A cognitive assessment tool designed for data collection in the field in low- and middle-income countries

Abstract

The Rapid Assessment of Cognitive and Emotional Regulation (RACER) is a tablet-based assessment tool for children that measures executive function (EF) skills. Instructions that are brief and visually presented; gamelike tasks are designed to easily engage children regardless of literacy level and variable test administration settings. RACER measures inhibitory control and working memory. This study presents the theoretical rationale and empirical evidence for tablet-based assessments of EF, the process of administering the RACER assessments. The current sample consists of students in Lebanon (N=1900) and Niger (N=850). The results indicate that individual differences in EF can be assessed by the RACER tablet tasks. Specifically, we demonstrate that EF scores are associated in expected ways with age and that tasks function similarly to what has been observed in high-income countries. The feasibility and utility for researchers, practitioners, and clinicians, of this cognitive assessment tool is discussed.

Minds Under Siege: Cognitive Signatures of Poverty and Trauma in Refugee and Non‐Refugee Adolescents

“…By contrast, Jordanian peers experienced less exposure to both poverty and the violence of war. We measured EF using computerized assessments (RACER tasks), observing task manipulation effects similar to those observed in Lebanon (Ford et al, 2019), Niger (Ford et al, 2019), and the United States (Sheridan, Kharitonova, Martin, Chatterjee & Gabrieli, 2014). Recent work based on the United States has demonstrated a disassociation between trauma and poverty in predicting EF, whereby exposure to poverty but not traumatic violence predicts EF task performance (Lambert et al, 2016;Sheridan et al, 2017).…”

“…By contrast, Jordanian peers experienced less exposure to both poverty and the violence of war. We measured EF using computerized assessments (RACER tasks), observing task manipulation effects similar to those observed in Lebanon (Ford et al, ), Niger (Ford et al, ), and the United States (Sheridan, Kharitonova, Martin, Chatterjee & Gabrieli, ).…”

“…The study was approved by the Prime Minister's Office of Jordan and Yale University. We conducted assessments in a private location; during a single session (~50 min), adolescents completed survey instruments, as well as tablet-based RACER tasks (first IC, then WM), optimized for use in LMIC and humanitarian settings (Ford, Kim, Brown, Aber, & Sheridan, 2019).…”

“…This study had many strengths, including assessments with a gender-balanced, representative sample, using regionally validated measures of mental health and psychosocial well-being (Panter-Brick, Dajani, et al, 2018;Panter-Brick, Hadfield, et al, 2018) and measures of EF sensitive to the demands of cognitive testing in under-resourced areas (Ford et al, 2019). It also has several limitations.…”

Measuring the psychosocial, biological, and cognitive signatures of profound stress in humanitarian settings: impacts, challenges, and strategies in the field

“…We found that average cortisol levels dropped by a third (38%) in response to the program; stress was down-regulated in youth with high cortisol levels and up-regulated in youth with blunted cortisol profiles, showing beneficial regularization over time [13,14]. [15] to measure working memory and inhibitory control, both important for learning abilities. We found no program impacts on these executive function skills, but showed that deficits in working memory were associated with pervasive poverty, rather than trauma exposure [16].…”