An Observational Cross-Sectional Study of Early Detection of 5 Neurodevelopmental Disorders of Children and prevention of Postnatal Depression by Mobile Health App (Preprint)

BACKGROUND Delay in the diagnosis of neurodevelopmental disorders (NDDs) of toddlers and postnatal depression (PND) is a major public health issue. In both cases, early intervention is crucial but too rarely implemented in practice. OBJECTIVE Our goal was to determine if a dedicated the mobile app can improve screening of 5 NDDs (autism spectrum disorder (ASD), language delay, dyspraxia, dyslexia and attention deficit hyperactivity disorder (ADHD)), and reduce PND incidence. METHODS We performed an observational, cross-sectional, data-based study in a population of young parents with a minimum of 1 child under 10 years of age at the time of inclusion and using Malo on a regular basis. We included between May 1, 2022, and February 8, 2024. the first 50,000 users matching the criteria and agreeing to participate. Parents received via the app, periodic questionnaires assessing skills on neurodevelopment domains. Mothers accessed a support program to prevent PND and were requested to answer regular questionnaires regarding PND. 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 for possible NDD and the incidence of PND detection after childbirth. One secondary outcome was the relevance of the NDD notification by a consultation as assessed by health professionals. RESULTS Among 55,618 children with median age of 11-months, 439 (0,8%) had at least 1 disorder for which a consultation was critically necessary. The median age of notification for probable ASD, language delay, dyspraxia, dyslexia and ADHD was 32.5, 16, 36, 80 and 61 months, respectively. The sensitivity of the alert notifications of suspected NDDs as assessed by the physicians was 78.6%, and the specificity was 98.2%. Among 8,243 mothers who completed a PND questionnaire, highly probable PND was detected in 938 (11.4%) mothers corresponding to a reduction of -31% versus our previous study without support program). CONCLUSIONS The algorithm-based alert suggesting NDD was highly specific with good sensitivity as assessed by real-life practitioners. The app was efficient in the early detection 5 NDD and PND and in possible reduction of PND incidence. CLINICALTRIAL NCT04958174