Validation of a Pediatric Cognitive Assessment Tool to Advance Knowledge on Children's Cognitive Development, Health...

Cognitive Assessment Tool for Pediatric Clinical Research (CAT-PCR) is a new brief nonverbal test battery validated in a Zambian school-aged population. CAT-PCR involves the standardized administration of two tests, WAVES and SYMBOLS. CAT-PCR provides measures of visuomotor processing (VMP) and visuographomotor constructional processing (VGCP). The psychometric properties of CAT-PCR were evaluated in a field trial complemented with an ancillary test-retest study.

Four-hundred-twenty children, aged 5 to 17 years, 51.2 percent female, speaking Bemba (81.1%), English (72.6 %), Nyanja (22.8%), Tonga (1.9%), and Lozi (1.2%), were recruited at multiple Zambian clinical sites and schools. Children able to speak one, two, and three or more languages composed 23.5, 10.0, and 66.5 percent of participants, respectively. CAT-PCR detected differences in cognitive performance between two comparable subgroups of children with or without conditions associated with increased risk for cognitive impairment. The poorer health group composition reflected a spectrum of conditions such as chronic neurologic or medical diseases (ie, epilepsy, human immunodeficiency virus/acquired immunodeficiency syndrome [HIV/AIDS], recurrent malaria, sickle cell disease, and other cardiac and metabolic conditions) or prolonged exposure to psychosocial stress and deprivation. The reliability was satisfactory. The intraclass correlation coefficient (95% confidence interval) at test-retest at 48 hours (n=86) was 0.85 (0.78, 0.91) for VGCP Index and 0.84 (0.76, 0.90) for VMP Index.

Study findings support the reliability, validity, and utility of CAT-PCR measures in evaluating the effect of health-related risks on the child's cognitive functioning and development. Further research should address the validity of CAT-PCR in response prediction, monitoring, and evaluation of health-promoting interventions.