New culturally appropriate Assessment Tools Investigating Various Executive functions and adaptive functioning among West afrIcanS Developed through cO-production Methods
What is this research project about?
This study focuses on developing culturally appropriate tools for assessing frontal lobe functioning (executive functions and adaptive functioning) for children and adolescents in West Africa, as well as risk factors affecting cognition and mental well-being. It delves into the views of children, their parents’ and teachers, as well as other stakeholders like in the local community on the normal day-to-day functions and behaviour of a responsible or clever child in the community. It also seeks to explore the West African concept of “home sense” or “native intelligence”, and what a child with ‘home sense’ or ‘native intelligence’ behaves like. It hopes to ultimately develop culturally appropriate tools to assess these aspects of brain functioning in children, with a view to possibly determine if and how such local a concept can be quantitatively measured and possibly incorporated into a locally validated instrument.
Why are we doing this research?
Assessment for executive function (EF) and adaptive function are integral parts of child and adolescent mental health services (CAMHS). There are many ways in which vulnerable children may end up in CAMHS due to brain injury causes such as infections, neurodevelopmental disorders (NDDs) like Autism and ADHD, and mental disorders like Schizophrenia and Bipolar Disorder. However, assessing brain injury in non-Western populations is easier said than done. Most importantly, there is the problem of measurement across different cultural contexts where items may be biased or simply culturally inappropriate. This may make any scores so-derived meaningless. Given that over the past few decades, children in the global South have seen a steady overall improvement in their standard of living, many more are surviving beyond the age of five, but the question is, are they thriving?
With the high prevalence of the known causes of brain injury in sub-Saharan Africa (such as infections like Meningitis and Cerebral Malaria), an accurate means of assessment and early identification of executive dysfunction in school-age children in West Africa will be quite useful. Particularly useful in this context, given the acute shortage of child psychiatrists and neuropsychologists in West Africa, will be an easy-to-use screening tool for frontal lobe damage for primary care workers, who are the first point of call for the vast majority of children with potential brain injury.
Finally, brain injury adversely affects educational outcomes, and early identification could alter educational trajectories for millions of children. This project seeks to develop such culturally appropriate tools for this population for these reasons and more.
What are the benefits of taking part in this study?
By taking part, you will help us gather valuable information that we hope will help us assess children who have behaviour difficulties related to diseases affecting their brains.
What do we hope to get out of this research project?
At the end of this project, we hope to get two newly developed ecologically validated assessment tools for West African children, one each for Executive Functioning and Adaptive Functioning. We also hope to create a third shorter mobile app based cognitive screening tool for use in primary care setting, increasing access to diagnostic care. With this, we hope to increase identification of the many West African children with brain injury who would otherwise have gone undiagnosed for intervention. This would also open up new opportunities for neuroscience research among one of the most genetically diverse populations on earth as validated assessment tools will now exist for this African population.
Who is organising and funding the research?
This study is being carried out by researchers from the University of Cambridge (UK), Komfo Anokye Teaching Hospital (Ghana), Kintampo Health Research Centre (Ghana), and the University of Ibadan (Nigeria). It has been funded by the Research England through the GCRF, and the Commonwealth Scholarship Secretariat.