Development, feasibility and acceptability of a gamified cognitive DEvelopmental assessment on an E-Platform (DEEP) in rural Indian pre-schoolers – a pilot study

Abstract

Background: Assessment of cognitive development is essential to identify children with faltering developmental attainment and monitor the impact of interventions. A key barrier to achieving these goals is the lack of standardized, scalable tools to assess cognitive abilities.Objective: This study aimed to develop a tablet-based gamified assessment of cognitive abilities of 3-year-old children which can be administered by non-specialist field workers.Methods: Workshops among domain experts, literature search for established and gamified paradigms of cognitive assessments and rapid review of mobile games for 3-year-old children was done to conceptualize games for this study. Formative household visits (N = 20) informed the design and content of the games. A cross-sectional pilot study (N = 100) was done to assess feasibility of the tool and check if increasing levels of difficulty and the expected variability between children were evident in game metrics. In-depth interviews (N = 9) were conducted with mothers of participating children to assess its acceptability.Results: Six cognitive domains were identified as being integral to learning – divided attention, response inhibition, reasoning, visual form perception and integration and memory. A narrative, musical soundtrack and positive reinforcement were incorporated into the tool to enhance participant engagement. Child performance determined level timers and difficulty levels in each game. Pilot data indicate that children differ in their performance profile on the tool as measured by the number of game levels played and their accuracy and completion time indicating that it might be possible to differentiate children based on these metrics. Qualitative data suggest high levels of acceptability of the tool amongst participants.Conclusions: A DEvelopmental assessment on an E-Platform (DEEP) has been created comprising distinct games woven into a narrative, which assess six cognitive domains, and shows high levels of acceptability and generates metrics which may be used for validation against gold standard cognitive assessments.

The role of RDoC in future classification of mentaldisorders

“…At least one such effort is already under way: A developmental battery that assesses six cognitive domains–employing “gamified” tasks on a mobile e-platform to engage participants’ interest–has been piloted for 3-year old children in rural India, with the goal of developing normative curves across development as the project grows. 18 These projects demonstrate that quantitatively based efforts at prevention, assessed relative to continuous population (or large-sample) distributions, are not simply a promissory note but are already being implemented.…”

Studying Executive Function Skills in Young Children in Low‐ and Middle‐Income Countries: Progress and Directions

“…Moreover, tasks that integrate the accuracy and speed of children’s responses measure EFs more sensitively and can be used with a wider range of ages, including with children in the transition from preprimary to primary school (Magnus, Willoughby, Blair, & Kuhn, ). Mobile phones and tablets are ubiquitous in low‐ and middle‐income countries, and recent studies in Kenya and India have demonstrated the feasibility and utility of tablet‐based assessments of EF skills in 3‐ to 5‐year‐olds (Bhavnani et al, ; Willoughby, Piper, Kwayumba et al, ). Large‐scale computerized assessments of EF skills that implement these recommendations are on the horizon (see Table for examples).…”

Promoting Developmental Potential in Early Childhood: A Global Framework for Health and Education

“…The lack of standardized measures suitable for use in assessment of young children in low-resource countries has been identified by Bhavnani [ 26 ] as a significant impediment for population-based screening and for assessing dimensions of child functioning for planning and monitoring interventions. The use of existing tools and measures is often not an option for a number of reasons.…”