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Translation and Cultural Adaptation of NIH Toolbox Cognitive Tests into Swahili and Dholuo Languages for Use in Children in Western Kenya

Published online by Cambridge University Press:  24 May 2021

Megan M. Duffey ,
David Ayuku ,
George Ayodo ,
Emily Abuonji ,
Mark Nyalumbe ,
Amy K. Giella ,
Julie N. Hook ,
Tuan M. Tran  and
Megan S. McHenry Open the ORCID record for Megan S. McHenry [Opens in a new window]
Megan M. Duffey
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
David Ayuku
Affiliation:
Moi University School of Medicine, Department of Mental Health & Behavioral Sciences, Eldoret, Kenya Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
George Ayodo
Affiliation:
Kenya Medical Research Institute, Centre of Global Health Research, Kisumu, Kenya Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
Emily Abuonji
Affiliation:
Kenya Medical Research Institute, Centre of Global Health Research, Kisumu, Kenya
Mark Nyalumbe
Affiliation:
Moi University School of Medicine, Department of Mental Health & Behavioral Sciences, Eldoret, Kenya
Amy K. Giella
Affiliation:
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Julie N. Hook
Affiliation:
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
Tuan M. Tran
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
Megan S. McHenry*
Affiliation:
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
*
*Correspondence and reprint requests to: Megan S. McHenry, MD, MS, FAAP, Assistant Professor of Pediatrics, Division of Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 705 Riley Hospital Drive, Room 5853, Indianapolis, IN 46202, USA. E-mail: msuhl@iu.edu
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Abstract

Objectives:

Performing high-quality and reliable cognitive testing requires significant resources and training. As a result, large-scale studies involving cognitive testing are difficult to perform in low- and middle-income settings, limiting access to critical knowledge to improve academic achievement and economic production in these populations. The NIH Toolbox® is a collection of cognitive, motor, sensory, and emotional tests that can be administered and scored using an iPad® tablet, reducing the need for training and quality monitoring; and thus, it is a potential solution to this problem.

Methods:

We describe our process for translation and cultural adaptation of the existing NIH Toolbox tests of fluid cognition into the Swahili and Dholuo languages for use in children aged 3–14 years in western Kenya. Through serial forward and back translations, cognitive interviews, group consensus, outside feedback, and support from the NIH Toolbox team, we produced translated tests that have both face validity and linguistic validation.

Results:

During our cognitive interviews, we found that the five chosen tests (one each of attention, cognitive flexibility, working memory, episodic memory, and processing speed) were generally well understood by children aged 7–14 years in our chosen populations. The cognitive interviews informed alterations in translation as well as slight changes in some images to culturally adapt the tests.

Conclusions:

This study describes the process by which we translated five fluid cognition tests from the NIH Toolbox into the Swahili and Dholuo languages. The finished testing application will be available for future studies, including a pilot study for assessment of psychometric properties.

Keywords

Academic SuccessChildCognitionDeveloping countriesLanguageLinguistics
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 4 , April 2022 , pp. 414 - 423
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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