The feasibility of a crowd-based early developmental milestone tracking application

Abstract

Objective Parents’ tracking of developmental milestones can assist healthcare providers with early detection of developmental delays and appropriate referrals to early intervention. Crowdsourcing is one way to update the content and age data distribution of developmental checklists for parents and providers. This feasibility study examined which developmental milestones parents chose to track and what they added beyond traditional milestones, using the babyTRACKS crowd-based mobile app. Method We analyzed the developmental diaries of 3,832 children, registered in the babyTRACKS app at an average age of 9.3 months. Their parents recorded a median of 5 milestones per diary, selecting from the accumulating lists of age-appropriate milestones or authoring new milestones. The final database included 645 types of milestones; 89.15% were developmental, of which 43.6% were comparable to the Centers for Disease Control (CDC) milestones while the rest were crowd-authored. Milestones were categorized into developmental domains: Gross Motor, Fine Motor, Oral Motor, Self-Care, Cognitive, Language Comprehension, Speech, Non-Verbal Communication, Social, Emotional, and Regulation. Results On average, the milestone domains of Gross Motor, Fine Motor, Cognitive and Social were the most added to diaries (20%-30% of a diary). Within the Cognitive, Speech and Language Comprehension domains there were significantly more CDC comparable versus crowd-authored milestones (29% versus 21%, 22% versus 10%, 8% versus 4%). In contrast, within the Regulation and Oral Motor domains there were more crowd versus CDC milestones (17% versus 3%, 9% versus 3%). Crowd-authored Speech milestones were significantly older by 7 months than CDC milestones. Conclusion Tracking daily observations of child development provides a window into personally relevant milestones for the child and parent. The crowd of parents can independently track and add new milestones across main developmental domains. Regulation and Oral Motor development especially interest parents. Parents may be less aware of early progress in Language Comprehension and Speech; thus, these domains require more structured screening. Designing mobile early screening which is crowd-based engages parents as proactive partners in developmental tracking.

Early childhood tracking application: Correspondence between crowd-based developmental percentiles and clinical tools

“…CCI minimizes redundancy in milestones and maximizes sample size for percentile computations. 29,34 Among 567 (70.52%) developmental milestone concepts, 199 (34.04%) were comparable to CDC milestones. The popularity of specific milestones varied greatly (M = 60.52, Mdn = 15, SD = 107.15).…”

“…Among the children, 54.6% reached all CDC-comparable milestones earlier than the CDC thresholds and 89% had no more than three unmet CDC milestones, consistent with previous research. 34 One advantage of babyTRACKS tracking of emerging milestones is its relevance to all parents, not only those concerned or at-risk. Thus, it fosters age-appropriate parent expectations and enables detection based on a child’s developmental trajectory.…”

“…Examples of babyTRACKS milestones judged as comparable to CDC milestones are: "Began to recognize familiar faces", "Started to bring things to mouth". Examples of milestones that were not comparable: "Is now able to hold bottle independently", "Moves head from one side to another while lying on tummy" (for more examples see) 34 .…”

“…They can also facilitate aggregating a global, open-access, contemporary developmental milestone database. 34 Previous baby-TRACKS research underscored the reliability and developmental value of the expert-curated crowd data approach of this system. 34 Nonetheless, the 'noise' associated with the variability in what, how, and when these data are recorded requires clinical investigation before integrating it into routine care.…”

“…44 The younger ba-byTRACKS ages, relative to CDC-recommended ages, agrees with research indicating discordance between CDC recommendations and other norms. 19,34 Median age differences between baby-TRACKS and CDC ranged from almost 4 months for Gross Motor to about 7 months for Cognitive milestones. This gap can be attributed to babyTRACKS recording the age at which children first achieve a milestone as opposed to CDC reflecting ages by which parents should worry if not achieved.…”