Early Detection of Neurodevelopmental Disorders of Toddlers and Postnatal Depression by Mobile Health App:
Fabrice Denis1, Laura Maurier1, Kevin Carillo2
1Institut Inter-Regional Jean Bernard, ELSAN, Le Mans, France.
Insights
A mobile app effectively identified potential neurodevelopmental disorders (NDDs) and postnatal depression (PND) in young families. Early detection through this tool can significantly improve intervention timeliness for both mothers and children.
Area of Science:
- Pediatric Health
- Maternal Mental Health
- Digital Health Interventions
Background:
- Delays in diagnosing neurodevelopmental disorders (NDDs) and postnatal depression (PND) pose significant public health challenges.
- Early intervention is critical for improving outcomes in both NDDs and PND.
Purpose of the Study:
- To evaluate the efficacy of the mobile application Malo in reducing diagnostic delays for NDDs and PND.
- To assess the app's ability to facilitate early recognition of these conditions.
Main Methods:
- An observational, cross-sectional study involving 4000+ parents using the Malo app regularly.
- Monthly in-app questionnaires assessed infant development (sociability, hearing, vision, motor, language, autism) and maternal PND symptoms.
- Automated in-app notifications alerted users to potential concerns, recommending physician consultation.
Main Results:
- 14.5% of children assessed had a disorder requiring consultation, with median notification ages ranging from 4 to 22 months.
- The app's NDD alert system demonstrated 100% sensitivity and 73.5% specificity.
- 16.6% of mothers screened positive for PND, with detection occurring 8-12 weeks postpartum.
Conclusions:
- The Malo app's algorithm-based alerts for suspected NDDs are highly sensitive and specific.
- The app is effective for the early detection of PND.
- Regular use of this multidomain familial smartphone app can facilitate early identification of NDDs and PND.
Background:
Delays in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) in mothers are major public health issues. In both cases, early intervention is crucial.
Objective:
We aimed to assess if a mobile app named Malo can reduce delay in the recognition of NDD and PND.
Methods:
We performed an observational, cross-sectional, data-based study in a population of young parents with a minimum of 1 child under 3 years of age at the time of inclusion and using Malo on a regular basis. We included the first 4000 users matching the criteria and agreeing to participate between November 11, 2021, and January 14, 2022. Parents received monthly questionnaires via the app, assessing skills on sociability, hearing, vision, motricity, language of their infants, and possible autism spectrum disorder. Mothers were also requested to answer regular questionnaires regarding PND, from 4-28 weeks after childbirth. When any patient-reported outcomes matched predefined criteria, an in-app notification was sent to the user, recommending the booking of an appointment with their family physician or pediatrician. The main outcomes were the median age of the infant at the time of notification for possible NDD and the median time of PND notifications after childbirth. One secondary outcome was the relevance of the NDD notification for a consultation as assessed by the physicians.
Results:
Among 4242 children assessed by 5309 questionnaires, 613 (14.5%) had at least 1 disorder requiring a consultation. The median age of notification for possible autism spectrum, vision, audition, socialization, language, or motor disorders was 11, 9, 17, 12, 22, and 4 months, respectively. The sensitivity of the alert notifications of suspected NDDs as assessed by the physicians was 100%, and the specificity was 73.5%. Among 907 mothers who completed a PND questionnaire, highly probable PND was detected in 151 (16.6%) mothers, and the median time of detection was 8-12 weeks.
Conclusions:
The algorithm-based alert suggesting NDD was highly sensitive with good specificity as assessed by real-life practitioners. The app was also efficient in the early detection of PND. Our results suggest that the regular use of this multidomain familial smartphone app would permit the early detection of NDD and PND.
Trial Registration:
ClinicalTrials.gov NCT04958174; https://clinicaltrials.gov/ct2/show/NCT04958174.
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