Billard Catherine, Jung Camille, Munnich Arnold, Gassama Sahawanatou, Touzin Monique, Mirassou Anne, Willig Thiébaut-Noël
Association pour la Recherche sur les Troubles des Apprentissages, Paris, France.
Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Front Pediatr. 2021 Oct 1;9:733713. doi: 10.3389/fped.2021.733713. eCollection 2021.
Learning disabilities (LDs) are a major public health issue, affecting cognitive functions and academic performance for 8% of children. If LDs are not detected early and addressed through appropriate interventions, they have a heavy impact on these children in the social, educational, and professional spheres, at great cost to society. The BMT- (Batterie Modulable de Tests informatisée, or "computerized Adaptable Test Battery") enables fast, easy, reliable assessments for each cognitive domain. It has previously been validated in children ages 4-13 who had no prior complaints. The present study demonstrates the sensitivity of the BMT-, relative to reference test batteries, for 191 children with cognitive difficulties. These 191 subjects were included in the study by the 14 pediatricians treating them for complaints in five cognitive domains: written language [60 (cases)]; mathematical cognition (40); oral language (60); handwriting, drawing, and visuospatial construction (45); and attention and executive functioning (45). In accordance with a predefined protocol, the children were administered BMT- tests first, by their pediatricians, and reference tests later, by specialists to whom the BMT- test results were not disclosed. Comparison of BMT- and reference test results made it possible to evaluate sensitivity and agreement between tests. For each of the five domains, the BMT- was very sensitive (0.91-1), and normal BMT- results were highly predictive of normal results for specialized reference tests [negative likelihood ratio (LR-): 0-0.16]. There was close agreement between BMT- and reference tests in all domains except attention and executive functioning, for which only moderate agreement was observed. The BMT- offers rapid, reliable, simple computerized assessments whose sensitivity and agreement with reference test batteries make it a suitable first-line instrument for LD screening in children 4-13 years old.
学习障碍是一个重大的公共卫生问题,影响着8%儿童的认知功能和学业成绩。如果学习障碍未能早期发现并通过适当干预加以解决,将会在社会、教育和职业领域对这些儿童产生严重影响,给社会带来巨大成本。BMT-(即“计算机化自适应测试组合”)能够对每个认知领域进行快速、简便且可靠的评估。此前它已在4至13岁且无既往病史的儿童中得到验证。本研究证明了BMT-相对于参考测试组合,对191名有认知困难儿童的敏感性。这191名受试者由14名儿科医生纳入研究,这些儿科医生针对他们在五个认知领域的问题进行治疗:书面语言[60例];数学认知(40例);口语(60例);书写、绘画和视觉空间构建(45例);注意力和执行功能(45例)。按照预先设定的方案,儿童首先由他们的儿科医生进行BMT-测试,随后由未被告知BMT-测试结果的专家进行参考测试。比较BMT-和参考测试结果能够评估测试之间的敏感性和一致性。对于五个领域中的每一个,BMT-都非常敏感(0.91 - 1),并且正常的BMT-结果高度预测了专业参考测试的正常结果[阴性似然比(LR-):0 - 0.16]。除了注意力和执行功能领域,BMT-和参考测试在所有领域都有密切一致性,在该领域仅观察到中等一致性。BMT-提供快速、可靠、简单的计算机化评估,其敏感性以及与参考测试组合的一致性使其成为4至13岁儿童学习障碍筛查的合适一线工具。