Concurrent validity of a touchscreen application to detect early cognitive delay

Objective: To explore the ability of an interactive screening tool to identify cognitive delay in children aged 18 to 24 months.

Design: Children were assessed using the Bayley Scale of Infant and Toddler Development-third edition (BSID-III) and a touchscreen measure of problem-solving (Babyscreen V.1.5). We examined the internal consistency and concurrent validity between the two measures. A BSID-III cognitive composite score (BSID-IIIcc) ≤1 SD below population mean was used to indicate a low average cognitive ability.

Results: 87 children with a mean (SD) age of 20.4 (1.3) months who experienced complications at delivery (n=53) and healthy age-matched controls (n=34) were included in the study. A moderate positive correlation between the BSID-IIIcc and the total number of tasks completed on the Babyscreen suggested reasonable concurrent validity (r=0.414, p<0.001). Children with a BSID-IIIcc ≤90 had lower median (IQR) Babyscreen score (7 (6, 8.5) vs 11 (8.5, 13); p=0.003) and a lower median (IQR) age-adjusted z-score (BST z-score) for number of items completed compared with those >90 (-1.08 (-1.5 to -0.46) vs 0.31 (-0.46 to 0.76); p=0.001). The area under the receiver operating characteristic curve for the prediction of a low normal BSID-IIIcc was 0.787 (CI 0.64 to 0.93). A BST z-score of <-0.44 yielded 82.4% sensitivity and 71.4% specificity in identifying children with cognitive delay.

Conclusions: A touchscreen-based application has concurrent validity with the BSID-IIIcc and could be used to screen for cognitive delay at 18-24 months of age.