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Digital speech assessments can detect cognitive decline, but are often limited to English speakers. The Toolkit to Examine Lifelike Language (TELL) app was adapted for diverse global populations, addressing linguistic and cultural needs in Chile and Kenya.

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Area of Science:

  • Digital health
  • Computational linguistics
  • Neuroscience

Background:

  • Digital speech assessments offer cost-effective, objective tools for early detection of cognitive decline and dementia.
  • Existing digital speech tools primarily serve English-speaking, high-income populations, creating global health inequities.
  • The Toolkit to Examine Lifelike Language (TELL) was developed to address the distinct needs of low- and middle-income countries.

Purpose of the Study:

  • To outline the adaptations and challenges in localizing the TELL app for Latin American and African countries, specifically Chile and Kenya.
  • To refine digital speech assessment tools for diverse linguistic, cultural, and technological contexts.
  • To enhance global accessibility of cognitive decline detection through localized digital health solutions.

Main Methods:

  • Formed interdisciplinary teams with local researchers and clinicians to customize TELL's interface, prompts, data acquisition, preprocessing, metrics, and visualizations.
  • Developed a protocol for translating app content into Spanish and Kiswahili using AI and human review.
  • Implemented country-specific customizations, including culture-specific and culture-neutral stimuli selection, enhanced data collection methods (videoconferencing, offline), and a five-step audio preprocessing system.

Main Results:

  • Successfully localized the TELL app (v.2.0) for use in Chile and Kenya, with translated content in Spanish and Kiswahili.
  • Developed tailored metrics integrating language-agnostic, language-specific, cross-linguistic, and multilingual resources.
  • Enhanced data collection and preprocessing capabilities to accommodate diverse environments and local demands, including offline modes and AI-driven audio adjustments.

Conclusions:

  • Cross-cultural adaptation of digital speech testing technologies involves significant hurdles, requiring innovative solutions and compromises.
  • Lessons learned provide best practices for streamlining digital assessments in underserved global regions.
  • The localized TELL app demonstrates a pathway toward more equitable access to cognitive health monitoring worldwide.