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Viñas-Guasch N, Chia PSQ, Yap MLM, Wu CY, Chen SHA. Cognitive pediatric tele-assessment: a scoping review. Front Psychol 2023; 14:1288021. [PMID: 38162979 PMCID: PMC10754967 DOI: 10.3389/fpsyg.2023.1288021] [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: 09/03/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Cognitive tele-assessment (CTA) adoption has increased considerably recently, in parallel with the maturation of the digital technologies that enable it, and the push to move assessment to the online format during the COVID-19 pandemic in 2019. This mode of assessment stems from remote assessment applications that originated in general tele-medicine, where it was typically used for patient screening as part of an intervention. The development of remote tele-medicine was later adapted for CTA in adult populations in tele-neuropsychiatry and tele-psychology and is increasingly applied in experimental research in cognitive science research with adult and pediatric populations, and for remote academic assessment. Compared to in-person assessment, CTA offers advantages such as decreasing time and logistic costs and facilitating the assessment of remote or special needs populations. However, given the novelty of CTA, its technical, methodological, and ethical issues remain poorly understood, especially in cases where methods for assessment of adults are used in pediatric populations. In the current paper, we provide a scoping review on the evolution of remote tele-assessment from the years 2000 to 2021, to identify its main themes, methodologies, and applications, and then focus on the issues of assessment in pediatric populations. Finally, we present recommendations on how to address the challenges previously mentioned.
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Affiliation(s)
- Nestor Viñas-Guasch
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Phoebe Si Qi Chia
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Michelle Li-Mei Yap
- Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Chiao-Yi Wu
- Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Centre for Research and Development in Learning (CRADLE), Nanyang Technological University, Singapore, Singapore
| | - S. H. Annabel Chen
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- Centre for Research and Development in Learning (CRADLE), Nanyang Technological University, Singapore, Singapore
- Lee Kong Chian School of Medicine (LKCMedicine), Nanyang Technological University, Singapore, Singapore
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Komanchuk J, Cameron JL, Kurbatfinski S, Duffett-Leger L, Letourneau N. A realist review of digitally delivered child development assessment and screening tools: Psychometrics and considerations for future use. Early Hum Dev 2023; 183:105818. [PMID: 37413949 DOI: 10.1016/j.earlhumdev.2023.105818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/18/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Developmental screening improves the detection of developmental concerns, yet numerous children are not screened/assessed. Remote child developmental tool administration has been utilized to increase screening and assessment accessibility. METHOD We conducted a realist review to: (1) identify existing multi-domain child development assessment and screening tools for children 0-5 years; (2) review psychometric data on their digital (i.e., only administered remotely) administration; and (3) explore contextual factors relevant to their digital administration. We searched APA PsycInfo, MEDLINE, CINAHL, and ERIC to identify tools and papers on their psychometrics. We reference-searched included articles and searched Google for relevant grey literature. RESULTS Of 33 multi-domain child development tools identified in objective one, five tools (in five studies) were delivered digitally and compared to traditional (e.g., paper) delivery (i.e., objective two). Studies evaluated within-group equivalence reliability (k = 2) and between-group equivalence (k = 3). Within-group equivalence reliability was established for the Vineland Adaptive Behavior Scales, and domains (e.g., gross motor) of the Ages and Stages Questionnaires 2nd edition (ASQ-2) and Revised Prescreening Denver Questionnaire (R-PDQ). Between group equivalence was demonstrated for Developmental Neuropsychological Assessment, 2nd Edition (NEPSY-II) subtests and Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3) items. In another between group evaluation, web-based and paper versions of the ASQ-2 were deemed generally equivalent. Digital Bayley-3 inter-observer reliability ranged from 0.82 to 1.0. Examiner support, time, tool modifications, family resources, and comfort promotion supported digital administration. CONCLUSION Digitally delivered ASQ-2, R-PDQ, Vineland, and Bayley-3 and NEPSY-II components show promise for equivalence with traditional administration.
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Affiliation(s)
| | - Judy L Cameron
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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Alexander K, Mazza D. Routine developmental screening in Australian general practice: a pilot study. BMC PRIMARY CARE 2023; 24:143. [PMID: 37430184 DOI: 10.1186/s12875-023-02093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Parents' Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations. METHODS The study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners. RESULTS Documented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners' motivation to use PEDS tools and perceptions of environmental constraints. CONCLUSIONS A team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices.
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Affiliation(s)
- Karyn Alexander
- Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Danielle Mazza
- Department of General Practice, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Ben-Sasson A, Jacobs K, Ben-Sasson E. Early childhood tracking application: Correspondence between crowd-based developmental percentiles and clinical tools. Health Informatics J 2023; 29:14604582231164695. [PMID: 36914414 DOI: 10.1177/14604582231164695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Barriers to child developmental screening lead to delayed diagnosis and intervention. babyTRACKS, a mobile application for tracking developmental milestones, presents parents their child's percentiles computed relative to crowd-based data. This study evaluated correspondence between crowd-based percentiles and traditional development measures. Research analyzed babyTRACKS diaries of 1951 children. Parents recorded attainment age for milestones across Gross Motor, Fine Motor, Language, Cognitive, and Social domains. Fifty-seven parents completed the Ages and Stages Questionnaire (ASQ-3), and 13 families participated in the Mullen Scales of Early Learning (MSEL) expert assessment. Crowd-based percentiles were compared with: Centers for Disease Control (CDC) norms for comparable milestones, ASQ-3 and MSEL scores. babyTRACKS percentiles correlated with the percentage of unmet CDC milestones, and with higher ASQ-3 and MSEL scores across several domains. Children who did not meet CDC age thresholds had lower babyTRACKS percentiles by about 20 points and those at ASQ-3 risk had lower babyTRACKS Fine Motor and Language scores. Repeated measures tests showed significantly higher MSEL versus babyTRACKS percentiles in the Language domain. Although ages and milestones in diary varied, the app percentiles corresponded with traditional measures, particularly in fine motor and language domains. Future research is needed for determining referral thresholds while minimizing false alarms.
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Affiliation(s)
- Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, 26748University of Haifa, Haifa, Israel
| | - Kayla Jacobs
- Computer Science Department, Technion, Haifa, Israel
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Eapen V, Winata T, Gilbert M, Nair R, Khan F, Lucien A, Islam R, Masi A, Lam-Cassettari C, Mendoza Diaz A, Dissanayake C, Karlov L, Descallar J, Eastwood J, Hasan I, Jalaludin B, Kohlhoff J, Liaw ST, Lingam R, Ong N, Tam CWM, Woolfenden S, Barbaro J. Parental experience of an early developmental surveillance programme for autism within Australian general practice: a qualitative study. BMJ Open 2022; 12:e064375. [PMID: 36442896 PMCID: PMC9710335 DOI: 10.1136/bmjopen-2022-064375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Implementing support and services early in the life course has been shown to promote positive developmental outcomes for children at high likelihood of developmental conditions including autism. This study examined parents'/caregivers' experiences and perceptions about a digital developmental surveillance pathway for autism, the autism surveillance pathway (ASP), and usual care, the surveillance as usual (SaU) pathway, in the primary healthcare general practice setting. DESIGN This qualitative study involves using a convenience selection process of the full sample of parents/caregivers that participated in the main programme, 'General Practice Surveillance for Autism', a cluster-randomised controlled trial study. All interviews were audio-recorded, transcribed and coded using NVivo V.12 software. An inductive thematic interpretive approach was adopted and data were analysed thematically. PARTICIPANTS Twelve parents/caregivers of children with or without a developmental condition/autism (who participated in the main programme) in South Western Sydney and Melbourne were interviewed. SETTINGS All interviews were completed over the phone. RESULTS There were seven major themes and 20 subthemes that included positive experiences, such as pre-existing patient-doctor relationships and their perceptions on the importance of knowing and accessing early support/services. Barriers or challenges experienced while using the SaU pathway included long waiting periods, poor communication and lack of action plans, complexity associated with navigating the healthcare system and lack of understanding by general practitioners (GPs). Common suggestions for improvement included greater awareness/education for parents/carers and the availability of accessible resources on child development for parents/caregivers. CONCLUSION The findings support the use of digital screening tools for developmental surveillance, including for autism, using opportunistic contacts in the general practice setting. TRIAL REGISTRATION NUMBER ANZCTR (ACTRN12619001200178).
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Affiliation(s)
- Valsamma Eapen
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Teresa Winata
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Melissa Gilbert
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Radhika Nair
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Feroza Khan
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Abbie Lucien
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Raisa Islam
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Anne Masi
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Christa Lam-Cassettari
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Antonio Mendoza Diaz
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Saint Lucia, Queensland, Australia
| | - Lisa Karlov
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Joseph Descallar
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Faculty of Medicine and Health, School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Iqbal Hasan
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- Centre for Research, Evidence Management and Surveillance, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Faculty of Medicine, School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Jane Kohlhoff
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Siaw-Teng Liaw
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia
| | - Raghu Lingam
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Natalie Ong
- Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Chun Wah Michael Tam
- Faculty of Medicine, School of Population Health, UNSW, Sydney, New South Wales, Australia
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Susan Woolfenden
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
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Sáiz-Manzanares MC, Marticorena-Sánchez R, Arnaiz-González Á. Improvements for Therapeutic Intervention from the Use of Web Applications and Machine Learning Techniques in Different Affectations in Children Aged 0–6 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116558. [PMID: 35682142 PMCID: PMC9180398 DOI: 10.3390/ijerph19116558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 02/05/2023]
Abstract
Technological advances together with machine learning techniques give health science disciplines tools that can improve the accuracy of evaluation and diagnosis. The objectives of this study were: (1) to design a web application based on cloud technology (eEarlyCare-T) for creating personalized therapeutic intervention programs for children aged 0–6 years old; (2) to carry out a pilot study to test the usability of the eEarlyCare-T application in therapeutic intervention programs. We performed a pilot study with 23 children aged between 3 and 6 years old who presented a variety of developmental problems. In the data analysis, we used machine learning techniques of supervised learning (prediction) and unsupervised learning (clustering). Three clusters were found in terms of functional development in the 11 areas of development. Based on these groupings, various personalized therapeutic intervention plans were designed. The variable with most predictive value for functional development was the users’ developmental age (predicted 75% of the development in the various areas). The use of web applications together with machine learning techniques facilitates the analysis of functional development in young children and the proposal of personalized intervention programs.
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Affiliation(s)
- María Consuelo Sáiz-Manzanares
- Research Group DATAHES, Departamento de Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad de Burgos, Pº Comendadores s/n, 09001 Burgos, Spain
- Correspondence: ; Tel.: +34-673-192-734
| | - Raúl Marticorena-Sánchez
- Research Group ADMIRABLE, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad de Burgos, Avd. de Cantabria s/n, 09006 Burgos, Spain; (R.M.-S.); (Á.A.-G.)
| | - Álvar Arnaiz-González
- Research Group ADMIRABLE, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad de Burgos, Avd. de Cantabria s/n, 09006 Burgos, Spain; (R.M.-S.); (Á.A.-G.)
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The feasibility of a crowd-based early developmental milestone tracking application. PLoS One 2022; 17:e0268548. [PMID: 35617244 PMCID: PMC9135273 DOI: 10.1371/journal.pone.0268548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/03/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Parents’ tracking of developmental milestones can assist healthcare providers with early detection of developmental delays and appropriate referrals to early intervention. Crowdsourcing is one way to update the content and age data distribution of developmental checklists for parents and providers. This feasibility study examined which developmental milestones parents chose to track and what they added beyond traditional milestones, using the babyTRACKS crowd-based mobile app. Method We analyzed the developmental diaries of 3,832 children, registered in the babyTRACKS app at an average age of 9.3 months. Their parents recorded a median of 5 milestones per diary, selecting from the accumulating lists of age-appropriate milestones or authoring new milestones. The final database included 645 types of milestones; 89.15% were developmental, of which 43.6% were comparable to the Centers for Disease Control (CDC) milestones while the rest were crowd-authored. Milestones were categorized into developmental domains: Gross Motor, Fine Motor, Oral Motor, Self-Care, Cognitive, Language Comprehension, Speech, Non-Verbal Communication, Social, Emotional, and Regulation. Results On average, the milestone domains of Gross Motor, Fine Motor, Cognitive and Social were the most added to diaries (20%-30% of a diary). Within the Cognitive, Speech and Language Comprehension domains there were significantly more CDC comparable versus crowd-authored milestones (29% versus 21%, 22% versus 10%, 8% versus 4%). In contrast, within the Regulation and Oral Motor domains there were more crowd versus CDC milestones (17% versus 3%, 9% versus 3%). Crowd-authored Speech milestones were significantly older by 7 months than CDC milestones. Conclusion Tracking daily observations of child development provides a window into personally relevant milestones for the child and parent. The crowd of parents can independently track and add new milestones across main developmental domains. Regulation and Oral Motor development especially interest parents. Parents may be less aware of early progress in Language Comprehension and Speech; thus, these domains require more structured screening. Designing mobile early screening which is crowd-based engages parents as proactive partners in developmental tracking.
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