Elevate: Improving the Cognitive Assessment of Individuals with Down Syndrome
Elevate is the result of 8 months of intensive work that was put together by my final year design team as part of our capstone design project. This repository contains the code for our final designed solution. A brief introduction to the problem spaces follows. Please consult the report for more details.
- Arumoy Shome: Lead Developer
- Maathusan Rajendram: Product Manager
- Mira Sleiman: Lead Designer
Situation of Concern
Down syndrome is a chromosomal disorder that impacts 1 in 700 births in the US alone. It is the most common chromosomal cause of mild to moderate intellectual disability. Currently, the modern form of assessment of cognitive abilities is through pen and paper (i.e. a Cognitive Test Battery). However, this current state of the art is very costly where the cost of a typical assessment can range anywhere from $300-$4400 for initial assessments to a full diagnostics assessment. Furthermore, an average assessment can take approximately 90 minutes per day which can range from 1 to 5 days depending on the scale of it. This makes the assessment process very time consuming. Last and most importantly, cognitive tasks are typically viewed as effortful, frustrating, and repetitive, which often leads to participant disengagement. This, in turn, can negatively impact data quality and/or reduce intervention effects. Due to the three main aforementioned downfalls of the current assessment process, an improved form of assessment is proposed.
Why Does This Matter?
From the user interviews conducted with the secondary users (parents of children with Down syndrome), it was found that individuals with Down syndrome typically only get assessed 1-2 times in their lifetime. This depicts the lack of effectiveness of the current assessment tools. Therefore, by reducing the cost and time taken per assessment, there is less of a barrier for taking the tests more frequently thus, providing the parents and guardians with more feedback on the progress of the development of their child.
A game-based assessment tool to determine the level of cognitive impairment of users was developed as the final design solution. The assessment tool was built using native web technologies. Phaser, a game engine was used to utilize the native web APIs through a single, uniform interface. The Mini Mental State Exam (MMSE) was used as a reference whilst developing the games. Three games were developed, each representing a test from three different categories of MMSE namely Registration, Attention and Calculation and Recall. Modifications were made to the games in order to define custom win and lose states based on the requirements dictated by the corresponding MMSE test. The scoring logic for each game was modified based on the MMSE scoring technique. Code was added to transmit metrics from game such as time taken to complete level, score, all answers (right and wrong) and total wrong answers (ie. repetitions until right answer was selected) which can be later used for analysis. Finally, the 3 games were combined into one such that they are played in a specific sequence, mimicking the way in which a MMSE evaluation would be carried out.