Usefulness of Child Development Assessments for Low-Resource Settings in Francophone Africa

Abstract

Objective Few tools are available to screen or assess infant’s cognitive development, especially in French-speaking Africa. This study evaluated the use of the French translation of the Mullen Scales of Early Learning (MSEL), and the ‘Ten Questions’ questionnaire (TQ) in 1-year-old children in Benin, a francophone country. Methods A cross-sectional study was conducted in three health centers serving a semi-rural area in Benin. Three hundred fifty-seven children aged 12 months and their mothers were enrolled in 2011. Infant development was assessed at local health centers followed by a home visit to collect information on socioeconomic status, maternal Raven score, maternal depressive symptoms, and mother–child interactions (HOME Inventory) and to administer the TQ. Results The infant’s gender (female), the HOME and maternal education were associated with a higher Early Learning Composite score in multivariate analyses (P=.02, P=.004, P=.007, respectively). The HOME and family wealth were also associated with the gross motor scale (P=.03 and P=.03, respectively). Mothers were more likely to report difficulties on the TQ when the child presented lower score on the MSEL. When considering the gross motor scale as the gold standard to define moderate delays, the two combined motor-related questions on the TQ showed good sensitivity and specificity (76.5 and 75.7). Conclusion In a low-resource rural setting in Africa, the TQ effectively identified three-quarters of 1-year-old infants with delayed development. After this screening, the MSEL may be useful for further assessment as it showed good feasibility and sensitivity to known risk factors for poor child development.

Prenatal Iron Deficiency, Neonatal Ferritin, and Infant Cognitive Function

“…The median age (interquartile range [IQR]) of pregnant women at their first ANC visit was 25 (21-30) years. At baseline, the median gestational age (IQR) was 23 (19)(20)(21)(22)(23)(24)(25)(26) weeks. The prevalence of ID among pregnant women at first and second ANC visits, and at delivery was 30.5%, 34.0%, and 28.4%, respectively ( Table 2).…”

“…20 The MSEL were translated and adapted for this setting. 21 Detailed quality assurance and reliability of assessments have been published. 21 Assessors were blinded to prenatal maternal and neonatal iron levels and birth outcomes.…”

Prenatal Hemoglobin Levels and Early Cognitive and Motor Functions of One-Year-Old Children

“…Cognitive and motor functions of 636 1-year-old children were assessed by using the Mullen Scales of Early Learning (MSEL), 10 which was translated and adapted for this setting. 11 The MSEL encompasses the developmental domains of childhood and consists of 5 scales: GM, fine motor, language reception, language expression, and visual reception. After scoring each item, crude scores obtained from each of the 5 scales were transformed into normalized age-specific scores called T scores.…”

Reducing neurodevelopmental disorders and disability through research and interventions

“…Childhood malnutrition, both through prenatal and perinatal maternal micronutrient deficiencies 36 , infant micronutrient deficiencies 37 , and protein-calorie deficiency, imposes a heavy burden on neurodevelopment [38][39][40] . The primary effects of malnutrition have been associated with elevated mortality, morbidity, and risk of cognitive and socioemotional impairment.…”