A systematic review of observational and report-based measures of caregiver sensitivity: A Latin American perspective

Abstract

Sensitivity is a cornerstone of early childhood mental health; however, its measurement relies heavily on tools developed in English-speaking, high-resource contexts. This systematic review identified observational and report-based instruments used to assess sensitivity in caregivers of children aged 0–6 years. It evaluated the methodological robustness and usability of these instruments within Latin American contexts. Following a systematic search in Web of Science, Scopus, PsycInfo, and Redalyc, 732 eligible studies were identified. Based on a frequency-of-use threshold, 16 instruments (14 observational and 2 report-based) represented across 616 papers were selected for in-depth evaluation. Measures were coded for theoretical alignment with Ainsworth's sensitivity definition, psychometric evidence, and usability—specifically training accessibility, administration complexity, and evidence of use with diverse Latin American populations (e.g., caregivers in rural settings or with lower educational levels). Results revealed that only a minority of measures adhered explicitly to Ainsworth's original definition. Most instruments prioritized warmth and positive affect, potentially leading to cross-cultural underdetection in contexts where responsiveness is expressed through proximity and routine-based care. While observational tools predominated, report-based measures showed limited validation and minimal regional use. These findings highlight the urgent need for culturally grounded validation and the development of accessible training programs for the region.