一种用于评估幼儿认知发展的新型数字工具“电子平台发育评估（DEEP）”与印度农村地区儿童成长的关联：一项概念验证研究。
The association of a novel digital tool for assessment of early childhood cognitive development, 'DEvelopmental assessment on an E-Platform (DEEP)', with growth in rural India: A proof of concept study.
作者信息
Bhavnani Supriya, Mukherjee Debarati, Bhopal Sunil, Sharma Kamal Kant, Dasgupta Jayashree, Divan Gauri, Soremekun Seyi, Roy Reetabrata, Kirkwood Betty, Patel Vikram
机构信息
Child Development Group, Sangath, Goa, India.
Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, India.
出版信息
EClinicalMedicine. 2021 Jun 18;37:100964. doi: 10.1016/j.eclinm.2021.100964. eCollection 2021 Jul.
BACKGROUND
There is an urgent need to fill the gap of scalable cognitive assessment tools for preschool children to enable identification of children at-risk of sub-optimal development and to support their timely referral into interventions. We present the associations between growth in early childhood, a well-established marker of cognitive development, and scores on a novel digital cognitive assessment tool called DEvelopmental Assessment on an E-Platform (DEEP) on a sample of 3-year old pre-schoolers from a rural region in north India.
METHODS
Between February 2018 and March 2019, 1359 children from the Sustainable Programme Incorporating Nutrition and Games (SPRING) programme were followed up at 3-years age and data on DEEP, anthropometry and a clinical developmental assessment, the Bayley's Scale of Infant and Toddler Development, 3rd edition (BSID-III) was collected. DEEP data from 200 children was used to train a machine learning algorithm to predict their score on the cognitive domain of BSID-III. The DEEP score of the remaining 1159 children was then predicted using this algorithm to examine the cross-sectional and prospective association of growth with the DEEP score.
FINDINGS
The magnitude of the concurrent positive association between height-for-age and cognitive -scores in 3-year olds was similar when cognition was measured by BSID-III (0.20 standard deviations increase for every unit change in specifically age-adjusted height (HAZ), 95% CI = 0.06-0.35) and DEEP (0.26 CI, 0.11-0.41). A similar positive prospective relationship was found between growth at 18 (0.21 CI, 0.17-0.26) and 12-months (0.18 CI, 0.13-0.23) and DEEP score measured at 3-years. Additionally, the relationship between growth and cognitive development was found to be dependant on socioeconomic status (SES).
INTERPRETATION
In this study, we suggest the utility of DEEP, a scalable, digital cognitive assessment tool, to measure cognition in preschool children. Further validation in different and larger datasets is necessary to confirm our findings.
FUNDING
The SPRING Programme was funded through a Wellcome Trust programme grant and the follow-up study by the Corporate Social Responsibility initiative grant from Madura Microfinance Ltd.
背景
迫切需要填补针对学龄前儿童的可扩展认知评估工具的空白，以便能够识别发育欠佳风险的儿童，并支持他们及时转诊接受干预。我们呈现了印度北部农村地区3岁学龄前儿童样本中，幼儿期生长（认知发展的一个公认标志）与一种名为电子平台发育评估（DEEP）的新型数字认知评估工具得分之间的关联。
方法
在2018年2月至2019年3月期间，对纳入营养与游戏的可持续项目（SPRING项目）中的1359名儿童进行了3岁时的随访，并收集了关于DEEP、人体测量学以及临床发育评估（贝利婴幼儿发展量表第三版，BSID-III）的数据。来自200名儿童的DEEP数据用于训练机器学习算法，以预测他们在BSID-III认知领域的得分。然后使用该算法预测其余1159名儿童的DEEP得分，以检验生长与DEEP得分之间的横断面和前瞻性关联。
研究结果
当用BSID-III测量认知时（特定年龄调整身高（HAZ）每单位变化，认知得分增加0.20标准差，95%置信区间=0.06-0.35）以及用DEEP测量时（0.26，0.11-0.41），3岁儿童年龄别身高与认知得分之间的同期正相关程度相似。在18个月（0.21，0.17-0.26）和12个月（0.18，0.13-0.23）时的生长与3岁时测量的DEEP得分之间也发现了类似的正前瞻性关系。此外，发现生长与认知发展之间的关系取决于社会经济地位（SES）。
解读
在本研究中，我们表明了可扩展的数字认知评估工具DEEP在测量学龄前儿童认知方面的效用。需要在不同的更大数据集中进行进一步验证以证实我们的发现。
资助
SPRING项目由惠康信托基金项目资助，后续研究由马杜拉小额信贷有限公司的企业社会责任倡议资助。
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