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Title: The predictive validity of early childhood neurodevelopmental assessment using eye tracking measures, with school-age neuropsychological performance in rural Ugandan HIV-affected children.

Speaker: Dr. Michael Boivin, Michigan State University, Department of Psychiatry and Neurology & Ophthalmology, College of Osteopathic Medicine

Date: Monday, December 9th, 2019
Time: 11:00 - 12:00 Noon
Location: Comal 212


Objective: Neurodevelopmental assessments in early childhood followed by neurocognitive assessments during the school-age years are sometimes used to monitor HIV-affected children in resource-constrained settings. This study evaluated the predictive validity of neurodevelopmental assessment both at one year and at four years of age with neuropsychological assessment at six years using measures adapted to the African context from high-income countries.

Participants & Methods: Children of mothers with HIV enrolled in a clinical trial study for caregiver training to enhance early childhood development (ECD). These children were HIV-exposed but uninfected (HEU). They were evaluated with the Mullen Scales of Early Learning (MSEL) in their local language and with the Early Childhood Vigilance Test (ECVT) of attention. The ECVT evaluated proportion of time children attend to a 6-minute animation with colourful animals that periodically greet the child and more across the screen and was scored using Tobii eye tracking instrumentation. Younger siblings or household children at about one year of age were evaluated with the Uganda modified Fagan Test of Infant Intelligence (FTII). All HEU study children were tested at least two years later with the Kaufman Assessment Battery for Children, 2nd Edition (KABC-2) and the visual computerized Tests of Variables of Attention (TOVA). Evaluation took place at the Tororo District Hospital in eastern Uganda.

Results: ECVT attention was significantly correlated with TOVA signal detection D prime performance for vigilance attention and with TOVA response time variability, sensitive measures of inattention. FTII proportion of time viewing novel (vs. familiar) faces was significantly related to overall KABC-2 performance, related especially to auditory working memory (KABC Number Recall; p<0.05). FTII proportional preference for novel faces was significantly related to TOVA percent omission errors (vigilance attention).

Conclusion: An eye-tracking based measure of infant measure of attention and working memory (human faces) can predict aspects of neurocognitive performance several years later. Gathering test results automatically, eye tracking-based cognitive assessments in infants can be beneficial in evaluating neurocognitive risk in HIV-infected and affected children; gauging benefits from early treatment and supportive care. We thus provide an innovative performance-based window into the integrity of brain/behaviour development in infancy and early childhood.


Since joining MSU in 2006, Michael J. Boivin has become internationally recognized as one of the foremost scientists in the neurodevelopmental and neuropsychological evaluation of African children. As a two-time Fulbright research fellow (DR Congo 1990-91; Uganda 2003-04), and a West African Research Association fellow (Senegal, 1997), he has pioneered research over the past 30 years in assessing the impact of interventions for HIV disease, cerebral malaria, konzo disease, intestinal parasite and anemia treatment, and malnutrition in children. He has conducted this work in such countries as Uganda, Malawi, the Democratic Republic of Congo (DRC), Benin, Mali, Zimbabwe, and South Africa. He has also served as a consultant for NIH-sponsored studies pertaining to HIV-affected children in Kenya, Tanzania, South Africa, and Nigeria. He has won NIH R01 grants and served as PI or Co-PI on NIH-Fogarty, NICHD, NIMH, and NIEHS-sponsored studies in all of these study domains. His most recent award was an NICHD R01 grant to evaluate the use of computer cognitive games for neuropsychological rehabilitation and evaluation in African children affected by HIV (March, 2019). Dr. Boivin is also an adjunct professor of psychiatry at the University of Michigan and has won various intramural research and training grants and awards through their medical school so support his African-based research.

These grants have focused on the use of early caregiver training in early childhood development to enhance cognitive and psychosocial development in Ugandan children affected by HIV, computerized cognitive rehabilitation training for children surviving severe malaria and children with HIV, the neuropsychological and immunological evaluation of children surviving severe malaria, and Congolese children affected by konzo disease from toxic cassava as well as children, epileptic children affected by nodding disease, and Congolese children in mining regions affected by toxic exposure from heavy metal exposure. In all of this work, Professor Boivin has mentored MSU and UM medical and graduate students in collaborative neurodevelopmental global health research in Africa. He has supervised their efforts resulting in scores of professional presentations at national and international professional meetings, and in peer-reviewed journal publications with many of these students serving as lead authors in those articles. He has also contributed to capacity building in these African countries, serving as a PhD and MMed advisor on dozens of research theses of junior African scholars in Uganda, Benin, South Africa, and the DRC.

Professor Boivin has published his findings from these studies in such leading journals as Nature, Lancet Global Health, Pediatrics, AIDS, PLoS ONE, Neuropsychology, and Clinical Infectious Diseases. He has also served as Protocol Chair of an NIH-sponsored multi-site clinical trials evaluations of the neuropsychological effects of HIV-infected children (10 study sites in six African countries); and a multi-site study of the neurodevelopmental effects of different antiretoviral treatment arms in mothers receiving anti-retroviral drugs to prevent transmission of mother-to-children HIV infection. Finally, Professor Boivin is lead editor of a book entitled Neuropsychology of Children in Africa: Perspectives in Risk and Resilience (Springer Publishing, 2013), sponsored by the American Academy of Pediatric Neuropsychology (AAPdN). This book is the first of its kind, and has become a landmark publication in the field which professor Boivin has used in a number of invited CME workshops internationally. As one of the leading pioneers and research scholars in his field for almost thirty years, Michael J. Boivin now leads the Psychistry Research Division for Global Mental Health and Development across the lifespan (the THRIVE Always program).

60 minutes
Department of Computer Science