How Do Neurocognitive Tests Relate to Reported Child Difficulties at 6 Years of Age in Benin?

The aim of this study was to examine the relationship between children's difficulties perceived by parents in the Ten Questions questionnaire (TQ) and children's assessments by the Kaufman Assessment Battery for Children, Second Edition (KABC-II) and the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2).

The study was carried out in the district of Allada, a semi-rural area of Benin, involving a cohort of 562 6-year-old children. A response was considered positive if the parent reported a difficulty for their child compared to other children.

The proportion of TQ-reported difficulties was 34.2%. More difficulties were reported by parents when their child had lower scores on the KABC-II (p < 0.001) and on the BOT-2 (p < 0.01). Greater family wealth, higher maternal education, and better child school attendance were associated with higher KABC-II Mental Processing Index (MPI) scores, higher BOT-2 scores, and fewer reported difficulties on the TQ. The likelihood of parents reporting difficulties was ˃60% when KABC-II MPI scores were low. When considering the KABC-II as the gold standard to define mild delays (mean minus 1 SD), the TQ demonstrated a sensitivity of 51.0% and specificity of 69.4%, which increased to 58% and 72%, respectively, when children attended school.

Objective assessments of children's abilities were associated with parents' perceived difficulties. In a low-resource rural setting in sub-Saharan Africa, the TQ is a useful tool for screening neurodevelopmental difficulties, particularly for children attending school.