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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Implications of family protective-risk index for screening cognitive development of children aged 13-15 years
Sirikul Isaranurug1, Sumalee Klinman, Jiraporn Chompikul
1ASEAN Institute for Health Development, Mahidol University, Salaya Campus, Phutthamonthon 4 Rd, Phutthamonthon District, Nakhon Pathom 73170, Thailand.
Insights
A family protective-risk index (FPRI) effectively screens children aged 13-15 for cognitive development issues. FPRI 3, using maternal education, occupation, family relationships, and life events, is the most effective screening tool.
Area of Science:
- Child Development
- Cognitive Psychology
- Public Health Screening
Background:
- Simple screening tools are crucial for community health prioritization.
- Identifying at-risk children early is essential for timely intervention.
Purpose of the Study:
- To evaluate the Family Protective-Risk Index (FPRI) for screening cognitive development in adolescents aged 13-15 years.
- To determine the most effective FPRI model for identifying children with potential cognitive developmental delays.
Main Methods:
- A cross-sectional survey of 319 children (13-15 years) using the TONI-3 for cognitive assessment.
- Developed three FPRI models based on family factors like parental education, occupation, income, relationships, life events, family type, and childcare quality.
- Utilized sensitivity, specificity, PPV, and NPV to assess predictive accuracy and identify optimal cut-off points.
Main Results:
- 52% of participants exhibited intellectual levels below 90.
- FPRI 1 and FPRI 2 showed high sensitivity but moderate specificity, PPV, and NPV.
- FPRI 3 demonstrated the best performance, with specific cut-off scores offering high PPV or high sensitivity and NPV, as indicated by ROC curve analysis.
Conclusions:
- FPRI 3, particularly at a score of 3, is recommended as a preliminary screening tool for health personnel.
- This index can identify families with children at risk for slow cognitive development, enabling prompt support.
- Early identification through FPRI 3 facilitates targeted interventions for at-risk youth.
Background:
A simple screening tool is essential for priority setting and operating activities in communities.
Objective:
The present study aimed to identify the implications of a family protective-risk index (FPRI) for screening cognitive development of children aged 13-15 years.
Material And Method:
The cross-sectional survey among 319 children aged 13-15 years old was conducted in one district. The cognitive development was measured by TONI version 3. Studied family factors consisted of parents' education, parents' occupation, sufficiency of family income, family relationships, stressful life events in the family, family type, and quality of child care. The protective characteristic of each factor was given one point and the risk was given zero point. FPRI was constructed in three models. The FPRI 1 was the cumulative effects of nine family factors mentioned above. The FPRI 2 was the cumulative effects of seven family factors that were significantly associated with cognitive development in the present study by Chi-square test: parents' education, parents' occupation, family relationship, stressful life events and family type. The FPRI 3 was constructed from 4 family factors that were significantly associated with cognitive development by logistic regression analysis: mother's education, mother's occupation, family relationship and stressful life events. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were applied to identify the optimal cut off point of prediction.
Results:
The present results showed that 52% of the sample had an intellectual level lower than 90. The FPRI 1 at 6 or 7 scores and the FPRI 2 at 4 or 5 scores yielded the same phenomena, high sensitivity but moderate specificity, PPV and NPV The FPRI 3 at 2 scores gave high PPV and moderate for the rest. The FPRI 3 at 3 scores gave high sensitivity and NPV moderate PPV and low specificity. Among three indices, the FPRI 3 was found to be the best index as its Receiver Operating Characteristic (ROC) curve was furthest into the top left corner.
Conclusion:
The FPRI 3 at 3 scores can be used as a preliminary screening tool for health personnel to identity families at risk of having children with slow cognitive development and then, provide urgent support and help.
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