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Kaltsa M, Babacheva E, Fotiadou G, Goutsiou E, Kantziou K, Nicolaidis K, Soubasi V. Early cognitive assessment in premature infants: the discriminatory value of eye-tracking vs. Bayley Scales. Front Psychol 2024; 15:1384486. [PMID: 38957884 PMCID: PMC11217545 DOI: 10.3389/fpsyg.2024.1384486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/23/2024] [Indexed: 07/04/2024] Open
Abstract
Introduction The testing of visuocognitive development in preterm infants shows strong interactions between perinatal characteristics and cognition, learning and overall neurodevelopment evolution. The assessment of anticipatory gaze data of object-location bindings via eye-tracking can predict the neurodevelopment of preterm infants at the age of 3 years; little is known, however, about the early cognitive function and its assessment methods during the first year of life. Methods The current study presents data from a novel assessment tool, a Delayed Match Retrieval (DMR) paradigm via eye-tracking was used to measure visual working memory (VWM) and attention skills. The eye-tracking task that was designed to measure infants' ability to actively localize objects and to make online predictions of object-location bindings. 63 infants participated in the study, 39 preterm infants and 24 healthy full term infants - at a corrected age of 8-9 months for premature infants and similar chronological age for full term infants. Infants were also administered the Bayley Scales of Infant and Toddler Development. Results The analysis of the Bayley scores showed no significant difference between the two groups while the eye-tracking data showed a significant group effect on all measurements. Moreover, preterm infants' VWM performance was significantly lower than full term's. Birth weight affected the gaze time on all Areas Of Interest (AOIs), overall VWM performance and the scores at the Cognitive Bayley subscale. Furthermore, preterm infants with fetal growth restriction (FGR) showed significant performance effects in the eye-tracking measurements but not on their Bayley scores verifying the high discriminatory value of the eye gaze data. Conclusion Visual working memory and attention as measured via eye-tracking is a non-intrusive, painless, short duration procedure (approx. 4-min) was found to be a significant tool for identifying prematurity and FGR effects on the development of cognition during the first year of life. Bayley Scales alone may not pick up these deficits. Identifying tools for early neurodevelopmental assessments and cognitive function is important in order to enable earlier support and intervention in the vulnerable group of premature infants, given the associations between foundational executive functional skills and later cognitive and academic ability.
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Affiliation(s)
- Maria Kaltsa
- Language Development Lab, School of English, Department of Theoretical and Applied Linguistics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evgenia Babacheva
- 2 Department of Neonatology and NICU, School of Medicine, General Hospital of Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Fotiadou
- LingLab, School of Philology, Department of Linguistics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evanthia Goutsiou
- 2 Department of Neonatology and NICU, School of Medicine, General Hospital of Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Kantziou
- 1 Neonatal Department and NICU, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Nicolaidis
- Phonetics Laboratory, School of English, Department of Theoretical and Applied Linguistics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Soubasi
- 2 Department of Neonatology and NICU, School of Medicine, General Hospital of Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Fleurkens-Peeters MJ, Zijlmans WC, Akkermans RP, Sanden MWNVD, Janssen AJ. The United States reference values of the Bayley III motor scale are suitable in Suriname. Infant Behav Dev 2024; 74:101922. [PMID: 38219575 DOI: 10.1016/j.infbeh.2024.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
To determine if the United States reference values of the Bayley Scales of Infant and Toddler Development, version III motor scale are suitable for Surinamese infants, we assessed 151 healthy infants at 3, 12, 24 and 36 months of age. The mean fine motor, gross motor, and composite scores of the total group did not significantly differ from the US norms, although some significant but not clinically relevant differences were found (lower fine motor scores at 12 months, lower gross motor and total composite scores at 24 months, and higher scores for gross motor and composite scores at 3 months).
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Affiliation(s)
- Maria Jaj Fleurkens-Peeters
- Academic Hospital Paramaribo, Department of Rehabilitation, Pediatric Physical Therapy, Paramaribo, Suriname; Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands
| | - Wilco Cwr Zijlmans
- Diakonessenhuis Hospital, Department of Pediatrics, Paramaribo, Suriname; Faculty of Medicine, Discipline of Pediatrics, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Reinier P Akkermans
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands; Radboud university medical center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, the Netherlands
| | - Maria Wg Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands; Radboud University Medical Center, Amalia Children's Hospital, Department of Rehabilitation, Pediatric Physical Therapy, Nijmegen, the Netherlands
| | - Anjo Jwm Janssen
- Radboud University Medical Center, Amalia Children's Hospital, Department of Rehabilitation, Pediatric Physical Therapy, Nijmegen, the Netherlands.
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Shorey S, Chong YS, Shi L, Chua JS, Mathews J, Lim SH, Du R, Chan YH, Tan TC, Chee C, Law E. Evaluating the Effects of the Supportive Parenting App on Infant Developmental Outcomes: Longitudinal Study. JMIR Mhealth Uhealth 2023; 11:e43885. [PMID: 36811952 PMCID: PMC9996416 DOI: 10.2196/43885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/04/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies have investigated the various effects of parenting on infant developmental outcomes. In particular, parental stress and social support have been found to significantly affect the growth of the newborn. Although many parents today use mobile apps to obtain more support in parenting and perinatal care, few studies have examined how these apps could affect infant development. OBJECTIVE This study aimed to examine the effectiveness of the Supportive Parenting App (SPA) in improving infant developmental outcomes during the perinatal period. METHODS This study adopted a 2-group parallel prospective longitudinal design and recruited 200 infants and their parents (N=400 mothers and fathers). The parents were recruited at 24 weeks of gestation for a randomized controlled trial conducted from February 2020 to July 2022. They were randomly allocated to either the intervention or control group. The infant outcome measures included cognition, language, motor skills, and social-emotional development. Data were collected from the infants when they were aged 2, 4, 6, 9, and 12 months. Linear and modified Poisson regressions were used to analyze the data to examine between- and within-group changes. RESULTS At 9 and 12 months post partum, the infants in the intervention group were found to have better communication and language skills than those in the control group. An analysis of motor development revealed that a larger proportion of the infants in the control group fell under the at-risk category, where they scored approximately 2 SDs below the normative scores. The control group infants scored higher on the problem solving domain at 6 months post partum. However, at 12 months postpartum, the infants in the intervention group performed better on cognitive tasks than those in the control group. Despite not being statistically significant, the intervention group infants were found to have consistently scored better on the social components of the questionnaires than the control group infants. CONCLUSIONS Overall, the infants whose parents had received the SPA intervention tended to fare better in most developmental outcome measures than those whose parents had received standard care only. The findings of this study suggest that the SPA intervention exerted positive effects on the communication, cognition, motor, and socioemotional development of the infants. Further research is needed to improve the content and support provided by the intervention to maximize the benefits gained by infants and their parents. TRIAL REGISTRATION ClinicalTrials.gov NCT04706442; https://clinicaltrials.gov/ct2/show/NCT04706442.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Yap Seng Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Luming Shi
- Singapore Clinical Research Institute, Singapore, Singapore
| | - Jing Shi Chua
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
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- Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jancy Mathews
- National University Polyclinics, Singapore, Singapore
| | | | - Ruochen Du
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Thiam Chye Tan
- Mount Elizabeth Novena Specialist Centre, Singapore, Singapore
| | | | - Evelyn Law
- National University Hospital, Singapore, Singapore
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Rasheed MA, Kvestad I, Shaheen F, Memon U, Strand TA. The predictive validity of Bayley Scales of Infant and Toddler Development-III at 2 years for later general abilities: Findings from a rural, disadvantaged cohort in Pakistan. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001485. [PMID: 36962863 PMCID: PMC10021670 DOI: 10.1371/journal.pgph.0001485] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 12/11/2022] [Indexed: 01/15/2023]
Abstract
Using data from a rural cohort in Pakistan (N = 1298), the study examined the predictive validity of the Bayley Scales of Infant and Toddler Development (BSID) 3rd edition on later tests of general abilities. The BSID III subscales (cognitive, language and motor) were administered at 2 years; general ability was assessed using the Verbal, Performance and Full-Scale score from the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) III at 4 years, and the Fluid Reasoning Index (FRI) from the Wechsler Intelligence Scale for Children (WISC) V at 8 years. The combined BSID subscales explained 15% of the variation of the WPPSI III full scale, 16% of the Verbal scale, 7% of the Performance scale and 1% of the FRI. BSID III scores at 24 months should be used with caution to predict future intellectual abilities.
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Affiliation(s)
- Muneera A Rasheed
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Ingrid Kvestad
- Regional Centre for Child Mental Health and Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Innlandet Hospital Trust, Lillehammer, Norway
| | - Fariha Shaheen
- Department of Paediatrics & Child Health, The Aga Khan University, Karachi, Pakistan
| | - Uzma Memon
- People's Primary Healthcare Initiative, Hyderabad, Pakistan
| | - Tor A Strand
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Innlandet Hospital Trust, Lillehammer, Norway
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Double-blinded randomized controlled trial of optimizing nutrition in preterm very low birth weight infants: Bayley scores at 18-38 months of age. J Perinatol 2023; 43:81-85. [PMID: 36473929 DOI: 10.1038/s41372-022-01572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Human milk supplementation for preterm infants in the neonatal intensive care unit (NICU) can be based on optimized nutrition (feeding adjustments based on growth and measurements of serum nutrients) or individualized nutrition (measurements of macronutrients in mother's own milk). OBJECTIVE To compare Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) at 18-38mo adjusted age in infants who had been randomly allocated to individualized+optimized nutrition (experimental group) vs optimized nutrition alone (control) in the NICU. METHODS Double-blinded randomized controlled trial in neonates <29wks gestational age (GA) and those <34wks GA and small for GA. RESULTS Bayley scores were assessed in 91/114 (80%) infants. The two study groups had similar frequencies of low cognitive, motor and language Bayley scores and similar age-adjusted Bayley scores in bivariate and multivariate analyses. CONCLUSIONS The type of human milk supplementation provided had no significant effect on Bayley scores assessed at 18-38mo. TRIAL REGISTRATION This randomized controlled trial was registered at ClinicalTrials.gov NCT02372136.
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Díaz-Gordon P, Naranjo-García AS, Gómez-Díaz LA, Gómez-Díaz OL, Sandoval-Gómez CC, Abreu-Peralta P, Arias-Chacón GL. Más allá de los límites de la disciplina con niños prematuros: una reflexión holística. MEDUNAB 2022. [DOI: 10.29375/01237047.4104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introducción. En este artículo se presenta una reflexión sobre la necesidad de tener una visión holística en la problemática de la prematurez, para que los equipos del área de salud puedan tener una comprensión de la multiplicidad de factores presentes en el parto prematuro, y sus consecuencias para el menor, la madre, los familiares y el personal de salud involucrado. Tema de reflexión. El tema se sustenta en dos investigaciones realizadas con las madres, los padres y los niños beneficiarios del Programa Madre Canguro en un hospital del Estado, en dos momentos, 2012 y 2014, con algunos de los autores del presente artículo. Conclusiones. Además de la revisión de la literatura científica relacionada con el tema y la problemática, se concluye que, bajo una mirada holística, se comprende de manera integral la problemática y se propicia una mejor comunicación con los padres; con el equipo de la atención en salud, se logra un manejo transdisciplinario, superando los objetos de estudios aislados. Se da así un abordaje integrador y significativo en la cotidianidad de cada actor, desde la piel, con el Programa Madre Canguro, hasta la racionalidad de la ciencia.
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Pavlova P, Maksimov D, Chegodaev D, Kiselev S. A psychometric study of the Russian-language version of the “Bayley Scales of Infant and Toddler Development–third edition”: An assessment of reliability and validity. Front Psychol 2022; 13:961567. [PMID: 36118487 PMCID: PMC9478792 DOI: 10.3389/fpsyg.2022.961567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe Bayley Scales of Infant and Toddler Development–third edition (Bayley-III) is one of the most widely used tools for assessing child development, and adapted versions of this instrument have been successfully used in many countries. No comprehensive psychometric studies of the Bayley-III have yet been performed in Russia.Materials and methodsThis psychometric study was part of the longitudinal study conducted by the Ural Federal University in 2016–2020. Within the project, the original Bayley-III manual was translated into Russian and then used in a cohort of 333 infants to assess cognition, expressive/receptive communication, and fine/gross motor skills. For the purpose of psychometric analysis, we selected the data for four age groups of children from the longitudinal study database: 4–6 months (N = 149), 10 months (N = 138), 15 months (N = 151), and 24 months (N = 124). The development scores of the sample children were compared with the original Bayley-III norms in each age strata separately. Reliability and validity of the translated instrument were examined using correlation analysis, tests of internal consistency, and confirmatory factor analysis (CFA).ResultsThe average scaled scores of the examined children were generally comparable with the original (US) Bayley-III norms, with the exception of those older than 1 year, who demonstrated 1.2–1.9 points better performance in cognitive development and gross motor skills and 0.9–2.6 points lower performance in expressive communication. The correlation of both raw and scaled scores between different scales was low to moderate in all age groups (Spearman’s ρ mostly within the range of 0.3–0.6; p < 0.001 for all pairwise correlations). Internal consistency tests confirmed high reliability of the translated instrument (Cronbach’s α = 0.74–0.87, McDonald’s ω = 0.79–0.89). CFA demonstrated a good fit of the three-factor model (cognitive, communicative, and motor components) in all age strata.ConclusionThe Russian version of the Bayley-III proved to be a psychometrically valid and reliable tool for assessing child development, at least in a research context. The development of the examined children was close to the original US norms, with some deviation in cognitive, gross motor, and expressive communication scores mostly in older children, which could be attributed to the biased sample.
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Affiliation(s)
- Polina Pavlova
- Laboratory for Brain and Neurocognitive Development, Department of Psychology, Ural Institute of Humanities, Ural Federal University, Yekaterinburg, Russia
- *Correspondence: Polina Pavlova,
| | - Dmitry Maksimov
- Laboratory for Brain and Neurocognitive Development, Department of Psychology, Ural Institute of Humanities, Ural Federal University, Yekaterinburg, Russia
- Department of Preventive and Family Medicine, Ural State Medical University, Yekaterinburg, Russia
| | - Dmitry Chegodaev
- Laboratory for Brain and Neurocognitive Development, Department of Psychology, Ural Institute of Humanities, Ural Federal University, Yekaterinburg, Russia
| | - Sergey Kiselev
- Laboratory for Brain and Neurocognitive Development, Department of Psychology, Ural Institute of Humanities, Ural Federal University, Yekaterinburg, Russia
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Impact of Differing Language Background Exposures on Bayley-III Language Assessment in a National Cohort of Children Born Less than 29 Weeks' Gestation. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9071048. [PMID: 35884032 PMCID: PMC9316512 DOI: 10.3390/children9071048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/25/2022] [Accepted: 07/09/2022] [Indexed: 11/16/2022]
Abstract
Preterm infants are at risk for adverse neurodevelopmental outcomes, especially language delay. Preterm infants < 29 weeks’ gestational age, cared for in Canadian Neonatal Follow-Up Network affiliated hospitals, were assessed between 18 to 21 months corrected age using the Bayley-III. Bayley-III Language Composite Scores were compared using univariate and multivariate analyses for children in three primary language groups: English, French and other. 6146 children were included. The primary language at home was English, French or another language for 3708 children (60%), 1312 children (21%) and 1126 children (18%), respectively, and overall, 44% were exposed to two or more languages at home. Univariate analysis showed that primary language was associated with lower Bayley-III Language scores; however, multivariate analyses demonstrated that neither primary language nor language of administration were significantly associated with lower language scores when adjusted for gestational age, other developmental delays and sociodemographic factors, but multiple language exposure was. Sociodemographic and other factors are more important in determining language development than primary language at home. Further studies are needed to examine the association between exposure to multiple languages and lower Bayley-III language scores in preterm infants.
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Kvestad I, Hysing M, Ranjitkar S, Shrestha M, Ulak M, Chandyo RK, Strand TA. The stability of the Bayley scales in early childhood and its relationship with future intellectual abilities in a low to middle income country. Early Hum Dev 2022; 170:105610. [PMID: 35728398 DOI: 10.1016/j.earlhumdev.2022.105610] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/11/2021] [Accepted: 06/11/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Bayley Scales of Infant and Toddler Development is widely used worldwide. The objective of the current study was to measure the stability of the Bayley Scales during early childhood and its relationship with intellectual abilities at four years in young Nepalese children. METHODS In a prospective cohort we used the Bayley 3rd edition to measure early child development in 529 Nepalese children at 6-11, 18-23 and 30-35 months. At four years, we used the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) to measure intellectual abilities. We expressed the stability of the Bayley scores by intraclass correlation coefficients (ICCs) and concordance correlation coefficients (CCCs). The relationship between the Bayley scores and the WPPSI full-scale IQ (FSIQ) at four years was examined in regression models. RESULTS The ICCs between the Bayley scores across timepoints were 0.01 (95 % CI -0.06, 0.04), 0.19 (95 % CI 0.15, 0.26) and 0.22 (95 % CI 0.17, 0.28) for the Cognitive, Language and Motor composite scores. The CCC for the composite scores ranged from 0.05 to 0.20 between 6 and 11 and 30-35 months and from 0.20 to 0.36 between 18 and 23 and 30-35 months. The Bayley scores at 6-11, 18-23 and 30-35 months explained 3 %, 20 % and 36 % of the variation of the FSIQ. CONCLUSION The stability of the Bayley scales is poor in early childhood, and its relationship with future intellectual abilities is poor in infancy but improves slightly with age in early childhood. Findings from this large community-based cohort of healthy at-risk children are relevant when measuring early child development worldwide.
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Affiliation(s)
- Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway.
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Suman Ranjitkar
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Merina Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Manjeswori Ulak
- Department of Child Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal; Centre for Intervention Science in Maternal and Child Health, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ram K Chandyo
- Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
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Oyungu E, El Kebbi O, Vreeman R, Nyandiko W, Monahan PO, Tu W, Khaitan A, Desta Z, Slogrove AL, Humphrey JM, Were E, Patel RC, Carlucci JG, Wools-Kaloustian K, McHenry MS. Predicting neurodevelopmental risk in children born to mothers living with HIV in Kenya: protocol for a prospective cohort study (Tabiri Study). BMJ Open 2022; 12:e061051. [PMID: 35379648 PMCID: PMC8981283 DOI: 10.1136/bmjopen-2022-061051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION For the growing number of children with in utero and postpartum exposure to HIV and/or antiretrovirals, it is unclear which exposures or risk factors play a significant role in predicting worse neurodevelopmental outcomes. This protocol describes a prospective longitudinal cohort study of infants born to mothers living with HIV and those born to mothers without HIV. We will determine which risk factors are most predictive of child neurodevelopment at 24 months. We aim to create a risk assessment tool to help predict which children are at risk for worse neurodevelopment outcomes. METHODS AND ANALYSIS This study leverages an existing Kenyan cohort to prospectively enrol 500 children born to mothers living with HIV and 500 to those without HIV (n=1000 total) and follow them from birth to age 24 months. The following factors will be measured every 6 months: infectious morbidity and biological/sociodemographic/psychosocial risk factors. We will compare these factors between the two groups. We will then measure and compare neurodevelopment within children in both groups at 24 months of age using the Child Behaviour Checklist and the Bayley Scales of Infant and Toddler Development, third edition. Finally, we will use generalised linear mixed modelling to quantify associations with neurodevelopment and create a risk assessment tool for children ≤24 months. ETHICS AND DISSEMINATION The study is approved by the Moi University's Institutional Research and Ethics Committee (IREC/2021/55; Approval #0003892), Kenya's National Commission for Science, Technology and Innovation (NACOSTI, Reference #700244) and Indiana University's Institutional Review Board (IRB Protocol #110990). This study carries minimal risk to the children and their mothers, and all mothers will provide written consent for participation in the study. Results will be disseminated to maternal child health clinics within Uasin Gishu County, Kenya and via papers submitted to peer-reviewed journals and presentation at international conferences.
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Affiliation(s)
- Eren Oyungu
- Department of Medical Physiology, Moi University College of Health Sciences, Eldoret, Kenya
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Ola El Kebbi
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Rachel Vreeman
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
- Arnold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Winstone Nyandiko
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
- Department of Child Health, Moi University College of Health Sciences, Eldoret, Kenya
| | - Patrick O Monahan
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Wanzhu Tu
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alka Khaitan
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Zeruesenay Desta
- Department of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Amy L Slogrove
- Department of Paediatrics & Child Health, Faculty of Medicine & Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - John M Humphrey
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Edwin Were
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
- Division of Obstetrics and Gynecology, Moi University College of Health Sciences, Eldoret, Kenya
| | - Rena C Patel
- University of Washington School of Medicine, Seattle, Washington, USA
| | - James G Carlucci
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kara Wools-Kaloustian
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Megan S McHenry
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Translation and Cultural Adaptation of NIH Toolbox Cognitive Tests into Swahili and Dholuo Languages for Use in Children in Western Kenya. J Int Neuropsychol Soc 2022; 28:414-423. [PMID: 34027848 PMCID: PMC8611114 DOI: 10.1017/s1355617721000497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Performing high-quality and reliable cognitive testing requires significant resources and training. As a result, large-scale studies involving cognitive testing are difficult to perform in low- and middle-income settings, limiting access to critical knowledge to improve academic achievement and economic production in these populations. The NIH Toolbox® is a collection of cognitive, motor, sensory, and emotional tests that can be administered and scored using an iPad® tablet, reducing the need for training and quality monitoring; and thus, it is a potential solution to this problem. METHODS We describe our process for translation and cultural adaptation of the existing NIH Toolbox tests of fluid cognition into the Swahili and Dholuo languages for use in children aged 3-14 years in western Kenya. Through serial forward and back translations, cognitive interviews, group consensus, outside feedback, and support from the NIH Toolbox team, we produced translated tests that have both face validity and linguistic validation. RESULTS During our cognitive interviews, we found that the five chosen tests (one each of attention, cognitive flexibility, working memory, episodic memory, and processing speed) were generally well understood by children aged 7-14 years in our chosen populations. The cognitive interviews informed alterations in translation as well as slight changes in some images to culturally adapt the tests. CONCLUSIONS This study describes the process by which we translated five fluid cognition tests from the NIH Toolbox into the Swahili and Dholuo languages. The finished testing application will be available for future studies, including a pilot study for assessment of psychometric properties.
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Krogh-Jespersen S, MacNeill LA, Anderson EL, Stroup HE, Harriott EM, Gut E, Blum A, Fareedi E, Fredian KM, Wert SL, Wakschlag LS, Norton ES. Disruption Leads to Methodological and Analytic Innovation in Developmental Sciences: Recommendations for Remote Administration and Dealing With Messy Data. Front Psychol 2022; 12:732312. [PMID: 35058833 PMCID: PMC8764157 DOI: 10.3389/fpsyg.2021.732312] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022] Open
Abstract
The COVID-19 pandemic has impacted data collection for longitudinal studies in developmental sciences to an immeasurable extent. Restrictions on conducting in-person standardized assessments have led to disruptive innovation, in which novel methods are applied to increase participant engagement. Here, we focus on remote administration of behavioral assessment. We argue that these innovations in remote assessment should become part of the new standard protocol in developmental sciences to facilitate data collection in populations that may be hard to reach or engage due to burdensome requirements (e.g., multiple in-person assessments). We present a series of adaptations to developmental assessments (e.g., Mullen) and a detailed discussion of data analytic approaches to be applied in the less-than-ideal circumstances encountered during the pandemic-related shutdown (i.e., missing or messy data). Ultimately, these remote approaches actually strengthen the ability to gain insight into developmental populations and foster pragmatic innovation that should result in enduring change.
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Affiliation(s)
- Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Leigha A. MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Erica L. Anderson
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Hannah E. Stroup
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Emily M. Harriott
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Ewa Gut
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Abigail Blum
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Elveena Fareedi
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Kaitlyn M. Fredian
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Stephanie L. Wert
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Elizabeth S. Norton
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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McHenry MS, Oyungu E, Yang Z, Ombitsa AR, Cherop C, Vreeman RC. Neurodevelopmental Outcomes of Young Children Born to HIV-Infected Mothers: A Pilot Study. Front Pediatr 2021; 9:697091. [PMID: 34746048 PMCID: PMC8566977 DOI: 10.3389/fped.2021.697091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Over 15 million children who were exposed to HIV perinatally but uninfected (HEU) are alive globally, and they are faced with multiple risk factors for poor neurodevelopment. While children who are HIV-infected (HIV+) appear to have worse neurodevelopmental scores compared to children unexposed and uninfected with HIV (HUU), the evidence is mixed in children who are HEU. This small descriptive pilot study aimed to compare neurodevelopmental scores of children who are HIV+, HEU, and HUU in Kenya. Methods: This cross-sectional pilot study included children ages 18-36 months who were HIV+, HEU, or HUU. Neurodevelopment was assessed, along with sociodemographic, lab, and growth data. Statistical analysis included descriptive statistics, one-way ANOVA, chi-squared, and adjusted linear regression models. Results: One hundred seventy two were included (n = 24 HIV+; n = 74 HEU; n = 74 HUU). Mothers of children who were HEU experienced more depressive symptoms (p < 0.001). The only neurodevelopmental differences were found among groups was that children who were HIV+ had higher receptive language scores (p = 0.007). Lower height-for-age z-scores and being left home alone were associated with worse neurodevelopmental scores. Conclusions: Being stunted, left completely alone for at least an hour within the last week, and having higher sociodemographic status were associated with worse neurodevelopmental scores. The higher levels of depressive symptoms within mothers of children who are HEU warrants further investigation.
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Affiliation(s)
- Megan S. McHenry
- Indiana University School of Medicine, Indianapolis, IN, United States
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Eren Oyungu
- Department of Child Health, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Ziyi Yang
- Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Cleophas Cherop
- Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Rachel C. Vreeman
- Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Arnhold Institute for Global Health, New York, NY, United States
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