mHealth developmental screening for preschool children in low-income communities

Area of Science:

• Child Development
• Public Health
• Digital Health

Background:

• Early detection of developmental delays in low-income communities is challenging, often occurring too late when children enter primary school.
• Existing screening methods may not be cost-effective or accessible for widespread use in underserved populations.
• mHealth solutions offer a potential avenue for timely and efficient developmental surveillance.

Purpose of the Study:

• To validate an mHealth-based developmental screening tool, the Parents' Evaluation of Developmental Status (PEDS) tools, for preschool children in low-income communities.
• To assess the performance of mHealth PEDS tools against a reference standard (Vineland-3) for identifying developmental delays.
• To explore the utility of mHealth PEDS tools for early developmental surveillance in resource-limited settings.

Main Methods:

• A cross-sectional study involving 276 preschool children from low-income communities.
• Screening was conducted using mHealth PEDS tools, with caregiver concerns compared to the Vineland-3 assessment.
• Performance metrics, including sensitivity and specificity, were evaluated using US standardized criteria.

Main Results:

• The mHealth PEDS tools identified 85.9% of children at risk, compared to 80.1% by the Vineland-3.
• High sensitivity (92.6%) was observed for the mHealth PEDS tools, but specificity was low (22.5%).
• Literacy skills were the most frequently delayed area identified by both screening methods.

Conclusions:

• mHealth PEDS tools show promise for preschool developmental surveillance in low socio-economic status (SES) settings.
• Low specificity suggests a need for adapted referral criteria or a secondary screening process to minimize false positives.
• Despite limitations, the mHealth PEDS tools may be a valuable, cost-effective resource for early identification of developmental concerns.