people who are street sellers, married and involved in
family care, or informal laborers. The shelter-care group included young people who are in, or have recently
left, shelter care, including orphanages, and those in conflict with the law. The figures in Table 2 are
approximate as some participants may belong to more than one group, for example, they may be on a
vocational course and living in a shelter or institution.
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Table 2. Demographic Characteristics of the Young People
None of the young people had previously taken part in an NGO program designed to enrich or ameliorate
the effects of adversity. Young people who opportunistically arrived at resource centers were recruited
before the programs began, and were told to come back in a few days time when an induction session would
be held before the programs started. The induction session was used to orientate the young person and
collect data. At the resource centers programs are provided, such as reading and writing, and using a
computer, and advice on vocational skills, money skills, and life skills, and the centers also serve as a safe
place to be during the day where semistructured interactions take place. It is normal practice to have an
orientation session before programs start to ensure that the young people’s needs will be met in the
proposed programs and that they are participating in the most appropriate programs for their needs.
We also arranged for observers to go to education establishments, shelters, villages, and slum communities.
We organized activities at which data could be gathered. The activities were a part of the normal work of the
participating NGO and often formed the preprogram introduction. Observation of activities to check that
programs meet the needs of the participating communities is usual practice for NGOs. Entry to programs
was open to all participants.
There were 13 adult observers comprising six men and seven women, some of whom came from
disadvantaged backgrounds themselves. They were all involved in NGO-type programs, but not at the
centers being used for the research and not in that geographic area. Observers had no knowledge of the
purpose of the study but were simply asked to observe an activity.
We agreed on a standard activity based on the host NGO induction session in Bengaluru, India. We formed
a steering group to establish the proportion of young people aged between 17 and 22 years needed to
represent the population of disadvantaged young people (see Participants section). Young people living in
shelter-type accommodation were offered a taster induction session that they could voluntarily join. During
the observations, up to 20 young people took part in any one session. After the nonparticipant observers had
assessed some sessions using the LSAS, they went to various locations where the sessions were organized.
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
All available participants took part in the sessions and were assessed. The observers found that the young
people did not generally exclude themselves from sessions. A pair of observers who did not communicate
with each other collected interrater reliability data (two groups with 24 young people in each) during a
session held at the same time for both groups. We also collected discriminant validity data during the
induction sessions, with 24 disadvantaged young people and 24 advantaged young people from high-
socioeconomic-level families in each of the two age groups. As it would not have been appropriate to offer
the advantaged group an NGO induction-type session in the format used with disadvantaged young people,
during these sessions the “advantaged” group took part in a football match. This activity was seen as
acceptable, as football is a game that crosses cultures and societies, and thus no group had an advantage. We
assessed reliability with a test and retest, with an interval of 14 days between the two tests.
Statistical Analysis
Participants in the validation study comprised 656 young people aged between 17 and 22 years (M=18.93,
SD = 1.64). As a visual inspection of histogram, boxplots, stem and leaf diagrams, and normality tests
suggested nonnormal distribution of data, we used nonparametric statistics. We calculated the mean,
standard deviation, and Cronbach’s alpha for the overall average scale score and for each item. Cronbach’s
alpha with item deleted was used to test if each item made an individual contribution to the overall score.
Mann-Whitney U and Wilcoxon W tests were used to test any differences between the two age groups of
17–19 years and 20–22 years. We also used the Mann-Whitney U test to assess gender differences within
age groups. Finally, we calculated interrater and test-retest reliability using the Ftest and Wilks’ Δ to test
differences, and to calculate discriminant validity.
Descriptive Statistics for the Life Skills Assessment Scale
Descriptive statistics (mean and standard deviation) were produced for the overall score for the LSAS and
for each LSAS item. The mean and standard deviation for the LSAS 8–16 years are included in Table 3 for
Table 3. Descriptive Statistics for the Life Skills Assessment Scale for 8–16 and 17–22 years
Note. LSAS = Life Skills Assessment Scale.
Data were analyzed to produce nonnormative scores (mean and standard deviation) for the two age groups
(see Table 3). The Mann-Whitney U and Wilcoxon W tests showed a significant difference between age
groups (z=-5.05,p< .001), with women (vs. men) scoring higher in the age group 17–19 years (p< .001).
There were no gender differences in the 20–22 age group.
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Reliability and Validity
The instrument showed excellent internal reliability (Cronbach’s α = .92), which was not improved by
removing individual items. Thus, we considered that the overall score (average of the five subscales) could
be used for remaining analyses. Interrater reliability was good (r=.76,p< .001) and test-retest reliability
was excellent (r=.95,p< .001; Koo & Li, 2016). Regarding discriminative validity, a significant difference
was found between the LSAS scores of the advantaged (vs. disadvantaged) groups = .18, p< .001),
indicating that the LSAS (17–22 years) can discriminate between advantaged and disadvantaged young
Statistical Properties of the Life Skills Assessment Scale
As descriptive statistics for the 17–19 and 20–22 age-group norms were similar to the norms for the 8-16
age group (see Table 3), the LSAS can be used seamlessly for practical everyday use with children and young
people aged from 8 to 22 years. Results showed good reliability and validity of the scale.
Practical Considerations When the Life Skills Assessment Scale is Being Used
As the LSAS is observer rated, there is a need for some observer interpretation regarding age
appropriateness and the amount of help needed to complete a task. As the statistical analysis indicated that
observers are generally able to do this reliably, the scale can be used with confidence. We also found this to
be the case for the original LSAS 8–16, which has now been used with disadvantaged children in many
countries in the developing world. If desired, an explanatory session can be held or role-play scenarios acted
out with new observers so that any questions about its administration can be raised. A free short web-based
induction is available.
Use of Normative Data from the Life Skills Assessment Scale
In practical use, if a single life skill is being assessed, an individual score can change only in units of 1, owing
to the scale structure. However, for multiple life skills assessments or assessment of multiple young people,
the normative data of M=2.7,SD = 0.74 can be used to make comparisons across time, groups, or
programs. For example, a movement of 1.0 for an individual life skill would indicate a clear improvement or
deterioration in the skill. For multiple life skills assessments or assessment of multiple young people
(perhaps if overall efficacy of a program is being considered), we would consider a figure of 0.74
(approximately one standard deviation) as indicating a significant change. We recommend that when the
LSAS is used for research, individual standard deviations are used to reliably assess precise change. The
distribution of women’s scores in the 17–19 years group (vs. men) showed higher scores. Although the
differences were modest and not relevant for practical use, this can be examined in future research.
Generalizability of the Life Skills Assessment Scale
Data for this study were gathered solely from disadvantaged young people in Bengaluru and surrounding
areas in India. Although this is rapidly becoming an area with an urban population, because of economic
migration locally and nationally, the young people came from a mixture of urban and rural backgrounds. We
suggest that, as this scale is development-centered, it can be used worldwide with disadvantaged children or
young people who are taking part in life-skills programs, as has been the case for the LSAS 8–16 years in
various developing countries. All children negotiate the same developmental milestones and need an
environment that enables them to do so. In all cultures, adversity and unmet basic needs result in similar
developmental problems that can continue into adulthood (Hoddinott et al., 2013). However, as established
life-skills assessment instruments (Nollan, Horn, Downs, Pecora, & Bressani, 2002) were developed for use
in countries in the Western world, they are not designed to assess the impact of severe adversity, for
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
example, severe poverty and malnutrition in developing countries. Although we cannot guarantee that the
norms will be exactly the same in all developing countries, we expect them to be very similar. This has been
confirmed by the use already made of the LSAS 8–16, as confirmed by the not-for-profit organization,
HundrED, whose goal is to help improve education by encouraging pedagogically sound, ambitious
innovations to spread across the world (, personal communication, November 9, 2019).
Research is currently underway by the authors to establish confirmation of the accuracy of the age norms in
other developing countries.
Our results showed that the LSAS is a simple, quick, yet reliable and valid instrument for use to measure life
skills of disadvantaged young people in developing countries. These data can be added to the reliable and
valid LSAS 8–16 to make a seamless assessment from 8–22 years. We believe that the LSAS is a unique
standardized life skills measure for this age group.
The authors acknowledge the tireless contributions of Kanthi Krishnamurthy, Annie Jacob, Khushboo
Kumari, Sheetal Lydia Prasad, and Chandrasekhar.
No author has any financial or similar interest in connection with this study, and all authors contributed
voluntarily. There was no specific funding for the study and there is no charge for the assessment sheet.
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
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Social Behavior and Personality: an international journal
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... Over 40% of India's population is below the age of 18 years and is the world's largest young population, of which 21% are adolescents. The adversities these children face are poverty, poor access to healthcare services and unsafe environment (Pearson et al., 2020;Sivagurunathan, 2015). It also includes familial and communal violence, parental abuse and neglect in the background of parental alcoholism (Jose & Cherayi, 2020). ...
... An attempt to elucidate these questions leads to examine the adolescents' marginality as involuntary positions and conditions because their family, groups and community at the margins of social, political, economic, ecological and biophysical systems prevent them from accessing resources, assets and services and restrain their freedom of choice, preventing the development of their capabilities and eventually causing poverty (Gatzweiler, 2011). Marginality presents the background for failure to thrive since it indicates poverty and consequent deprivation that continue to define poor health and nutritional status (Pearson et al., 2020) and increased rate of psychopathology . ...
... Studies estimate about 59% of the children under 5 years of age are stunted (Naandi Foundation, 2011) and 48% as official estimates (IIPS, 2017). Save the Children reports that number of children experiencing adversity has been on increase as they live in conflict areas and are members of displaced populations (Pearson et al., 2020). Adolescents facing adversity in India tend to cluster around lower socio-economic group, lower caste groups in villages and urban slums along with their families, communities and social groups and these locations are at the social margins (Cherayi, 2019;Jose, 2017;Varghese, 2011). ...
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All human beings are inherently motivated for self-improvement and growth. People tend to respond diversely in the face of adversity, from succumbing and recovering to remaining resilient and thrive. The present narrative review is not an exhaustive review of the existing literature on thriving but is an informed effort to add to the adolescent thriving discourse within the conceptual background of social marginality in the Indian context. This review thus defines and summarizes perspectives, determinants and assessment of thriving. It also discusses the interaction between social marginality, adversity and adolescences. Finally, this review discusses the opportunities opened by the new National Education Policy 2020 for thriving interventions and research.
... Controlled allocation to groups was agreed on the basis that more people applied for the program than could be offered places immediately. The program and the use of the Life Skills Assessment Scale (LSAS; Kennedy et al., 2014;Pearson et al., 2020) had already been established at the facility. ...
... The independent variable was group (intervention or wait-list control). The dependent variable was observer-rated life skills, which we assessed using the LSAS (Pearson et al., 2020), as the only validated measure available for this population. On arrival, participants were allocated to one of the groups. ...
... The LSAS (Pearson et al., 2020) is a 5-item observer-rated measure of life skills, designed to be used with children, adolescents, and young people in low socioeconomic communities. Items are rated on a 5-point Likert scale (1 = does not yet do, 2 = does with lots of help, 3 = does with some help, 4 = does with a little help, 5 = does independently), and are summed to give a total score. ...
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Adolescence may be a window of opportunity to attenuate the effects of early social adversity, which impedes cognitive, emotional, and social development, and increases risk of psychopathology into adulthood. We ran a pragmatic randomized controlled trial to assess the impact of a brief intervention designed to facilitate life skills for psychosocial competence. Socially disadvantaged young people living in South India who had experienced early adversity ( N = 645; age range = 17–22 years) participated in the intervention or were assigned to a wait-list control group. The intervention led to large differences in life skills between the two groups. This brief, scalable intervention can be made available to address the impact of early social adversity on young people's development.
... Research demonstrates that extreme poverty and failure to thrive are intrinsically linked and further give rise to emotion regulation difficulties such as being highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing high anxiety levels among individuals (Pearson et al., 2020). The political and educational leaders in New Delhi recognized these contextual challenges and the needs of children. ...
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The timeframe for achieving the Sustainable Development Goals (SDGs) is tight, and the world also faces the debilitating consequences of COVID-19. NISSEM Global Briefs aim to show how SDG Target 4.7 themes and social and emotional learning (SEL) can be embedded in education policies, programs, curricula, materials, and practice to help make progress towards sustainable development. This third volume of NISSEM Global Briefs focuses on social and emotional learning in context and includes 13 papers by a total of 60 contributors. With a preface by Stefania Giannini, Assistant
... Research demonstrates that extreme poverty and failure to thrive are intrinsically linked and further give rise to emotion regulation difficulties such as being highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing high anxiety levels among individuals (Pearson et al., 2020). The political and educational leaders in New Delhi recognized these contextual challenges and the needs of children. ...
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Social and emotional learning (SEL) has been on the rise in recent decades in various countries and cultures across the globe. Its rise is not only a reflection of the increasing social and emotional challenges that children and young people are facing in the twenty first century and the need for education to address such issues, but also a result of the increasing evidence that SEL has social, emotional and academic benefits. Universal, school-based SEL has been found to be particularly helpful to support the social and emotional needs of vulnerable and marginalized children. In this chapter, we argue that SEL as a universal, inclusive approach is very well placed to effectively address the social and emotional needs of vulnerable and marginalized children and young people, both to promote their positive development and to prevent social, emotional and behavior difficulties. Universal interventions, however, may need to be complemented by additional targeted interventions. Integrated multi-tiered interventions within an inclusive whole school approach will ensure that vulnerable and marginalized children are more likely to be reached and supported without the risk of labelling and stigmatization.
... Research demonstrates that extreme poverty and failure to thrive are intrinsically linked and further give rise to emotion regulation difficulties such as being highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing high anxiety levels among individuals (Pearson et al., 2020). The political and educational leaders in New Delhi recognized these contextual challenges and the needs of children. ...
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Despite increasing attention to the relationship between children’s socio-emotional learning (SEL), mental health and well-being and their education in the Global South, less attention has been given to the implications for girls’ education and gender equality specifically. In this paper, we start to address this gap drawing on evidence from the RISE Ethiopia research study. To set the context, we first consider the gendered inequalities that impact girls’ education and gender equality in Ethiopia more generally and how these inequalities have been exacerbated during the COVID-19 pandemic. Against this backdrop, we take account of the potential benefits that strengthening girls’ SEL may have for their education, mental health and well-being. Second, drawing on quantitative and qualitative evidence from our RISE Ethiopia research both prior to, and during the COVID-19 pandemic, we explore the factors that may have influenced girls’ SEL during this time, changes to girls’ SEL over the course of the COVID-19 school closures, and the association between girls’ SEL, their academic learning and mental health and well-being once schools reopened. Finally, reflecting on the evidence, we outline potential opportunities for strengthening girls’ SEL, mental health and well-being in school through girls’ clubs and other means.
... and inter-rater reliability. The scale was standardized for three age groups, namely 8-10 years, 11-13 years, and 14-16 years (Kennedy et al., 2014;Pearson et al., 2020). ...
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The present study examines the effectiveness of an After-School Life Skills (ASLS) intervention to improve the life skills of 110 students from socially disadvantaged backgrounds at public schools of urban Bangalore in south India. These students completed ASLS intervention from 2014 to 2018 during which the life skills were assessed on a yearly interval and the data were analyzed using repeated measure ANOVA. The results show that ASLS intervention significantly improved the students’ life skills. Post hoc comparisons at time 1 shows that young students who participated in ASLS intervention significantly improved their life skills over the 4 years’ time, although no significant variances were observed between measurement periods. The overall effect was found to be significant in improving the life skills, which shows that integrating life skills education in the school curriculum is critical and a timely need.
... Items were developed using focus groups to operationalise the ten life skills identified by the World Health Organisation. The resulting 5-item scale has now been validated for different age groups (Kennedy et al., 2014;Pearson et al., 2020) Dr Fiona Kennedy, Dr David Pearson, Dr Katherine Newman-Taylor, Suchetha Bhat There is now overwhelming evidence that severe social adversity is associated with disrupted development and mental health issues. ...
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This article summarises all of our work in India over the last 16 years, including program development, outcome measurement, randomised pragmatic trials and social influencing
... Research demonstrates that extreme poverty and failure to thrive are intrinsically linked and further give rise to emotion regulation difficulties such as being highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing high anxiety levels among individuals (Pearson et al., 2020). The political and educational leaders in New Delhi recognized these contextual challenges and the needs of children. ...
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In 2018, the Happiness Curriculum was launched as a daily 45-minute class, six days a week, for over 800,000 students from nursery to grade 8 in 1,024 government schools in New Delhi, India. This paper discusses the Happiness Curriculum as an innovative large-scale intervention aimed at building social and emotional skills of children and reimagining the purpose of education. It provides an overview of the Happiness Curriculum and the pedagogical practices adopted by teachers to implement this notable intervention. The components of the curriculum – mindfulness, stories and activities, and expression – are described with examples to demonstrate the process of teaching and learning social and emotional skills focused on promoting holistic development of students. We argue that the Happiness Curriculum enables students to become aware of different aspects of oneself, develop the ability to understand and respond to expectations in relationships empathetically, and inculcate human values to make meaningful contributions to society. We reflect on how the curriculum has been contextualized and culturally adapted to understand and respond to the needs of children from disadvantaged backgrounds and refer to parallel education reforms that support its effective implementation in this context. Finally, we emphasize the need to adopt an intersectional and equity lens to social and emotional learning that can nurture and enhance children’s happiness and well-being.
... Research demonstrates that extreme poverty and failure to thrive are intrinsically linked and further give rise to emotion regulation difficulties such as being highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing high anxiety levels among individuals (Pearson et al., 2020). The political and educational leaders in New Delhi recognized these contextual challenges and the needs of children. ...
... Research demonstrates that extreme poverty and failure to thrive are intrinsically linked and further give rise to emotion regulation difficulties such as being highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing high anxiety levels among individuals (Pearson et al., 2020). The political and educational leaders in New Delhi recognized these contextual challenges and the needs of children. ...
Full-text available
The 4th Industrial Revolution (IR) is disrupting almost every industry across the globe. Characterized as ‘a fusion of technologies,’ the 4th IR is blurring the line between physical and digital spaces and influencing the rapid transformation of business and government systems with the potential to improve the quality of our life, including educational opportunities (Schwab, 2016). This paper discusses challenges of the 4th IR in four sub-Saharan African countries – Burkina Faso, South Africa, Togo, and Uganda – as they relate to the skills that cannot be replaced by robots and machinesand the importance of social and emotional learning skills. The premise of this paper is that SEL can help young people respond to the challenges and opportunities of the 4th IR even in countries that are less technologically advanced and might seem weakly influenced or uninfluenced by it. It concludes with implications for educational materials, in particular the use of online resources and social media as a fast-growing method for providing information and training, and on what needs to be considered for designing educational materials in the post-COVID era.
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This book offers timely and necessary help for clinicians, researchers and students who are not specialists in the field of dissociation to improve their understanding of the wide range dissociative symptoms and how to treat them - Arnoud Arntz, from the foreword
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Adversity, including malnutrition, has had irrefutable effects on child development and mental health. India, for example, has approximately 160 million children in poverty: The growth of up to 59% of rural and 48% of all children is stunted. Hundreds of thousands of nongovernmental organizations (NGOs) work with these disadvantaged children to increase their life skills and ameliorate effects of adversity. Yet a simple effective measure of program impact has remained elusive. We used observational data from 1,136 disadvantaged children aged 8 to 16 years to construct a simple 5-item impact assessment scale. Although the scale was developed in India, we envisage that it could be used with disadvantaged children worldwide.
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Background: Despite widespread acceptance of the 'biopsychosocial model', the aetiology of mental health problems has provoked debate amongst researchers and practitioners for decades. The role of psychological factors in the development of mental health problems remains particularly contentious, and to date there has not been a large enough dataset to conduct the necessary multivariate analysis of whether psychological factors influence, or are influenced by, mental health. This study reports on the first empirical, multivariate, test of the relationships between the key elements of the biospychosocial model of mental ill-health. Methods and findings: Participants were 32,827 (age 18-85 years) self-selected respondents from the general population who completed an open-access online battery of questionnaires hosted by the BBC. An initial confirmatory factor analysis was performed to assess the adequacy of the proposed factor structure and the relationships between latent and measured variables. The predictive path model was then tested whereby the latent variables of psychological processes were positioned as mediating between the causal latent variables (biological, social and circumstantial) and the outcome latent variables of mental health problems and well-being. This revealed an excellent fit to the data, S-B χ(2) (3199, N = 23,397) = 126654.8, p<.001; RCFI = .97; RMSEA = .04 (.038-.039). As hypothesised, a family history of mental health difficulties, social deprivation, and traumatic or abusive life-experiences all strongly predicted higher levels of anxiety and depression. However, these relationships were strongly mediated by psychological processes; specifically lack of adaptive coping, rumination and self-blame. Conclusion: These results support a significant revision of the biopsychosocial model, as psychological processes determine the causal impact of biological, social, and circumstantial risk factors on mental health. This has clear implications for policy, education and clinical practice as psychological processes such as rumination and self-blame are amenable to evidence-based psychological therapies.
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Growth failure is associated with adverse consequences, but studies need to control adequately for confounding. We related height-for-age z scores (HAZs) and stunting at age 24 mo to adult human capital, marriage, fertility, health, and economic outcomes. In 2002-2004, we collected data from 1338 Guatemalan adults (aged 25-42 y) who were studied as children in 1969-1977. We used instrumental variable regression to correct for estimation bias and adjusted for potentially confounding factors. A 1-SD increase in HAZ was associated with more schooling (0.78 grades) and higher test scores for reading and nonverbal cognitive skills (0.28 and 0.25 SDs, respectively), characteristics of marriage partners (1.39 y older, 1.02 grade more schooling, and 1.01 cm taller) and, for women, a higher age at first birth (0.77 y) and fewer number of pregnancies and children (0.63 and 0.43, respectively). A 1-SD increase in HAZ was associated with increased household per capita expenditure (21%) and a lower probability of living in poverty (10 percentage points). Conversely, being stunted at 2 y was associated with less schooling, a lower test performance, a lower household per capita expenditure, and an increased probability of living in poverty. For women, stunting was associated with a lower age at first birth and higher number of pregnancies and children. There was little relation between either HAZ or stunting and adult health. Growth failure in early life has profound adverse consequences over the life course on human, social, and economic capital.
Children with very low weight for age or height and those who do not maintain an appropriate growth pattern may have failure to thrive (FTT), also known as weight faltering. If confirmed by repeated valid measurements, FTT should prompt a search for causes of undernutrition, including neglect, family food insecurity, and underlying medical conditions. Inadequate caloric intake is the most common cause of FTT, but inadequate nutrient absorption or increased metabolism is also possible. Difficulty attaining or maintaining appropriate weight is the first indication of FTT, and sustained undernutrition can impede appropriate height, head circumference, and the development of cognitive skills or immune function in extreme cases. Early identification and management of the issues causing undernutrition are critical. In most cases, an appropriate growth velocity can be established with outpatient management based on proper nutrition and family support. Primary care physicians can effectively treat most children with FTT, and subspecialist consultation or hospitalization is rarely indicated.
Objective: Intraclass correlation coefficient (ICC) is a widely used reliability index in test-retest, intrarater, and interrater reliability analyses. This article introduces the basic concept of ICC in the content of reliability analysis. Discussion for researchers: There are 10 forms of ICCs. Because each form involves distinct assumptions in their calculation and will lead to different interpretations, researchers should explicitly specify the ICC form they used in their calculation. A thorough review of the research design is needed in selecting the appropriate form of ICC to evaluate reliability. The best practice of reporting ICC should include software information, "model," "type," and "definition" selections. Discussion for readers: When coming across an article that includes ICC, readers should first check whether information about the ICC form has been reported and if an appropriate ICC form was used. Based on the 95% confident interval of the ICC estimate, values less than 0.5, between 0.5 and 0.75, between 0.75 and 0.9, and greater than 0.90 are indicative of poor, moderate, good, and excellent reliability, respectively. Conclusion: This article provides a practical guideline for clinical researchers to choose the correct form of ICC and suggests the best practice of reporting ICC parameters in scientific publications. This article also gives readers an appreciation for what to look for when coming across ICC while reading an article.
Failure to thrive (FTT) is a common problem that occurs when caloric intake is insufficient to maintain growth. For the majority of children it can be reversed with behavioral modifications and increased caloric provisions. In a minority of cases, FTT is the symptom of underlying organic disease. Routine evaluation with laboratory tests, imagining studies, and endoscopy results in an etiology of FTT in <1.4% of cases, and when investigations are positive the organic etiology is most often suspected based on history and/or physical examination. Therefore, these evaluations should be limited to those children with clear symptoms of organic disease and those who fail to grow with behavioral and nutritional interventions. [Pediatr Ann. 2016;45(2):e46-e49.].
Although the world witnessed an unprecedented pace of poverty reduction over the last decades, reducing the number of people living in extreme poverty by more than 700 million, approximately 1.2 billion people remained entrenched in destitution in 2010. 1 In order to leverage developing country efforts and galvanize the international development community to exert concerted effort to end extreme poverty, the World Bank has established the twin goals of ending extreme poverty by 2030 and promoting shared prosperity by fostering income growth of the bottom 40 percent of the population in every country. Ending extreme poverty in just one generation is a formidable challenge by all accounts that requires a thorough understanding of the state of the poor.
After decades of ignoring or minimising the prevalence and effects of negative events in childhood, researchers have recently established that a broad range of adverse childhood events are significant risk factors for most mental health problems, including psychosis. Researchers are now investigating the biological and psychological mechanisms involved. In addition to the development of a traumagenic neurodevelopmental model for psychosis, the exploration of a range of psychological processes, including attachment and dissociation, is shedding light on the specific aetiologies of discrete phenomena such as hallucinations and delusions. It is argued that the theoretical, clinical and primary prevention implications of our belated focus on childhood are profound.