# Can Functional Cognitive Assessments for Children/Adolescents Be Transformed into Digital Platforms? A Conceptual Review

## TL;DR

Most traditional cognitive assessments for children and adolescents lack digital versions, creating a gap between real-world tools and technology-based solutions.

## Contribution

A conceptual framework is proposed to guide the development of digital cognitive assessments that maintain ecological validity and leverage advanced technologies.

## Key findings

- Only 31% of functional cognitive assessments have been adapted into digital formats.
- High ecological validity assessments are less likely to be available digitally.
- Emerging technologies like VR could improve real-world context replication in digital assessments.

## Abstract

What are the main findings?
Most functional cognitive assessments (n = 13) for children and
adolescents with high ecological validity remain unavailable in digital
formats, highlighting a significant gap between traditional tools and
technology-based solutions.Digitization of these assessments offers potential benefits, such
as improved accessibility, precision in data collection, and scalability;
however, replicating real-life contexts and capturing strategy use digitally
remains challenging.

Most functional cognitive assessments (n = 13) for children and
adolescents with high ecological validity remain unavailable in digital
formats, highlighting a significant gap between traditional tools and
technology-based solutions.

Digitization of these assessments offers potential benefits, such
as improved accessibility, precision in data collection, and scalability;
however, replicating real-life contexts and capturing strategy use digitally
remains challenging.

What is the implication of the main finding?
Innovative digital tools are needed that successfully achieve
high ecological validity by preserving real-world context and observation of
strategies, while maximizing digital availability through advanced technologies
(e.g., VR, mobile platforms).The proposed conceptual framework can guide clinicians,
researchers, and developers in prioritizing features for future
technology-enhanced assessments, promoting evidence-based, context-sensitive
evaluation practices.

Innovative digital tools are needed that successfully achieve
high ecological validity by preserving real-world context and observation of
strategies, while maximizing digital availability through advanced technologies
(e.g., VR, mobile platforms).

The proposed conceptual framework can guide clinicians,
researchers, and developers in prioritizing features for future
technology-enhanced assessments, promoting evidence-based, context-sensitive
evaluation practices.

Background/Objectives: Functional cognition, integrating cognitive abilities during real-life task performance, is essential for understanding daily functioning in children and adolescents. Traditional paper-based cognitive assessments in controlled environments often lack ecological validity. Although performance-based assessments more accurately represent functioning in natural contexts, most have not been transformed into digital formats. With technology increasingly embedded in education and healthcare, examining the extent/nature of adaptations, benefits, and challenges of digitizing these tools is important. This conceptual review aimed to (1) examine the extent/nature of traditional performance-based cognitive assessments adapted into digital platforms, (2) compare ecological validity/scoring metrics of traditional and digital tools, and (3) identify opportunities and propose recommendations for future development. Methods: We used an AI-based tool (Elicit Pro, Elicit Plus 2024) to conduct a literature search for publications from the past decade, focusing on transformations of traditional assessments into digital platforms for children and adolescents. This initial search yielded 240 items. After screening, 45 were retained for manual review. Studies were extracted based on their discussion of the assessments (traditional or digital) and assessment tools used. Ultimately, 13 papers that met the inclusion criteria were evaluated based on units of analysis. Results: The analysis yielded three units. The first unit focused on digital transformation trends: four assessments (31%) were converted to digital platforms, two (15%) were developed as native digital tools, and the majority (seven, 54%) remained traditional. In the second unit, assessments were evaluated according to ecological validity and digital availability, demonstrating that assessments with high ecological validity tended not to be digitally accessible. The third unit synthesized scoring metrics, identifying eight distinct cognitive domains. Conclusions: Digitizing functional cognitive assessments offers greater accessibility, precision, and scalability, but replicating real-world contexts remains challenging. Emerging technologies may enhance ecological validity and support development of effective, technology-enhanced assessment practices.