Eye-tracking-based assessment of cognitive function in low-resource settings

Forssman, Linda; Ashorn, Per; Ashorn, Per; Maleta, Kenneth; Matchado, Andrew; Kortekangas, Emma; Leppänen, Jukka

doi:10.1136/archdischild-2016-310525

Cited by 51 publications

(59 citation statements)

References 26 publications

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“…The present study examined the development of visual attention capabilities in a large sample of infants living in rural settings in Malawi. Consistent with prior research in Western countries and a previous study in Malawi (Forssman et al., ), the results showed the predicted pattern of results at group level in tasks assessing visual search, anticipatory attention shifts, and attention to faces. The results also showed that there are changes in most of these measures between 7 and 9 months, consistent with the prediction that the measures are sensitive to development of visual attentional processes.…”

Section: Discussionsupporting

confidence: 91%

“…The non‐face‐patterns were created by phase‐scrambling the faces used in the experiment (see Peltola et al., for details). The faces were pictures of two Black females that had been tested in a small‐scale pilot study to look familiar to the local people and provide valid examples of the happy and fearful expressions (Forssman et al., ). The second stimulus was a geometric shape (black and white circles or a checkerboard pattern), which was superimposed by a still picture showing the first frame of a child‐friendly cartoon animation.…”

Section: Methodsmentioning

confidence: 99%

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Early development of visual attention in infants in rural Malawi

Pyykkö

Forssman

Maleta

et al. 2018

Developmental Science

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Eye tracking research has shown that infants develop a repertoire of attentional capacities during the first year. The majority of studies examining the early development of attention comes from Western, high‐resource countries. We examined visual attention in a heterogeneous sample of infants in rural Malawi (N = 312–376, depending on analysis). Infants were assessed with eye‐tracking‐based tests that targeted visual orienting, anticipatory looking, and attention to faces at 7 and 9 months. Consistent with prior research, infants exhibited active visual search for salient visual targets, anticipatory saccades to predictable events, and a robust attentional bias for happy and fearful faces. Individual variations in these processes had low to moderate odd‐even split‐half and test‐retest reliability. There were no consistent associations between attention measures and gestational age, nutritional status, or characteristics of the rearing environment (i.e., maternal cognition, psychosocial well‐being, socioeconomic status, and care practices). The results replicate infants’ early attentional biases in a large, unique sample, and suggest that some of these biases (e.g., bias for faces) are pronounced in low‐resource settings. The results provided no evidence that the initial manifestation of infants’ attentional capacities is associated with risk factors that are common in low‐resource environments.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Early development of visual attention in infants in rural Malawi

Pyykkö

Forssman

Maleta

et al. 2018

Developmental Science

Self Cite

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“…As did Forssman et al (2017) with Malawian infants using Tobii eye tacking instrumentation and a cognitive visual tracking task, we also established the feasibility of eye tracking measures with children in a medical clinic serving a disadvantaged rural Ugandan sample of at-risk children. We also established ways in which of ECVT eye tracking measures correlated to other cognitive and neurodevelopmental assessments in our study children.…”

Section: Discussionmentioning

confidence: 99%

“…However, we know of only one published report where Tobii eye tracking instrumentation has been used to evaluate neurocognitive response with children in the African setting. Forssman and colleagues (2017) presented a visual tracking and visual switching task to a sample of both Finnish (N=39) and Malawian (N=40) nine-month old infants in order to establish the feasibility of this sort of eye-tracking measure in a cross-cultural study (Forssman et al, 2017). Both groups of infants had a very high completion rate for the visual testing procedure while providing valid eye tracking data (> 90%), and parents in both cultures had a high acceptance rate of this kind of evaluation for their children.…”

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confidence: 99%

The feasibility of automated eye tracking with the Early Childhood Vigilance Test of attention in younger HIV-exposed Ugandan children.

Boivin¹,

Weiss²,

Chhaya³

et al. 2017

Neuropsychology

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Objective Tobii eye tracking was compared to webcam-based observer scoring on an animation viewing measure of attention (ECVT) to evaluate the feasibility of automating measurement and scoring. Outcomes from both scoring approaches were compared to the Mullen Scales of Early Learning (MSEL), Color-Object Association Test (COAT), and Behavior Rating Inventory of Executive Function for preschool children (BRIEF-P). Method 44 children 44 to 65 months of age were evaluated with the ECVT, COAT, MSEL, and BRIEF-P. Tobii X2-30 portable infrared cameras were programmed to monitor pupil direction during the ECVT 6-minute animation, and compared to observer-based PROCODER webcam scoring. Results Children watched 78% of the cartoon (Tobii) compared to 67% (webcam scoring), although the two measures were highly correlated (r=0.90,P=0.001). It is possible for two such measures to be highly correlated even if one is consistently higher than the other (Bergemann et al., 2012). Both ECVT Tobii and webcam ECVT measures significantly correlated with COAT immediate recall (r=0.37,P=0.02 versus r=0.38,P=0.01 respectively) and total recall (r=0.33,P=0.06 versus r=0.42,P=0.005) measures. However, neither the Tobii eye tracking nor PROCODER webcam ECVT measures of attention correlated with MSEL composite cognitive performance or BRIEF-P global executive composite. Conclusion ECVT scoring using Tobii eye tracking is feasible with at-risk very young African children and consistent with webcam-based scoring approaches in their correspondence to one another and other neurocognitive performance-based measures. By automating measurement and scoring, eye tracking technologies can improve the efficiency and help better standardize ECVT testing of attention in younger children. This holds promise for other neurodevelopmental tests where eye movements, tracking, and gaze length can provide important behavioral markers of neuropsychological and neurodevelopmental processes associated with such tests.

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“…Forssman et al report the findings of a feasibility study that applied the same set of eye-tracking tasks, which were designed to evaluate social cognition and learning, to a group of infants from a high-income country (Finland) and a low-income country (Malawi) 8. The authors' motivation is clear: poverty and malnutrition are major determinants of neurodevelopmental impairment, so the burden of these problems is high in low-income countries.…”

mentioning

confidence: 99%