Development & validation of a scalable mobile platform for screening of developmental neuropsychiatric disorders in low-resource settings

发展

• 批准号: MR/P023894/1
• 负责人: Bhismadev Chakrabarti
• 金额: $ 64.31万
• 依托单位: University of Reading
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP023894%2F1
• 关键词: Development; validation; scalable; mobile; platform

Worldwide, 1 in 161 children are diagnosed or diagnosable with Autism Spectrum Disorders (ASD). In India, our own study found a prevalence just over 1% in children aged 2 to 9 years. Although parents may notice ASD symptoms as early as 24 months, social and economic barriers to access to qualified health personnel mean that most of these children do not receive early diagnosis or intervention - or indeed any diagnosis or intervention at all. Moreover, many parents are unaware of age-appropriate developmental milestones and therefore clinical opinion is sought only when symptoms become obvious and impossible to ignore. This avoidable delay is an unfolding tragedy in light of evidence showing that front-line worker-delivered, parent-mediated interventions (e.g. PASS) lead to better behavioural and social outcomes. Scalable methods to flag up probable ASD would promote early referral to scarce specialist diagnostic facilities, connecting families with affordable, scalable, community-based interventions. We will realise this goal by developing a low-cost mobile screening platform ('Screening Tools for Autism Risk using Technology' (START)) usable in the home or in a routine health facility by the same non-specialist health workers who deliver PASS or other front-line interventions.START will collect data from multiple sources. First, parents will be asked simple questions about their child's everyday behaviour, based on established questionnaires that have been validated in the Indian cultural context. To help parents identify and report subtle abnormalities, these questions will be supplemented by videos illustrating typical versus ASD behaviours. This video-enabled questionnaire will be delivered on a tablet PC. Second, low-cost eye-tracking technology on the same tablet PC will be used to monitor the child's eye movements in simple tasks, such as those assessing preference for social versus non-social images, and measuring how quickly attention shifts to new objects appearing on the screen. Finally, a segment of parent and child interaction will be recorded using the inbuilt camera, and used to code for signs of atypical behaviour. This combination of multiple measures will provide independent channels of data collected on a single platform, potentially improving on current screening methods that rely on one technique solely. Combining these techniques becomes especially important in a setting where challenges such as poor awareness about ASD may impact on parent reporting of abnormal behaviour (for example, parents may not have noticed that their child avoids direct gaze).START's central innovation is its integration with existing front-line workers in LMICs, by adapting methods successfully employed in high income countries (HICs) to LMIC environments and resources. By virtue of its design to require minimal training, it will promote task-shifting - a concept the World Health Organization defines as "a process of delegation whereby tasks are moved, where appropriate, to less specialized health workers" and thus will reach wider populations. This task-shifting approach reduces the burden on the small number of highly-skilled mental-health professionals in LMICs, who then are free to focus on confirming diagnoses and prescribing appropriate interventions which, in turn, can also be delivered by non-specialist workers. The resulting enhancement to detection of ASD may also help develop community awareness and, in the longer term, address the barrier of low demand for services in these areas.The development and application of the START platform involves collaborations across the breadth of basic and applied sciences - including public health research, technology, clinical psychology and neuroscience, and will be led by world-class institutions in the UK and India. Such global partnerships will build research capacity in India to bridge these wide detection gaps for neuropsychiatric disorders in low resource settings.

在全球范围内，每161名儿童中就有1名被诊断或可诊断患有自闭症谱系障碍（ASD）。在印度，我们自己的研究发现，2至9岁儿童的患病率略高于1%。虽然父母可能早在24个月时就注意到ASD症状，但获得合格卫生人员的社会和经济障碍意味着这些儿童中的大多数没有得到早期诊断或干预-甚至根本没有任何诊断或干预。此外，许多父母不知道与年龄相适应的发育里程碑，因此只有当症状变得明显且无法忽视时才寻求临床意见。这种可以避免的延迟是一场正在上演的悲剧，因为有证据表明，一线工作人员提供的、父母介导的干预措施（例如PASS）会带来更好的行为和社会成果。标记可能的ASD的可扩展方法将促进早期转诊到稀缺的专家诊断设施，将家庭与负担得起的，可扩展的，基于社区的干预措施联系起来。我们将通过开发一个低成本的移动的筛查平台（“使用技术的自闭症风险筛查工具”（START））来实现这一目标。START将从多个来源收集数据。首先，根据在印度文化背景下经过验证的既定问卷，向父母提出关于孩子日常行为的简单问题。为了帮助父母识别和报告细微的异常，这些问题将通过视频来补充，说明典型的ASD行为。这一视频调查问卷将在平板电脑上发布。其次，同一台平板电脑上的低成本眼动追踪技术将用于监测儿童在简单任务中的眼动，例如评估对社交图像和非社交图像的偏好，以及测量注意力转移到屏幕上出现的新物体的速度。最后，一段父母和孩子的互动将使用内置的摄像头记录，并用于编码的非典型行为的迹象。这种多种措施的结合将提供在单一平台上收集数据的独立渠道，可能会改善目前仅依赖一种技术的筛查方法。结合这些技术变得特别重要的设置中的挑战，如对自闭症的认识不足，可能会影响家长报告的异常行为（例如，家长可能没有注意到，他们的孩子避免直接凝视）START的核心创新是它与现有的一线工作人员在低收入国家的整合，通过调整的方法成功地采用高收入国家（HIC）的低收入国家的环境和资源。由于其设计要求最低限度的培训，它将促进任务转移-世界卫生组织将这一概念定义为“一个授权过程，在适当情况下将任务转移给专业性较低的卫生工作者”，从而将惠及更广泛的人口。这种任务转移方法减轻了中低收入国家少数高技能心理健康专业人员的负担，他们可以自由地专注于确认诊断和处方适当的干预措施，而这些干预措施也可以由非专业工作人员提供。由此产生的对ASD检测的增强也可能有助于提高社区意识，并从长远来看，解决这些领域服务需求低的障碍。START平台的开发和应用涉及基础科学和应用科学的广泛合作-包括公共卫生研究，技术，临床心理学和神经科学，并将由英国和印度的世界级机构领导。这种全球伙伴关系将建设印度的研究能力，以弥补资源匮乏环境下神经精神疾病检测方面的巨大差距。

项目成果

A cross-cultural study of autistic traits across India, Japan and the UK.

• DOI: 10.1186/s13229-018-0235-3
• 发表时间: 2018
• 期刊: Molecular autism
• 影响因子: 6.2
• 作者: Carruthers S;Kinnaird E;Rudra A;Smith P;Allison C;Auyeung B;Chakrabarti B;Wakabayashi A;Baron-Cohen S;Bakolis I;Hoekstra RA
• 通讯作者: Hoekstra RA

Quantifying social preference in young children using two tasks on a mobile platform

在移动平台上使用两项任务来量化幼儿的社交偏好

• DOI: 10.31234/osf.io/3un5e
• 发表时间: 2019
• 作者: Dubey I

Individual differences in responsivity to social rewards: Insights from two eye-tracking tasks.

• DOI: 10.1371/journal.pone.0185146
• 发表时间: 2017
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Chakrabarti B;Haffey A;Canzano L;Taylor CP;McSorley E
• 通讯作者: McSorley E

Quantifying preference for social stimuli in young children using two tasks on a mobile platform.

• DOI: 10.1371/journal.pone.0265587
• 发表时间: 2022
• 期刊: PLOS ONE
• 影响因子: 3.7
• 作者: Dubey, Indu;Brett, Simon;Ruta, Liliana;Bishain, Rahul;Chandran, Sharat;Bhavnani, Supriya;Belmonte, Matthew K.;Estrin, Georgia Lockwood;Johnson, Mark;Gliga, Teodora;Chakrabarti, Bhismadev
• 通讯作者: Chakrabarti, Bhismadev

EEG signatures of cognitive and social development of preschool children-a systematic review.

• DOI: 10.1371/journal.pone.0247223
• 发表时间: 2021
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Bhavnani S;Lockwood Estrin G;Haartsen R;Jensen SKG;Gliga T;Patel V;Johnson MH
• 通讯作者: Johnson MH