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

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.