Scalable Transdiagnostic Early Assessment of Mental Health (STREAM): a study protocol
Vikram Patel,
Melissa Gladstone,
Gillian Lancaster,
Alok Ranjan,
Gauri Divan,
Gareth McCray,
Emily Jones,
Sheffali Gulati,
Maria M Crespo-Llado,
Mark H Johnson,
Emmie Mbale,
Debarati Mukherjee,
Elin H Williams,
Nicholas M Thompson,
Supriya Bhavnani,
Diksha Gajria,
Teresa Del Bianco,
Georgia Lockwood-Estrin,
Luke Mason,
Vukiwe Ngoma,
Chisomo Namathanga,
Richard Nkhata,
Allan Bennie,
Ulemu Kawelama,
Naina Midha,
Anindita Singh,
Innocent Mpakiza,
Akshat Gautam,
Matthew K Belmonte,
Sharat Chandran,
Bhismadev Chakrabarti
Affiliations
Vikram Patel
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
Melissa Gladstone
Department of Women and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
Gillian Lancaster
Primary Care & Health Sciences, Keele University, Keele, UK
Alok Ranjan
Child Development Group, Sangath, India
Gauri Divan
Child Development Group, Sangath, India
Gareth McCray
School of Medicine, Keele University, Keele, UK
Emily Jones
Centre for Brain & Cognitive Development, Birkbeck University of London, London, UK
Sheffali Gulati
Center of Excellence & Advanced Research for Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
Maria M Crespo-Llado
Department of Women and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
Mark H Johnson
Department of Psychology, University of Cambridge, Cambridge, UK
Emmie Mbale
Department of Paediatrics, Kamuzu University of Health Sciences, Blantyre, Malawi
Debarati Mukherjee
Indian Institute of Public Health – Bengaluru, Public Health Foundation of India, Bangalore, Karnataka, India
Elin H Williams
Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
Nicholas M Thompson
Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
Supriya Bhavnani
Child Development Group, Sangath, India
Diksha Gajria
Child Development Group, Sangath, India
Teresa Del Bianco
School of Social Sciences and Professions, London Metropolitan University, London, UK
Georgia Lockwood-Estrin
University of East London, London, UK
Luke Mason
Institute of Psychiatry, Psychology and Neuroscience, King`s College London, London, UK
Vukiwe Ngoma
Kamuzu University of Health Sciences, Blantyre, Malawi
Chisomo Namathanga
Kamuzu University of Health Sciences, Blantyre, Malawi
Richard Nkhata
Kamuzu University of Health Sciences, Blantyre, Malawi
Allan Bennie
Kamuzu University of Health Sciences, Blantyre, Malawi
Ulemu Kawelama
Kamuzu University of Health Sciences, Blantyre, Malawi
Naina Midha
Child Development Group, Sangath, India
Anindita Singh
Child Development Group, Sangath, India
Innocent Mpakiza
Kamuzu University of Health Sciences, Blantyre, Malawi
Akshat Gautam
Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
Matthew K Belmonte
The Com DEALL Trust, Bengaluru, Karnataka, India
Sharat Chandran
Indian Institute of Technology Bombay, Mumbai, Maharashtra, India
Bhismadev Chakrabarti
Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
Introduction Early childhood development forms the foundations for functioning later in life. Thus, accurate monitoring of developmental trajectories is critical. However, such monitoring often relies on time-intensive assessments which necessitate administration by skilled professionals. This difficulty is exacerbated in low-resource settings where such professionals are predominantly concentrated in urban and often private clinics, making them inaccessible to many. This geographic and economic inaccessibility contributes to a significant ‘detection gap’ where many children who might benefit from support remain undetected. The Scalable Transdiagnostic Early Assessment of Mental Health (STREAM) project aims to bridge this gap by developing an open-source, scalable, tablet-based platform administered by non-specialist workers to assess motor, social and cognitive developmental status. The goal is to deploy STREAM through public health initiatives, maximising opportunities for effective early interventions.Methods and analysis The STREAM project will enrol and assess 4000 children aged 0–6 years from Malawi (n=2000) and India (n=2000). It integrates three established developmental assessment tools measuring motor, social and cognitive functioning using gamified tasks, observation checklists, parent-report and audio-video recordings. Domain scores for motor, social and cognitive functioning will be developed and assessed for their validity and reliability. These domain scores will then be used to construct age-adjusted developmental reference curves.Ethics and dissemination Ethical approval has been obtained from local review boards at each site (India: Sangath Institutional Review Board; All India Institute of Medical Science (AIIMS) Ethics Committee; Indian Council of Medical Research—Health Ministry Screening Committee; Malawi: College of Medicine Research and Ethics Committee; Malawi Ministry of Health—Blantyre District Health Office). The study adheres to Good Clinical Practice standards and the ethical guidelines of the 6th (2008) Declaration of Helsinki. Findings from STREAM will be disseminated to participating families, healthcare professionals, policymakers, educators and researchers, at local, national and international levels through meetings, academic journals and conferences.
