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López-Vallejo S, Burneo-Garcés C, Pérez-García M. Development of working memory and inhibitory control in early childhood: Cross-sectional analysis by age intervals and gender in Ecuadorian preschoolers. PLoS One 2024; 19:e0299394. [PMID: 38743790 PMCID: PMC11093310 DOI: 10.1371/journal.pone.0299394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 02/09/2024] [Indexed: 05/16/2024] Open
Abstract
Working memory (WM) and inhibitory control (IC) play a crucial role in learning during early childhood. The literature suggests a non-linear developmental trajectory of executive functions (EFs) with varied results according to gender, usually attributed to environmental factors. However, there is insufficient and inconclusive data on whether this pattern is reproduced in the Latin American preschool population since most studies have been conducted in English-speaking, European, and Asian environments. Thus, objectively comparing children's executive performance across diverse international geographical contexts becomes challenging. This study aimed to conduct a cross-sectional analysis of the performance in WM and IC of 982 Ecuadorian preschoolers aged between 42 and 65 months (M = 53.71; SD = 5.714) and belonging to medium-high, medium, and low-medium socioeconomic strata. The participants consisted of 496 boys (M = 53.77; SD = 5.598) and 486 girls (M = 53.65; SD = 5.834), representing nine cities in Ecuador. To assess the effect of age and gender on performance in these two domains, the sample was divided into four 6-month age intervals. Two tests were administered to the participants, and a survey was conducted with 799 of their usual caregivers. Viewing the cross-sectional mean scores of the WM and IC tests as a temporal continuum reveals an upward trend in each age interval studied. Girls outperformed boys on the IC test, showing statistically significant differences in the earliest age interval. The gender differences in executive performance reported in the literature emphasize the need to explore the modulating effect of environmental variables on early childhood development. This information could offer valuable insights for adapting and optimizing cognitive and didactic strategies in early childhood tailored to the characteristics and needs of the preschool population.
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Affiliation(s)
- Sofía López-Vallejo
- Department of Personality, Assessment, and Psychological Treatment, University of Granada (UGR), Granada, Spain
- The Brain, Mind, and Behavior Research Center at the University of Granada (CIMCYC-UGR), Granada, Spain
| | - Carlos Burneo-Garcés
- University of Otavalo, Dirección de Posgrado, Otavalo, Ecuador
- Escuela de Psicología, Universidad de las Américas, Quito, Ecuador
| | - Miguel Pérez-García
- Department of Personality, Assessment, and Psychological Treatment, University of Granada (UGR), Granada, Spain
- The Brain, Mind, and Behavior Research Center at the University of Granada (CIMCYC-UGR), Granada, Spain
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Zoumenou R, Bodeau-Livinec F, Chausseboeuf L, Boivin MJ, Wendland J. Is Neurodevelopmental Assessment in Early Childhood Predictive of Performance Assessed Later in Childhood and Adolescence in Sub-Saharan Africa? A Systematic Review of the Literature. Arch Clin Neuropsychol 2024; 39:98-116. [PMID: 37470401 PMCID: PMC10802230 DOI: 10.1093/arclin/acad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Most neurodevelopmental tests used to assess child development in sub-Saharan Africa were developed in western or high-income countries, raising the question of their usefulness with African children. OBJECTIVE This systematic review identified and synthesized key findings from studies measuring development in children in Sub-Saharan Africa in early childhood and again at school age, to assess neurocognitive associations longitudinally from infancy through middle childhood. METHODS The study was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, selecting articles referenced in the PubMed, PsycInfo, and Embase databases using the following inclusion criteria: published between 2000 and 2022, written in French or English, and presenting results dealing with the objective assessment of child's neurodevelopment. All articles were registered in the Zotero reference manager and analyzed by title, abstract, and full text. RESULTS Several of the seven selected studies confirmed that attention and working memory in infancy can predict children's neurocognitive performance, including mathematical ability, at school age. In two of the studies, children with poor mental development at 1 year of age are more likely to present with poorer behavioral development at school age, including learning difficulties in school and risk for grade repetition. CONCLUSION Cognitive ability assessed in early childhood is strongly associated with performance at school age in cohorts of African children followed longitudinally. Even with assessments adapted cross-culturally, infants and preschoolers at risk for poor developmental outcomes can be identified to better receive strategic early interventions to enhance their development.
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Affiliation(s)
- Roméo Zoumenou
- Institut de Recherche pour le Developpement, Mère et enfant face aux infections tropicales, 75006 Paris, France
- Laboratoire psychopathologie et processus en santé, Institute de psychologie, 92774 Boulogne, France
| | - Florence Bodeau-Livinec
- Institut de recherche en santé, environnement et travail (IRSET), Ecole des hautes etudes en santé (EHESP), 93210 Saint-Denis, France
| | - Léa Chausseboeuf
- Laboratoire psychopathologie et processus en santé, Institute de psychologie, 92774 Boulogne, France
| | - Michael J Boivin
- Department of Psychiatry and Department of Neurology & Ophthalmology, Michigan State University, East Lansing, MI 48824 USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA
| | - Jaqueline Wendland
- Laboratoire psychopathologie et processus en santé, Institute de psychologie, 92774 Boulogne, France
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Wilson CJ, Bowden SC, Byrne LK, Joshua NR, Marx W, Weiss LG. The cross-cultural generalizability of cognitive ability measures: A systematic literature review. INTELLIGENCE 2023. [DOI: 10.1016/j.intell.2023.101751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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National Mean IQ Estimates: Validity, Data Quality, and Recommendations. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2022. [DOI: 10.1007/s40806-022-00351-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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de Erausquin GA, Snyder H, Brugha TS, Seshadri S, Carrillo M, Sagar R, Huang Y, Newton C, Tartaglia C, Teunissen C, Håkanson K, Akinyemi R, Prasad K, D'Avossa G, Gonzalez‐Aleman G, Hosseini A, Vavougios GD, Sachdev P, Bankart J, Mors NPO, Lipton R, Katz M, Fox PT, Katshu MZ, Iyengar MS, Weinstein G, Sohrabi HR, Jenkins R, Stein DJ, Hugon J, Mavreas V, Blangero J, Cruchaga C, Krishna M, Wadoo O, Becerra R, Zwir I, Longstreth WT, Kroenenberg G, Edison P, Mukaetova‐Ladinska E, Staufenberg E, Figueredo‐Aguiar M, Yécora A, Vaca F, Zamponi HP, Re VL, Majid A, Sundarakumar J, Gonzalez HM, Geerlings MI, Skoog I, Salmoiraghi A, Boneschi FM, Patel VN, Santos JM, Arroyo GR, Moreno AC, Felix P, Gallo C, Arai H, Yamada M, Iwatsubo T, Sharma M, Chakraborty N, Ferreccio C, Akena D, Brayne C, Maestre G, Blangero SW, Brusco LI, Siddarth P, Hughes TM, Zuñiga AR, Kambeitz J, Laza AR, Allen N, Panos S, Merrill D, Ibáñez A, Tsuang D, Valishvili N, Shrestha S, Wang S, Padma V, Anstey KJ, Ravindrdanath V, Blennow K, Mullins P, Łojek E, Pria A, Mosley TH, Gowland P, Girard TD, Bowtell R, Vahidy FS. Chronic neuropsychiatric sequelae of SARS-CoV-2: Protocol and methods from the Alzheimer's Association Global Consortium. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12348. [PMID: 36185993 PMCID: PMC9494609 DOI: 10.1002/trc2.12348] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/11/2022] [Accepted: 06/14/2022] [Indexed: 12/27/2022]
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has caused >3.5 million deaths worldwide and affected >160 million people. At least twice as many have been infected but remained asymptomatic or minimally symptomatic. COVID-19 includes central nervous system manifestations mediated by inflammation and cerebrovascular, anoxic, and/or viral neurotoxicity mechanisms. More than one third of patients with COVID-19 develop neurologic problems during the acute phase of the illness, including loss of sense of smell or taste, seizures, and stroke. Damage or functional changes to the brain may result in chronic sequelae. The risk of incident cognitive and neuropsychiatric complications appears independent from the severity of the original pulmonary illness. It behooves the scientific and medical community to attempt to understand the molecular and/or systemic factors linking COVID-19 to neurologic illness, both short and long term. Methods This article describes what is known so far in terms of links among COVID-19, the brain, neurological symptoms, and Alzheimer's disease (AD) and related dementias. We focus on risk factors and possible molecular, inflammatory, and viral mechanisms underlying neurological injury. We also provide a comprehensive description of the Alzheimer's Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-CoV-2 infection (CNS SC2) harmonized methodology to address these questions using a worldwide network of researchers and institutions. Results Successful harmonization of designs and methods was achieved through a consensus process initially fragmented by specific interest groups (epidemiology, clinical assessments, cognitive evaluation, biomarkers, and neuroimaging). Conclusions from subcommittees were presented to the whole group and discussed extensively. Presently data collection is ongoing at 19 sites in 12 countries representing Asia, Africa, the Americas, and Europe. Discussion The Alzheimer's Association Global Consortium harmonized methodology is proposed as a model to study long-term neurocognitive sequelae of SARS-CoV-2 infection. Key Points The following review describes what is known so far in terms of molecular and epidemiological links among COVID-19, the brain, neurological symptoms, and AD and related dementias (ADRD)The primary objective of this large-scale collaboration is to clarify the pathogenesis of ADRD and to advance our understanding of the impact of a neurotropic virus on the long-term risk of cognitive decline and other CNS sequelae. No available evidence supports the notion that cognitive impairment after SARS-CoV-2 infection is a form of dementia (ADRD or otherwise). The longitudinal methodologies espoused by the consortium are intended to provide data to answer this question as clearly as possible controlling for possible confounders. Our specific hypothesis is that SARS-CoV-2 triggers ADRD-like pathology following the extended olfactory cortical network (EOCN) in older individuals with specific genetic susceptibility.The proposed harmonization strategies and flexible study designs offer the possibility to include large samples of under-represented racial and ethnic groups, creating a rich set of harmonized cohorts for future studies of the pathophysiology, determinants, long-term consequences, and trends in cognitive aging, ADRD, and vascular disease.We provide a framework for current and future studies to be carried out within the Consortium. and offers a "green paper" to the research community with a very broad, global base of support, on tools suitable for low- and middle-income countries aimed to compare and combine future longitudinal data on the topic.The Consortium proposes a combination of design and statistical methods as a means of approaching causal inference of the COVID-19 neuropsychiatric sequelae. We expect that deep phenotyping of neuropsychiatric sequelae may provide a series of candidate syndromes with phenomenological and biological characterization that can be further explored. By generating high-quality harmonized data across sites we aim to capture both descriptive and, where possible, causal associations.
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Schirmbeck K, Runge R, Rao N, Wang R, Richards B, Chan SWY, Maehler C. Assessing executive functions in preschoolers in Germany and Hong Kong: testing for measurement invariance. JOURNAL OF CULTURAL COGNITIVE SCIENCE 2022. [DOI: 10.1007/s41809-022-00112-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dutra NB, Chen L, Anum A, Burger O, Davis HE, Dzokoto VA, Fong FTK, Ghelardi S, Mendez K, Messer EJE, Newhouse M, Nielsen MG, Ramos K, Rawlings B, dos Santos RAC, Silveira LGS, Tucker-Drob EM, Legare CH. Examining relations between performance on non-verbal executive function and verbal self-regulation tasks in demographically-diverse populations. Dev Sci 2022; 25:e13228. [PMID: 35025126 PMCID: PMC10782846 DOI: 10.1111/desc.13228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/14/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
Self-regulation is a widely studied construct, generally assumed to be cognitively supported by executive functions (EFs). There is a lack of clarity and consensus over the roles of specific components of EFs in self-regulation. The current study examines the relations between performance on (a) a self-regulation task (Heads, Toes, Knees Shoulders Task) and (b) two EF tasks (Knox Cube and Beads Tasks) that measure different components of updating: working memory and short-term memory, respectively. We compared 107 8- to 13-year-old children (64 females) across demographically-diverse populations in four low and middle-income countries, including: Tanna, Vanuatu; Keningau, Malaysia; Saltpond, Ghana; and Natal, Brazil. The communities we studied vary in market integration/urbanicity as well as level of access, structure, and quality of schooling. We found that performance on the visuospatial working memory task (Knox Cube) and the visuospatial short-term memory task (Beads) are each independently associated with performance on the self-regulation task, even when controlling for schooling and location effects. These effects were robust across demographically-diverse populations of children in low-and middle-income countries. We conclude that this study found evidence supporting visuospatial working memory and visuospatial short-term memory as distinct cognitive processes which each support the development of self-regulation.
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Affiliation(s)
- Natália B. Dutra
- Laboratório de Evolução do Comportamento Humano, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Núcleo de Teoria e Pesquisa do Comportamento, Universidade Federal do Pará, Belém, Brazil
| | - Lydia Chen
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Oskar Burger
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Helen E. Davis
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Vivian A. Dzokoto
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Frankie T. K. Fong
- Early Cognitive Development Centre, School of Psychology, The University of Queensland, Brisbane, Australia
| | - Sabrina Ghelardi
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Kimberly Mendez
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Emily J. E. Messer
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Morgan Newhouse
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Mark G. Nielsen
- Early Cognitive Development Centre, School of Psychology, The University of Queensland, Brisbane, Australia
- Faculty of Humanities, The University of Johannesburg, Johannesburg, South Africa
| | - Karlos Ramos
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Bruce Rawlings
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
- Department of Psychology, Durham University, Durham, UK
| | - Renan A. C. dos Santos
- Laboratório de Evolução do Comportamento Humano, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Lara G. S. Silveira
- Laboratório de Evolução do Comportamento Humano, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Cristine H. Legare
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
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Exploring the development of attentional set shifting in young children with a novel Intradimensional/Extradimensional shift task. J Exp Child Psychol 2022; 221:105428. [PMID: 35489135 DOI: 10.1016/j.jecp.2022.105428] [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: 07/08/2021] [Revised: 01/21/2022] [Accepted: 03/09/2022] [Indexed: 11/22/2022]
Abstract
Attentional set shifting is a core part of cognition, allowing quick and flexible adaption to new demands. The study of its development during early childhood has been hampered by a shortage of measures not requiring language. This article argues for a revival of the Intradimensional/Extradimensional (ID/ED) shift task by presenting a new nonverbal version of the task (Shifting Tray task). Children (N = 95 3- to 5-year-olds; 49 girls; predominantly European White) were presented with pairs of trays, each filled with a substrate and an upside-down cup on top, and were asked to find stickers. In the pre-switch phase, children learned (through trial and error) which dimension (substrate or cup) was predictive of the rewards. In the post-switch phase, all stimuli were exchanged. For children in the intradimensional shift condition, the dimension predictive of the sticker was the same as the one predictive in the pre-switch phase. For children in the extradimensional shift condition, the previously irrelevant dimension was now relevant. Results showed that most 3-year-olds were able to switch, and older children did not outperform younger children. The easy and flexible nature of the task allows researchers to investigate the impact of labels and instructions and to use it in cross-cultural and comparative research.
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A Systematic Review of the Validity and Realiability of Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology among Children and Adolescents in Low- and Middle-Income Countries. Neuropsychol Rev 2022; 32:974-1016. [PMID: 35349054 PMCID: PMC9630223 DOI: 10.1007/s11065-022-09538-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2022]
Abstract
Minimal but increasing number of assessment instruments for Executive functions (EFs) and adaptive functioning (AF) have either been developed for or adapted and validated for use among children in low and middle income countries (LAMICs). However, the suitability of these tools for this context is unclear. A systematic review of such instruments was thus undertaken. The Systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist (Liberati et al., in BMJ (Clinical Research Ed.), 339, 2009). A search was made for primary research papers reporting psychometric properties for development or adaptation of either EF or AF tools among children in LAMICs, with no date or language restrictions. 14 bibliographic databases were searched, including grey literature. Risk of bias assessment was done following the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) guidelines (Mokkink et al., in Quality of Life Research,63, 32, 2014). For EF, the Behaviour Rating Inventory of Executive Functioning (BRIEF- multiple versions), Wisconsin Card Sorting Test (WCST), Go/No-go and the Rey-Osterrieth complex figure (ROCF) were the most rigorously validated. For AFs, the Vineland Adaptive Behaviour Scales (VABS- multiple versions) and the Child Function Impairment Rating Scale (CFIRS- first edition) were most validated. Most of these tools showed adequate internal consistency and structural validity. However, none of these tools showed acceptable quality of evidence for sufficient psychometric properties across all the measured domains, particularly so for content validity and cross-cultural validity in LAMICs. There is a great need for adequate adaptation of the most popular EF and AF instruments, or alternatively the development of purpose-made instruments for assessing children in LAMICs. Systematic Review Registration numbers: CRD42020202190 (EF tools systematic review) and CRD42020203968 (AF tools systematic review) registered on PROSPERO website (https://www.crd.york.ac.uk/prospero/).
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Glenn Fowler M, Boivin MJ, Familiar I, Nyangoma B. Central Nervous System and Neurodevelopmental Outcomes of HIV+ and HIV exposed children: A Mini Review of Recent Findings and Lessons Learned from the Field. Neurosci Lett 2022; 775:136501. [PMID: 35122932 DOI: 10.1016/j.neulet.2022.136501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 01/11/2022] [Accepted: 01/28/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Mary Glenn Fowler
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Michael J Boivin
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Itziar Familiar
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
| | - Betty Nyangoma
- Dept of Pathology, Johns Hopkins U. School of Medicine Baltimore MD, USA; Dept of PsychiatryMichigan State U. East Lansing, MI, USA; Makerere U. Johns Hopkins U. Research Collaboration, USA; Kampala Uganda
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Kusi-Mensah K, Nuamah ND, Wemakor S, Agorinya J, Seidu R, Martyn-Dickens C, Bateman A. Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology Among Children in Developing Country Contexts: a Scoping Review of Current Tools. Neuropsychol Rev 2021; 32:459-482. [PMID: 34870774 PMCID: PMC9381467 DOI: 10.1007/s11065-021-09529-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022]
Abstract
Several tools have been developed to assess executive function (EFs) and adaptive functioning, although in mainly Western populations. Information on tools for low-and-middle-income country children is scanty. A scoping review of such instruments was therefore undertaken. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis- Scoping Review extension (PRISMA-ScR) checklist (Tricco et al., in Annals of Internal Medicine 169(7), 467–473, 2018). A search was made for primary research papers of all study designs that focused on development or adaptation of EF or adaptive function tools in low-and-middle-income countries, published between 1st January 1894 to 15th September 2020. 14 bibliographic databases were searched, including several non-English databases and the data were independently charted by at least 2 reviewers. The search strategy identified 5675 eligible abstracts, which was pruned down to 570 full text articles. These full-text articles were then manually screened for eligibility with 51 being eligible. 41 unique tools coming in 49 versions were reviewed. Of these, the Behaviour Rating Inventory of Executive Functioning (BRIEF- multiple versions), Wisconsin Card Sorting Test (WCST), Go/No-go and the Rey-Osterrieth complex figure (ROCF) had the most validations undertaken for EF tests. For adaptive functions, the tools with the most validation studies were the Vineland Adaptive Behaviour Scales (VABS- multiple versions) and the Child Function Impairment Rating Scale (CFIRS- first edition). There is a fair assortment of tests available that have either been developed or adapted for use among children in developing countries but with limited range of validation studies. However, their psychometric adequacy for this population was beyond the scope of this paper.
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Affiliation(s)
- Kwabena Kusi-Mensah
- Department of Psychiatry, University of Cambridge, Clifford Allbutt Building Cambridge Biomedical Campus CB2 OAH, Cambridge, UK. .,Komfo Anokye Teaching Hospital, P. O. Box 1934, Kumasi, Ghana.
| | | | - Stephen Wemakor
- Department of Psychiatry, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, 48109, MI, USA
| | | | | | | | - Andrew Bateman
- Department of Psychiatry, University of Cambridge, Clifford Allbutt Building Cambridge Biomedical Campus CB2 OAH, Cambridge, UK.,School of Health and Social Care, University of Essex, Colchester, UK
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Perumal N, Manji KP, Darling AM, Kisenge RR, Kvestad I, Hysing M, Belinger DC, Urassa W, Strand TA, Duggan CP, Fawzi WW, Sudfeld CR. Gestational Age, Birth Weight, and Neurocognitive Development in Adolescents in Tanzania. J Pediatr 2021; 236:194-203.e6. [PMID: 33901518 PMCID: PMC8403162 DOI: 10.1016/j.jpeds.2021.04.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/08/2021] [Accepted: 04/19/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To investigate the association between gestational age, birthweight, and birthweight adjusted for gestational age, with domains of neurocognitive development and behavioral problems in adolescents in Tanzania. STUDY DESIGN Data from a long-term follow-up of adolescents aged 11-15 years born to women previously enrolled in a randomized controlled trial of prenatal multiple micronutrient supplementation in Dar es Salaam, Tanzania, were used. A battery of neurodevelopmental tests were administered to measure adolescent general intelligence, executive function, and behavioral problems. The INTERGROWTH-21st newborn anthropometric standards were used to derive birthweight for gestational age z-scores. We assessed the shape of relationships using restricted cubic splines and estimated the associations of gestational age, birthweight, and birthweight for gestational age z-score with adolescent development using multivariable linear regressions. RESULTS Among adolescents studied (n = 421), higher gestational age (per week), birthweight (per 100 grams), and birthweight for gestational age z-score (per SD) were linearly associated with higher intelligence score (adjusted standardized mean difference, 0.05 SD [95% CI, 0.01-0.09], 0.04 SD [95% CI, 0.02-0.06], and 0.09 SD [95% CI, 0.01-0.17], respectively). Birthweight and birthweight for gestational age z-score, but not gestational age, were also associated with improved executive function. Low birthweight (<2500 g) was associated with lower intelligence and executive function scores. Associations between birthweight and executive function were stronger among adolescents born to women with higher education. CONCLUSIONS The duration of gestation and birthweight were positively associated with adolescent neurodevelopment in Tanzania. These findings suggest that interventions to improve birth outcomes may also benefit adolescent cognitive function.
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Affiliation(s)
- Nandita Perumal
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Karim P Manji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Anne Marie Darling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Rodrick R Kisenge
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ingrid Kvestad
- Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway
| | - Mari Hysing
- Department of Psychological Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | | | - Willy Urassa
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer, Norway; Faculty of Medicine, Centre for International Health, University of Bergen, Bergen, Norway
| | - Christopher P Duggan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Pozuelo JR, Kilford EJ. Adolescent health series: Adolescent neurocognitive development in Western and Sub-Saharan African contexts. Trop Med Int Health 2021; 26:1333-1344. [PMID: 34270856 DOI: 10.1111/tmi.13656] [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: 11/29/2022]
Abstract
The transitional period of adolescence has long been associated with physical, social and behavioural change. During this time, adolescents start to develop their own self-identity, make important life decisions and acquire the necessary skills to successfully transition to adulthood. More recently, advances in brain imaging technology have enabled increased understanding of structural and functional changes in the human brain during this developmental period, and how they relate to social, emotional, motivational and cognitive development. The ability to integrate these developing cognitive processes in increasingly complex social contexts is a key aspect of mature decision-making, which has implications for adolescent health, educational, economic and social outcomes. Insights from the field of developmental cognitive neuroscience could increase our understanding of this influential stage of life and thus inform potential interventions to promote adolescent health, a critical goal for global health research. Many social changes occur during adolescence and the social environment shapes both brain and cognitive development and the decisions adolescents make. Thus, it is important to study adolescent neurocognitive development in socio-cultural context. Yet, despite evidence from Western studies that socio-cultural and economic factors impact on adolescent neurocognitive development, existing studies of adolescent neurocognitive development in sub-Saharan Africa are relatively scarce. We summarise research findings from Western and sub-Saharan African contexts and highlight areas where research is lacking. Longitudinal studies from more diverse global samples will be needed to build a comprehensive model of adolescent development, that characterises both commonalities in developmental trajectories, as well as the way these can meaningfully differ between both individuals and contexts.
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Affiliation(s)
- Julia R Pozuelo
- Department of Psychiatry, University of Oxford, Oxford, UK.,Centre for the Study of African Economies, Blavatnik School of Government and Economics Department, University of Oxford, Oxford, UK
| | - Emma J Kilford
- Institute of Cognitive Neuroscience, University College London, London, UK.,Department of Clinical, Educational & Health Psychology, University College London, London, UK
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Boivin MJ, Zoumenou R, Sikorskii A, Fievet N, Alao J, Davidson L, Cot M, Massougbodji A, Bodeau-Livinec F. [Formula: see text]Neurodevelopmental assessment at one year of age predicts neuropsychological performance at six years in a cohort of West African Children. Child Neuropsychol 2021; 27:548-571. [PMID: 33525970 PMCID: PMC8035243 DOI: 10.1080/09297049.2021.1876012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
Rural children from Benin, west Africa were evaluated with the Mullen Scales of Early Learning (MSEL) at one year of age and then at six years with the Kaufman Assessment Battery for Children (KABC-II), the visual computerized Tests of Variables of Attention (TOVA), and the Bruininks-Oseretsky Test (BOT-2) of motor proficiency (N = 568). Although both the MSEL and KABC-II were available to the assessors in French, instructions to the mother/child were in local language of Fon. Mothers were evaluated with the Edinburgh Postpartum Depression Scale (EPDS), Caldwell HOME Scale, educational level and literacy, and a Socio-Economic Scale - also in their local language (Fon). After adjusting for maternal factors, MSEL cognitive composite was correlated with KABC-II with moderate effect sizes, but not with TOVA scores. Overall eta-squared effect for the multivariate models were moderately to strongly correlated (.07 to .37). Neurodevelopmental assessments in early childhood adapted cross-culturally are predictive of school-age neuropsychological cognitive ability.
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Affiliation(s)
- Michael J Boivin
- Michigan State University Departments of Psychiatry and of Neurology & Ophthalmology, University of Michigan Department of Psychiatry
| | | | | | - Nadine Fievet
- Mère et Enfant Face aux Infections Tropicales, Université Paris Descartes, Paris, France
| | - Jules Alao
- Mère et Enfant Face aux Infections Tropicales, Université Paris Descartes, Paris, France
| | - Leslie Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Michel Cot
- Université Paris Descartes, Paris, France
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Université d'Abomey-Calavi, Cotonou, Benin
| | - Florence Bodeau-Livinec
- École des hautes études en santé publique (EHESP), EPOPé team, UMR1153, F-35000 Rennes, France
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16
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Villagomez AN, Muñoz FM, Peterson RL, Colbert AM, Gladstone M, MacDonald B, Wilson R, Fairlie L, Gerner GJ, Patterson J, Boghossian NS, Burton VJ, Cortés M, Katikaneni LD, Larson JCG, Angulo AS, Joshi J, Nesin M, Padula MA, Kochhar S, Connery AK. Neurodevelopmental delay: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2020; 37:7623-7641. [PMID: 31783983 PMCID: PMC6899448 DOI: 10.1016/j.vaccine.2019.05.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/09/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Adrienne N Villagomez
- University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital of Colorado, Aurora, CO, USA
| | - Flor M Muñoz
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Robin L Peterson
- University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital of Colorado, Aurora, CO, USA
| | - Alison M Colbert
- University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital of Colorado, Aurora, CO, USA
| | - Melissa Gladstone
- Department of Women and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | | | - Rebecca Wilson
- University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital of Colorado, Aurora, CO, USA
| | - Lee Fairlie
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Gwendolyn J Gerner
- Kennedy Krieger Institute, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jackie Patterson
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Nansi S Boghossian
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Vera Joanna Burton
- Kennedy Krieger Institute, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Jennifer C G Larson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Abigail S Angulo
- University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital of Colorado, Aurora, CO, USA
| | - Jyoti Joshi
- Center for Disease Dynamics Economics & Policy, Amity Institute of Public Health, Amity University, India
| | - Mirjana Nesin
- Division of Microbiology and Infectious Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Michael A Padula
- Children's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, PA, USA
| | - Sonali Kochhar
- Global Healthcare Consulting, India; University of Washington, Seattle, USA; Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Amy K Connery
- University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital of Colorado, Aurora, CO, USA.
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Xu C, Ellefson MR, Ng FFY, Wang Q, Hughes C. An East-West contrast in executive function: Measurement invariance of computerized tasks in school-aged children and adolescents. J Exp Child Psychol 2020; 199:104929. [PMID: 32711217 DOI: 10.1016/j.jecp.2020.104929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/07/2020] [Accepted: 05/31/2020] [Indexed: 11/17/2022]
Abstract
Existing cross-cultural findings related to school-aged children's executive function (EF) from studies using computerized tasks highlight both an East-West contrast (East > West) and potential methodological confounds (e.g., contrasting levels of computer fluency). Capitalizing on two recent data sets, this multisite study of 1,311 children living in mainland China (n = 453; Mage = 11.89 years, SD = 0.87), Hong Kong (n = 371; Mage = 12.21 years, SD = 0.99), and the United Kingdom (n = 487; Mage = 11.91 years, SD = 0.93) tested measurement invariance of a computerized EF-task battery prior to investigating cultural contrasts in mean levels of EF efficiency scores. Our models established partial scalar invariance across sites. Latent factor means were substantially lower for British children than for their counterparts from either mainland China or Hong Kong, with a significant but smaller contrast between the latter two groups. Within the Chinese sample, self-reported computer use was unrelated to variation in children's performance on online tests of EF, indicating that peripheral effects of task modality are unlikely to explain the between-culture differences in EF task performance.
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Affiliation(s)
- Chengyi Xu
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge CB2 3RQ, UK.
| | | | - Florrie Fei-Yin Ng
- Department of Educational Psychology, Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Qian Wang
- Department of Psychology, Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Claire Hughes
- Centre for Family Research, Department of Psychology, University of Cambridge, Cambridge CB2 3RQ, UK
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Griffin A, Deeba F, Dennison T, Moore A. Perspectives on neuropsychology and clinical care in paediatric and adolescent medicine. Clin Child Psychol Psychiatry 2020; 25:687-697. [PMID: 32370549 DOI: 10.1177/1359104520915249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As a child and adolescent neuropsychology service based within a paediatric psychology team at a large teaching hospital, we meet children and young people across the age range who experience cognitive impairment as a result of long-term health conditions or traumatic brain injury. We have a remit of providing a neuropsychological assessment and report. Typically, a neuropsychology report includes recommendations for home and for school. However, research suggests that their uptake is variable and depends on the understanding and resources of families and school systems. As a stretched service, we have very limited capacity to follow the work through to the extent that we might like. Therefore, we are always seeking effective ways to support the ongoing adaptation and implementation of the assessment recommendations in the child's various day-to-day contexts. We address both the cognitive functioning and the psychological well-being of the child as a unified whole. Drawing on systemic ideas influences our communications with children, families, schools and the medical teams in ways which help bridge the gap between hospital-based assessment and everyday life. This article describes how we are integrating our systemic and neurodevelopmental perspectives to make the assessment and the findings a meaningful intervention in themselves. We consider ways of sharing neuropsychology findings which promote the child's psychological well-being in their different contexts: hospital, home, school, community and culture.
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Affiliation(s)
- Angela Griffin
- Child Psychology Department, University Hospital Southampton Foundation Trust, UK
| | - Farah Deeba
- Department of Clinical Psychology, University of Dhaka, Bangladesh
| | - Taryn Dennison
- Child Psychology Department, University Hospital Southampton Foundation Trust, UK
| | - Anna Moore
- Child Psychology Department, University Hospital Southampton Foundation Trust, UK
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Colbert AM, Lamb MM, Asturias EJ, Muñoz FM, Bauer D, Arroyave P, Hernández S, Martínez MA, Paniagua-Avila A, Olson D, Calvimontes DM, Bolaños GA, El Sahly HM, Connery AK. Reliability and Validity of an Adapted and Translated Version of the Mullen Scales of Early Learning (AT-MSEL) in Rural Guatemala. Child Care Health Dev 2020; 46:327-335. [PMID: 31978249 DOI: 10.1111/cch.12748] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 01/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A growing literature base supports the use of tests developed in high-income countries to assess children in low resource settings when carefully translated, adapted, and applied. Evaluation of psychometric properties of adapted and translated measures within populations is necessary. The current project sought to evaluate the reliability and validity of an adapted and translated version of the Mullen Scales of Early Learning (AT-MSEL) in rural Guatelama. METHODS The reliability and validity of the AT-MSEL in rural Guatemala were analyzed for children ages 0-5 years. RESULTS Interrater reliability coefficients (ICC = 0.99-1.0) and internal consistency (Cronbach's alpha = 0.91-0.93) were excellent for all subscales. General linear models utilizing paired data showed consistency between standard scores (p < 0.0001). Mean raw scores increased with chronological age, as expected. Across age groups, subscales were significantly, positively correlated with one another (p < 0.05 - < 0.001) with one exception, visual reception and expressive language at the 0-10 month age range (p = 0.43). CONCLUSIONS The AT- MSEL showed strong psychometric properties in a sample of young children in rural Guatemala. Findings demonstrate that the AT-MSEL can be used validly and reliably within this specific population of children. This work supports the concept that tests developed in high-income countries can be used to assess children in low resource settings when carefully translated, adapted and applied.
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Affiliation(s)
- Alison M Colbert
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
| | | | - Edwin J Asturias
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
| | | | | | - Paola Arroyave
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Sara Hernández
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | | | | | - Daniel Olson
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
| | | | - Guillermo A Bolaños
- Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | | | - Amy K Connery
- Children's Hospital Colorado, Aurora, Colorado.,University of Colorado, Aurora, Colorado
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20
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Anum A, Washington-Nortey M, Dzokoto V. Strategic planning in LAMIC mental health research: A Ghana case study. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1719621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | | | - Vivian Dzokoto
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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21
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Schirmbeck K, Rao N, Maehler C. Similarities and differences across countries in the development of executive functions in children: A systematic review. INFANT AND CHILD DEVELOPMENT 2020. [DOI: 10.1002/icd.2164] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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22
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Molleman L, Kanngiesser P, van den Bos W. Social information use in adolescents: The impact of adults, peers and household composition. PLoS One 2019; 14:e0225498. [PMID: 31751413 PMCID: PMC6874082 DOI: 10.1371/journal.pone.0225498] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/06/2019] [Indexed: 11/24/2022] Open
Abstract
Social learning strategies are key for making adaptive decisions, but their ontogeny remains poorly understood. We investigate how social information use depends on its source (adults vs. peer), and how it is shaped by household composition (extended vs. nuclear), a factor known to modulate social development. Using a simple estimation task, we show that social information strongly impacts the behaviour of adolescents aged 11 to 15 years (N = 256), especially when its source is an adult. However, social information use does not depend on household composition: the relative impact of adults and peers was similar in adolescents from both household types. Furthermore, adolescents were found to directly copy others' estimates surprisingly frequently. This study provides novel insights into adolescents' social information use and contributes to understanding the ontogeny of social learning strategies.
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Affiliation(s)
- Lucas Molleman
- Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
- Department of Developmental Psychology, University of Amsterdam, The Netherlands
- Center for Adaptive Rationality, Max Planck Institute for Human Development Berlin, Germany
| | - Patricia Kanngiesser
- Faculty of Education and Psychology, Freie Universität Berlin, Germany
- Faculty of Education, Leipzig University, Germany
| | - Wouter van den Bos
- Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
- Department of Developmental Psychology, University of Amsterdam, The Netherlands
- Center for Adaptive Rationality, Max Planck Institute for Human Development Berlin, Germany
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23
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Colbert AM, Bauer D, Arroyave P, Hernández S, Martínez MA, Lamb MM, Paniagua-Avila A, Olson D, Calvimontes DM, Bolaños GA, El Sahly EJ, Muñoz FM, Connery AK. Performance of Young Children in Rural Guatemala on the Mullen Scales of Early Learning. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz029.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
The literature supports using tests developed in high-income countries to assess children in low and lower-middle income countries (LMICs) when carefully translated, adapted, and applied (Holding et al., 2018; Mitchell et al., 2017). Research has shown the Mullen Scales of Early Learning (MSEL) to have adequate validity and sensitivity when used in LMICs (Bangirana et al., 2014; Koura et al., 2013), as well as equivalency to the American normative sample in lower risk populations (Bornman et al., 2010). Here, we describe the pattern of MSEL results in rural Guatemala.
Participants and Method
Children (n = 842; M enrollment age = 15.9 months; range 0-5 years) enrolled in an observational study of postnatal Zika exposure in rural Guatemala were administered an adapted and translated version of the MSEL (Connery et al., in press). To date, 352 children completed one, 393 children completed two, and 97 children completed three MSELs, for a total of 1,429 administrations.
Results
MSEL composite scores were similar to the American normative sample in children <12 months (M = 93.3, SD = 11.1), but lower for children ages 1-5 years (mean = 71.1, SD = 15.1, p < 0.0001). Moreover, lower scores were observed in children ages 1-5 years for all MSEL subscales, with the largest differences observed in receptive language (<12 years: mean = 47.8, SD = 7.1; 1-5 years: mean = 35.1, SD = 10.0, p < 0.0001).
Conclusions
Results are consistent with research that demonstrates a widening gap in test performance over time between children from higher and lower risk communities (Fernald et al., 2011; Paxson et al., 2005; Schady et al., 2015). Although findings are not meant to diagnose individual children, they highlight population changes in neurodevelopmental skills and the need for a better understanding of developmental patterns in LMICs. Future analyses will evaluate the impact of developmental risk factors over time and the performance of the MSEL in this population.
References
Bangirana, P., Opoka, R. O., Boivin, M. J., Idro, R., Hodges, J. S., Romero, R. A., … John, C. C. (2014). Severe Malarial Anemia is Associated With Long-term Neurocognitive Impairment. Clinical Infectious Diseases, 59(3), 336–344. https://doi.org/10.1093/cid/ciu293. Bornman, J., Sevcik, R. A., Romski, M., & Pae, H. K. (2010). Successfully Translating Language and Culture when Adapting Assessment Measures, ppi_254 111.118. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1741-1130.2010.00254.x. Fernald, L. C. H., Weber, A., Galasso, E., & Ratsifandrihamanana, L. (2011). Socioeconomic gradients and child development in a very low income population: Evidence from Madagascar. Developmental Science, 14(4), 832–847. https://doi.org/10.1111/j.1467-7687.2010.01032.x. Holding, P., Anum, A., van de Vijver, F. J. R., Vokhiwa, M., Bugase, N., Hossen, T., … Gomes, M. (2018). Can we measure cognitive constructs consistently within and across cultures? Evidence from a test battery in Bangladesh, Ghana, and Tanzania. Applied Neuropsychology: Child, 7(1), 1-13 https://doi.org/10.1080/21622965.2016.1206823. Koura, K. G., Boivin, M. J., Davidson, L. L., Ouédraogo, S., Zoumenou, R., Alao, M. J., … Bodeau-Livinec, F. (2013). Usefulness of child development assessments for low-resource settings in francophone Africa. Journal of Developmental and Behavioral Pediatrics : JDBP, 34(7), 486–93. https://doi.org/10.1097/DBP.0b013e31829d211c. Mitchell, J. M., Tomlinson, M., Bland, R. M., Houle, B., Stein, A., & Rochat, T. J. (2017). Confirmatory factor analysis of the Kaufman assessment battery in a sample of primary school-aged children in rural South Africa. South African Journal of Psychology, 1–19. https://doi.org/10.1177/0081246317741822. Paxson, C., Schady, N., Izquierdo, S., León, M., Lucio, R., Ponce, J., … Hall, W. (2005). Cognitive Development among Young Children in Ecuador The Roles of Wealth, Health, and Parenting. Retrieved from http://econ.worldbank.org. Schady, N., Behrman, J., Araujo, M. C., Azuero, R., Bernal, R., Bravo, D., … Vakis, R. (2015). Wealth gradients in early childhood cognitive development in five Latin American countries. The Journal of Human Resources, 50(2), 446–463. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25983344.
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Connery AK, Colbert AM, Lamb MM, Hernández S, Martínez MA, Bauer D, Arroyave P, El Sahly HM, Paniagua-Avila A, Calvimontes M, Bolaños GA, Olson D, Asturias EJ, Munoz FM. Receptive language skills among young children in rural Guatemala: The relationship between the Test de Vocabulario en Imagenes Peabody and a translated and adapted version of the Mullen Scales of Early Learning. Child Care Health Dev 2019; 45:702-708. [PMID: 31270836 DOI: 10.1111/cch.12702] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/24/2019] [Accepted: 06/30/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Children in low- and lower middle income countries (LMICs) often have poorer language skills compared with children from high-income countries. Limited availability of culturally and linguistically appropriate assessment measures in LMICs, especially for young children, can hinder early identification and prevention efforts. Here, we describe receptive language (RL) skills among young children in rural Guatemala and report on the validity of a translated and culturally adapted developmental measure of RL. METHODS Children (n = 157; m = 53.6 months, range = 42-68 months) enrolled in a prospective cohort study of postnatally acquired Zika virus infection were administered the Test de Vocabulario en Imagenes Peabody (TVIP) and the RL scale from a translated and adapted version of the Mullen Scales of Early Learning (MSEL). Performance on the TVIP was compared with the Latin American normative sample. Correlational analysis examined the relationship between performance on the TVIP and the MSEL-RL. RESULTS Mean scores were significantly below the normative sample mean on the TVIP, t(126) = -11.04, p < .001; d = 1.00. Performance on the TVIP among children who passed the practice items (n = 127) was significantly positively associated with performance on the MSEL-RL (r = .50, p < .001), but not significantly associated with age or gender. Older age (p < .0001) and female gender (p = .018) were associated with passing the TVIP practice items. CONCLUSIONS Delays in RL vocabulary were identified among young children in rural Guatemala on the TVIP. The association between scores on the TVIP and the RL scale of the MSEL provides preliminary support for the construct validity of this translated and adapted version of the MSEL.
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Affiliation(s)
- Amy K Connery
- Children's Hospital Colorado, Aurora, Colorado.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado
| | - Alison M Colbert
- Children's Hospital Colorado, Aurora, Colorado.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado
| | - Molly M Lamb
- Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Sara Hernández
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - María Alejandra Martínez
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Desirée Bauer
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Paola Arroyave
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Hana M El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Alejandra Paniagua-Avila
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Mirella Calvimontes
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Guillermo Antoñio Bolaños
- Center for Human Development, Fundación para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala
| | - Daniel Olson
- Children's Hospital Colorado, Aurora, Colorado.,Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Edwin J Asturias
- Children's Hospital Colorado, Aurora, Colorado.,Center for Global Health and Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Flor M Munoz
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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25
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Ruiseñor-Escudero H, Familiar I, Nyakato M, Kutessa A, Namukooli J, Ssesanga T, Joyce C, Laughton B, Grab J, Chernoff M, Vhembo T, Fairlie L, Kamthunzi P, Boivin M. Building capacity in neurodevelopment assessment of children in sub-Saharan Africa: A quality assurance model to implement standardized neurodevelopment testing. Child Neuropsychol 2019; 25:466-481. [PMID: 30105934 PMCID: PMC6375801 DOI: 10.1080/09297049.2018.1497588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 06/10/2018] [Indexed: 10/28/2022]
Abstract
Compromised neurodevelopment (ND) among infants and children is prevalent in sub-Saharan Africa. Standardized testing of ND is frequently prohibitive in these contexts, as tests require skilled staff for their application. In this paper, we present a quality assurance (QA) model (QualiND) for standardized ND testing, discussing findings and implications from our experience applying the Kaufman Assessment Battery for Children second edition (KABC-II). The QualiND model was implemented within IMPAACT P1104s study, a multisite, prospective study including 615 children affected by HIV. From 2014 to 2016, the QualiND managed 18 testers across 6 sites located in 4 African countries applying the KABC-II in 9 local languages. The QualiND is a multilevel, video-assisted iterative model incorporating remote evaluation, feedback, and supervision roles. Using an ad hoc rubric, videos of test application were evaluated by experienced staff in a centralized QA center. At each study site, testers and supervisors reviewed feedback from videos received via email from the QA center and devised an action plan to address testing errors and deficiencies. There were few instances of invalid tests and few barriers to test completion. Over 97% of KABC-II tests across sites were considered to be valid by the QA center. Overall, the QualiND model was a useful platform for remote supervision to nonspecialist and minimally trained research staff. The QualiND model may be useful to researchers and organizations involved in measuring early child development using standardized tests in low and middle-income countries.
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Affiliation(s)
| | - Itziar Familiar
- a Psychiatry Department , Michigan State University , East Lansing , USA
| | - Mary Nyakato
- b Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) , Kampala , Uganda
| | - Agatha Kutessa
- b Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) , Kampala , Uganda
| | | | | | - Celeste Joyce
- d Chris Hani HIV Unit , University of Witwatersrand , Soweto , South Africa
| | - Barbara Laughton
- e Department of Pediatrics and Child Health , Tygerberg University , Tygerberg , South Africa
| | - Janet Grab
- f Wits Reproductive Health & HIV Institute , Shandukani Clinic , Johannesburg , South Africa
| | - Miriam Chernoff
- g Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health , Harvard University , Boston , USA
| | - Tichaona Vhembo
- h Harare Family Care , University of Zimbabwe , Harare , Zimbabwe
| | - Lee Fairlie
- f Wits Reproductive Health & HIV Institute , Shandukani Clinic , Johannesburg , South Africa
| | - Portia Kamthunzi
- i Lilongwe Clinical Research Institute , Kamuzu Central Hospital , Lilongwe , Malawi
| | - Michael Boivin
- a Psychiatry Department , Michigan State University , East Lansing , USA
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Effect of antenatal and infant micronutrient supplementation on middle childhood and early adolescent development outcomes in Tanzania. Eur J Clin Nutr 2019; 73:1283-1290. [PMID: 30718805 PMCID: PMC6679819 DOI: 10.1038/s41430-019-0403-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 11/26/2022]
Abstract
Background: There is growing evidence that nutritional interventions in the first 1,000 days of life may influence long-term health and development outcomes. Few studies have examined the effect of maternal and infant micronutrient supplementation on development outcomes in sub-Saharan Africa. Methods: We conducted a follow-up study of two randomized trials of antenatal and infant micronutrient supplementation conducted in Dar es Salaam, Tanzania. We assessed the effect of maternal multiple micronutrient (MMN) supplementation in pregnancy on development of children at 11–14 years of age. We also examined the effect of infant zinc and MMN supplementation on development at 6–8 years of age. We use generalized linear models to assess standardized mean differences (SMDs) in general intelligence, executive function and mental health scores. Results: We followed-up 446 children whose mothers were enrolled in the maternal MMN supplementation trial and 365 children who were enrolled in the infant zinc and MMN supplementation trial. We found no effect of maternal MMN supplementation on general intelligence (SMD: −0.03; 95% CI: −0.15, 0.09), executive function (SMD: 0.00; 95% CI: −0.11, 0.11) and mental health scores (SMD: 0.06; 95% CI: −0.10, 0.22). We also found no effect of either infant zinc or MMN supplementation on any of the three development domains (p-values >0.05). Conclusions: We found that antenatal MMN supplementation and infant zinc and MMN supplementation did not have a large effect on development outcomes in middle childhood and early adolescence in Tanzania.
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Sanou AS, Diallo AH, Holding P, Nankabirwa V, Engebretsen IMS, Ndeezi G, Tumwine JK, Meda N, Tylleskar T, Kashala-Abotnes E. Effects of schooling on aspects of attention in rural Burkina Faso, West Africa. PLoS One 2018; 13:e0203436. [PMID: 30183764 PMCID: PMC6124811 DOI: 10.1371/journal.pone.0203436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 08/21/2018] [Indexed: 11/25/2022] Open
Abstract
Background We aimed to study the effects of schooling on aspects of attention using the Test of Variables of Attention (TOVA) among children in rural Burkina Faso. Methods We re-enrolled children of a previously community-based cluster randomized exclusive breastfeeding trial in rural Burkina Faso. A total of 534 children (280 boys and 254 girls) aged 6 to 8 years were assessed using the TOVA. We examined the effect size difference using Cohen’s d, ANOVA and conducted regression analyses. Results Forty nine percent of the children were in school. Children not in school performed poorly with a small effect size difference for ‘Response Time’, ‘Errors of omission’, and ‘Errors of commission’ compared to children in school. The effect size difference was moderate for ‘Response Time Variability’, and ‘D prime score’. Conclusion Schooling affects different aspects of attention in rural Burkina Faso. In settings where literacy and schooling rate is low, public sensitizations of the benefits of schooling need to be reinforced and advice on sending children to school need to be provided continuously.
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Affiliation(s)
- Anselme Simeon Sanou
- Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Public Health, Centre MURAZ Research Institute, Bobo-Dioulasso, Burkina Faso
- * E-mail:
| | - Abdoulaye Hama Diallo
- Department of Public Health, Centre MURAZ Research Institute, Bobo-Dioulasso, Burkina Faso
- Department of Public Health, University of Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Victoria Nankabirwa
- Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
- Centre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ingunn Marie S. Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - James K. Tumwine
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Nicolas Meda
- Department of Public Health, Centre MURAZ Research Institute, Bobo-Dioulasso, Burkina Faso
- Department of Public Health, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Thorkild Tylleskar
- Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Esperance Kashala-Abotnes
- Centre for International Health, Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Bodeau-Livinec F, Davidson LL, Zoumenou R, Massougbodji A, Cot M, Boivin MJ. Neurocognitive testing in West African children 3-6 years of age: Challenges and implications for data analyses. Brain Res Bull 2018; 145:129-135. [PMID: 29630997 DOI: 10.1016/j.brainresbull.2018.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/07/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE When testing African children with developmental and cognitive standardized tests from high-income countries (HIC), investigators are uncertain as to whether to apply the HIC norms for these tests when standardizing a child's raw-score performance on the basis of age. The present study compared the construct validity of both raw and HIC-based standardized scores for the Mullen Scales of Early Learning (MSEL) and the Kaufman Assessment Battery in Children - 2nd edition (KABC-II) for Beninese children in a rural setting from three to six years of age. METHODS Seventy-four children 3-4 yrs of age were assessed with the MSEL, and 61 eligible older children (5-6 yrs of age) were assessed with the KABC-II. Assessors spoke the instructions to the children and caregivers for the assessment items in the local language. The developmental quality of the home environment was evaluated with the Caldwell Home Observation for Measurement of the Environment (HOME) inventory, and a material possessions and housing quality checklist was used as a measure of socio-economic status (SES). Children's mothers were given the Raven's Progressive Matrices test (nonverbal cognitive ability), and the Edinburgh Postpartum Depression Scale (EPDS) (emotional wellbeing). RESULTS For the MSEL, the 4-yr old group performed significantly better than the 3-yr old group on both the raw and standardized score comparisons for all scales. These differences were attenuated when using standardized scores, although the MSEL standardized cognitive composite score was still highly significant between years of age. When comparing 5- to 6-yr olds on KABC-II subtest and global scale performance, comparisons between the raw and standardized mean score performances were much less consistent. Generally, 6-yr olds performed significantly better than 5-yr olds on the raw score comparisons on the KABC-II subtests, but not so for standardized scores. Parent-child interactions assessed through the HOME measure was associated with both raw and standardized MSEL cognitive composite score outcomes on a multiple regression analysis. SES was the only significant predictor for KABC-II raw and standardized outcomes. CONCLUSION Standardization using HIC norms was not optimal, resulting in minimal impact to account for age when using the MSEL, and lower scores for oldest children compared with youngest children when using the KABC2. This is likely due to children in Benin drifting away from HIC-based norms with each passing year of age, systematically lowering standardized performance measures. These findings support the importance of having a local comparison group of reference or control children to allow for adjusted (for age, HOME, and SES) raw score comparisons when using western-based tests for developmental and neuropsychological evaluation.
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Affiliation(s)
- Florence Bodeau-Livinec
- EHESP, F-35000 Rennes, France; Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
| | - Leslie L Davidson
- Columbia University, Mailman School of Public Health and the College of Physicians and Surgeons, NY, USA.
| | - Roméo Zoumenou
- Institut de Recherche pour le Développement, Mère et enfant face aux infections tropicales, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France; The Centre Biomédical des Cordeliers, Université Pierre et Marie Curie, Paris, France; PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France.
| | | | - Michel Cot
- Institut de Recherche pour le Développement, Mère et enfant face aux infections tropicales, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France; The Centre Biomédical des Cordeliers, Université Pierre et Marie Curie, Paris, France; PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France.
| | - Michael J Boivin
- Departments of Psychiatry and Neurology & Ophthalmology, Michigan State University, 909 fee Road, Rm 321, West Fee Hall, East Lansing, MI, 48824, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
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Boivin MJ, Mohanty A, Sikorskii A, Vokhiwa M, Magen JG, Gladstone M. Early and middle childhood developmental, cognitive, and psychiatric outcomes of Malawian children affected by retinopathy positive cerebral malaria. Child Neuropsychol 2018; 25:81-102. [PMID: 29570016 DOI: 10.1080/09297049.2018.1451497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The objective is to determine the short -and long-term developmental, cognitive, and psychiatric effects of retinopathy positive cerebral malaria (CM-R) among young children in a prospective study assessing them around the onset of disease and again 2 years at preschool and again at school age. In total, 109 children were recruited from the Queen Elizabeth Central Hospital in Blantyre, Malawi, (N = 49) with CM-R and non-malaria controls (N = 60). Children were assessed for overall motor, language, and social skills using the Malawi Developmental Assessment Tool (MDAT) at preschool age. At school age, the same children were then given the Kaufman Assessment Battery for Children, second edition (KABC-II), which assessed global cognitive performancememory, and learning; as well as the Test of Variables of Attention (TOVA), which assessed attention. The Achenbach Child Development Checklist (CBCL) was administered at both time points to assess emotional and behavioral patterns. Controls scored significantly better on all KABC-II global domains as well as on the mental processing index than their CM-R group counterparts, but showed no performance differences in the TOVA and CBCL assessments at school age, or in the MDAT and CBCL assessments at preschool age. The MDAT total score was significantly correlated with the KABC-II sequential processing, learning, and mental processing index among CM-R survivors but not among controls. Persisting neurocognitive effects of CM can be captured with the KABC-II at school age. The MDAT at preschool age is correlated with the KABC-II among CM-R survivors and can be used to capture early emerging developmental deficits due to CM-R.
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Affiliation(s)
- Michael J Boivin
- a Departments of Psychiatry and Neurology & Ophthalmology , Michigan State University , East Lansing , USA.,b Department of Psychiatry , University of Michigan , Ann Arbor , Michigan , USA
| | - Arpita Mohanty
- c College of Osteopathic Medicine , Michigan State University , East Lansing , Michigan , USA
| | - Alla Sikorskii
- d Psychiatry and Statistics & Probability , Michigan State University , East Lansing , Michigan , USA
| | - Maclean Vokhiwa
- e Department of Psychology , Chancellor College - University of Malawi , Zomba , Malawi
| | - Jed G Magen
- f Department of Psychiatry , Michigan State University , East Lansing , Michigan , USA
| | - Melissa Gladstone
- g Paediatrics and Neurodisability , Women's and Children's Health, University of Liverpool , Liverpool , UK
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Chernoff MC, Laughton B, Ratswana M, Familiar I, Fairlie L, Vhembo T, Kamthunzi P, Kabugho E, Joyce C, Zimmer B, Ariansen JL, Jean-Philippe P, Boivin MJ. Validity of Neuropsychological Testing in Young African Children Affected by HIV. J PEDIAT INF DIS-GER 2018; 13:185-201. [PMID: 30100780 DOI: 10.1055/s-0038-1637020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Introduction Western-constructed neuropsychological tests have been used in low and middle income countries to assess the impact of HIV/AIDS and other chronic illnesses. We explore using such instruments cross-culturally in a sub-Saharan Africa setting. Methods IMPAACT P1104S was a two-year observational study carried out at six clinical sites (South Africa- 3 sites, Malawi, Uganda and Zimbabwe) to assess and compare neuropsychological outcomes in three cohorts of children 5-11 years of age: HIV-infected (HIV), HIV-exposed but uninfected (HEU) and HIV unexposed and uninfected (HU). Descriptive statistics compared socio-demographic characteristics among children at sites. Instruments included the KABC-II cognitive ability, TOVA attention/impulsivity, BOT-2 motor proficiency tests, and BRIEF executive function problems. Test characteristics were assessed using intraclass and Spearman non-parametric correlations, linear regression and principal factor analyses. Results Of the 611 participants, 50% were male and mean age ranged from 6.6 to 8 years. In Malawi, Uganda and Zimbabwe, substantial proportions of families lived in rural settings in contrast to the South African sites. Intraclass correlation coefficients between weeks 0 and 48 were highest for the KABC scores, ranging between 0.42 to 0.71.Correlations among similar test domains were low to moderate but significant, with positive correlation between KABC Sequential and TOVA scores and negative correlation between BRIEF and KABC scores. TOVA response time scores correlated negatively with the BOT-2 Total points score. Strong and significant associations between individual measures of growth, disability and development with all test scores were observed. Performance-based measures were markedly lower for HIV compared to HEU and HU participants, even after controlling for age, sex and site. Factor analyses confirmed the underlying theoretical structure of the KABC scaled item scores. Conclusion The KABC, TOVA, BRIEF and BOT-2 were valid and reliable tools for assessing the neuropsychological impact of HIV in four sub-Saharan African countries.
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Affiliation(s)
- Miriam C Chernoff
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Barbara Laughton
- Family Clinical Research Unit, Tygerberg Hospital, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, RSA
| | - Mmule Ratswana
- Wits Reproductive Health & HIV Institute (WRHI), Shandukani Clinic, Johannesburg, RSA
| | - Itziar Familiar
- Department of Psychiatry, Michigan State University, East Lansing, MI
| | - Lee Fairlie
- Wits Reproductive Health & HIV Institute (WRHI), Shandukani Clinic, Johannesburg, RSA
| | - Tichaona Vhembo
- Harare Family Care CRS, University of Zimbabwe, College of Health Sciences Clinical Trials Unit, Harare, Zimbabwe
| | - Portia Kamthunzi
- University of North Carolina Project- Lilongwe, Malawi CRS, Malawi
| | - Enid Kabugho
- Makerere University-Johns Hopkins University Research Collaboration (MUJHU CARE LTD) CRS, Kampala, Uganda
| | - Celeste Joyce
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, South Africa
| | | | - J L Ariansen
- Clinical Research Management, FHI360, Durham, NC
| | | | - Michael J Boivin
- Department of Psychiatry, Michigan State University, East Lansing, MI.,Department of Neurology and Ophthalmology, Michigan State University, East Lansing, MI.,Department of Psychiatry, the University of Michigan, Ann Arbor, MI
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