Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 22, 2022
Open Peer Review Period: Mar 22, 2022 - Mar 29, 2022
Date Accepted: Apr 19, 2022
(closed for review but you can still tweet)
Early Detection of Neurodevelopmental Disorders of Toddlers, and Postnatal Depression by Mobile Health Application: an Observational Cross-Sectional Study
ABSTRACT
Background:
Delay in diagnosis of neurodevelopment disorders (NDD) of toddlers and postnatal depression (PND) is a major public health issue. In both cases, early intervention is crucial.
Objective:
We aimed to assess if a mobile application named Malo can reduce delay in the recognition of NDD and PND.
Methods:
We performed an observational, cross-sectional data-based study in a population of young parents with a minimum of one child under 3 at the time of inclusion and using Malo on a regular basis. We included the first 4000 users matching the criteria and agreeing to participate between November 11, 2021 and January 14, 2022. Parents received monthly questionnaires, via the application, assessing skills on sociability, hearing, vision, motricity and language of their infants and possible autism spectrum disorder. Mothers were also requested to answer regular questionnaires regarding PND, from 4 to 28 weeks after childbirth. When any patient-reported outcomes matched predefined criteria, an in-app notification was sent to the user, recommending the booking of an appointment with their family physician or pediatrician. The main outcomes were the median age of the infant at the time of notification of possible NDD and the median time of PND notifications after childbirth. One secondary outcome was the relevance of the consultation after NDD notification as assessed by the physicians.
Results:
Among 4242 children assessable by 5309 questionnaires, 14.5% (613) had at least one disorder requiring a consultation. The median age of notification for possible autism spectrum, vision, audition, socialization, language, or motor disorders was 11, 9, 17, 12, 22 and 4 months respectively. The sensitivity of the alert notifications of suspected neurodevelopmental disorders as assessed by physician was 100% and specificity was 73.5%. Among 907 mothers who completed a postnatal depression questionnaire, highly probable postnatal depression was detected in 16.6% (151) of mothers and median time of detection was 8-12 weeks.
Conclusions:
The algorithm-based alert suggesting NDD was highly sensitive with good specificity as assessed by real life practitioners. The app was also efficient in early detection of PND. Our results suggests that regular use of this multidomain familial smartphone application would permit early detection of NDD and PND. Clinical Trial: ClinicalTrials.gov Identifier: NCT04958174
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