Early Detection of Neurodevelopmental Disorders of Toddlers and Postnatal Depression by Mobile Health App: Observational Cross-sectional Study

Abstract

Background Delays in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) in mothers are major public health issues. In both cases, early intervention is crucial. Objective We aimed to assess if a mobile app named Malo can reduce delay in the recognition of NDD and PND. Methods We performed an observational, cross-sectional, data-based study in a population of young parents with a minimum of 1 child under 3 years of age at the time of inclusion and using Malo on a regular basis. We included the first 4000 users matching the criteria and agreeing to participate between November 11, 2021, and January 14, 2022. Parents received monthly questionnaires via the app, assessing skills on sociability, hearing, vision, motricity, language of their infants, and possible autism spectrum disorder. Mothers were also requested to answer regular questionnaires regarding PND, from 4-28 weeks after childbirth. When any patient-reported outcomes matched predefined criteria, an in-app notification was sent to the user, recommending the booking of an appointment with their family physician or pediatrician. The main outcomes were the median age of the infant at the time of notification for possible NDD and the median time of PND notifications after childbirth. One secondary outcome was the relevance of the NDD notification for a consultation as assessed by the physicians. Results Among 4242 children assessed by 5309 questionnaires, 613 (14.5%) had at least 1 disorder requiring a consultation. The median age of notification for possible autism spectrum, vision, audition, socialization, language, or motor disorders was 11, 9, 17, 12, 22, and 4 months, respectively. The sensitivity of the alert notifications of suspected NDDs as assessed by the physicians was 100%, and the specificity was 73.5%. Among 907 mothers who completed a PND questionnaire, highly probable PND was detected in 151 (16.6%) mothers, and the median time of detection was 8-12 weeks. Conclusions The algorithm-based alert suggesting NDD was highly sensitive with good specificity as assessed by real-life practitioners. The app was also efficient in the early detection of PND. Our results suggest that the regular use of this multidomain familial smartphone app would permit the early detection of NDD and PND. Trial Registration ClinicalTrials.gov NCT04958174; https://clinicaltrials.gov/ct2/show/NCT04958174

Evidence-Based Implementation of the Family-Centered Model and the Use of Tele-Intervention in Early Childhood Services: A Systematic Review

“…Practices based on the family-centered model ensure family commitment and are related to positive therapeutic outcomes [ 41 , 42 , 43 , 44 , 48 , 53 , 59 , 61 , 63 , 64 , 65 ]. As shown in the previous section, variables such as competence, self-efficacy, satisfaction, and empowerment are of great importance since, to some extent, the intervention will depend on them.…”

“…Subsequent research continues this line of prevention and intervention in determining aspects of the health of infants aged 0 to 6 years, showing rates of effectiveness and acceptability, in which the figure of the family and its context are highlighted in the process [ 42 , 45 , 51 , 53 , 54 , 57 ].…”

Implications of Early Diagnosis and Intervention in the Management of Neurodevelopmental Delay (NDD) in Children: A Systematic Review and Meta-Analysis

“…The forest plot as shown in Figure 2 below provides a clear interpretation of the findings of this study [14][15][16][17][18][19][20][21][22][23][24][25][26]. The columns indicate the included studies, the intervention group, the control group, the weight, and the outcome effect in the numerical and graphical format [27].…”

“…For instance, the effectiveness of the ESDM model for treating and managing developmental delays arising from autism spectrum disorder was noted [ 15 , 16 ]. A study identified an algorithm-based mobile application named Malo to effectively diagnose and recognize NDD and post-natal depression (PND) [ 18 ]. Also, a model-based study proposed using the Bayesian network (BN) model to predict early motor development problems for delayed children [ 19 ].…”

“…Figure 3 provides a negative risk difference, meaning that early intervention and diagnosis reduced the risk of severe NDDs in children [14][15][16][17][18][19][20][21][22][23][24][25][26]. In other words, a negative risk difference means that it was easy to manage NDD children following early intervention and diagnosis.…”