Wearable Sensors for Early Identification of Poor Neurodevelopment in Guatemala

项目摘要 在大多数低收入和中等收入国家，更多的儿童在受艾滋病毒/艾滋病影响的情况下活到成年。 早期疾病、营养不良和不良经历的发育后遗症。在危地马拉农村， 在拟议的研究将进行时，处于发育受损风险的婴儿数量是最高的 在世界上，由于营养不良、贫困和预防性保健有限的高比率，去识别和瞄准 为处于危险中的儿童提供的服务，大多数社区项目依赖于基本的生长指标或父母- 报告的问题，技术是间接的措施，发展和不敏感的婴儿期。作为 因此，关于婴儿发育障碍发作的数据几乎完全缺失， 干预措施是在重大不利影响已经发生之后很久才开始的。技术来支持 因此，及早识别非典型发展将有助于及早干预， 神经发育结果。 由于肢体运动是发育中的中枢神经系统最早的输出之一， 为了解决这个早期识别的挑战，这里提出的是定量区分典型和非典型的早期肢体 危地马拉农村地区发育迟缓婴儿的运动模式 可穿戴运动传感器这个项目的第一个目的是确定婴儿最早期的 使用可穿戴设备的风险婴儿12个月时的自发肢体运动和发育结局 运动传感器。该项目的第二个目的是确定可穿戴传感器评估是否更 在预测高危婴儿的发育结果方面，比目前的临床评估更准确。 总之，我们的工作解决了对非典型神经发育婴儿的新方法的需求 由于营养不良和其他风险因素。我们将在危地马拉农村开展这项工作， 这些婴儿风险因素的比率是世界上最高的。我们的研究结果有可能改善生活质量， 通过早期发现非典型发展，为危地马拉人和其他低收入国家公民提供健康成果， 支持早期干预和改善神经发育结果。此外，这 探索性/发展性研究应用是一个多学科能力建设项目，涉及儿科 医学物理治疗和生物统计学该项目将通过一个项目， 南加州大学（一家美国机构）和玛雅健康联盟（一家LMIC）之间的合作伙伴关系 机构）。拟议的研究计划将加强LMIC机构的研究能力， 危地马拉，特别是通过培训当地保健工作人员和博士生， 婴儿的神经发育评估，这是一个关键的需要，因为当地的发展 残疾和发育迟缓。

Project Summary In most low- and middle-income countries (LMICs), more children are surviving into adulthood affected by the developmental sequelae of early illness, undernutrition and adverse experiences. In rural Guatemala, where the proposed study would take place, the number of infants at risk for impaired development is among the highest in the world, due to high rates of undernutrition, poverty, and limited preventive health care. To identify and target services to infants at children at risk, most community programs rely on basic growth indicators or parent- reported concerns, techniques which are indirect measures of development and not sensitive in infancy. As a result, data on the onset of developmental disabilities in infants are almost completely missing, and early interventions are begun well after significant adverse effects have already occurred. Technologies to support earlier identification of atypical development would therefore support earlier intervention and improved neurodevelopmental outcomes. As limb movements are one of the earliest outputs of the developing central nervous system, the novel response to this early identification challenge proposed here is to quantitatively differentiate typical and atypical early limb movement patterns in infants at risk for developmental disability due to stunting in rural Guatemala using wearable motion sensors. The first aim of this project is to determine the relationship between infants’ earliest spontaneous limb movements and developmental outcomes at 12 months in infants at risk using wearable motion sensors. The second aim of this project is to determine whether wearable sensor assessment is more accurate than current clinical assessments in predicting developmental outcomes in infants at risk. Taken together, our work addresses the need for novel approaches for infants with atypical neurodevelopment due to undernutrition and other risk factors. We will conduct this work in rural Guatemala, which has one of the highest rates of these infant risk factors in the world. Our results have the potential to improve quality of life and health outcomes for Guatemalans and other LMIC citizens through earlier identification of atypical development, supporting earlier intervention and improved neurodevelopmental outcomes. Further, this exploratory/developmental research application is a multidisciplinary capacity-building project involving pediatric medicine, physical therapy, and biostatistics. The project will build research capacity in Guatemala, through a partnership between the University of Southern California (a U.S. institution) and Maya Health Alliance (an LMIC institution). The proposed research plan will strengthen the research capabilities at the LMIC institution and in Guatemala, specifically through training of local healthcare staff and PhD students in conducting neurodevelopmental assessments in infants, a critical need given the high local prevalence of developmental disability and stunting.