Effects of age and cognition on a cross-cultural paediatric adaptation of the Sniffin' Sticks Identification Test

Abstract

Objectives: To study the effects of age and cognition on the performance of children aged 3 to 18 years on a culturally adapted version of the 16 item smell identification test from Sniffin' Sticks (SS16).

Methods: A series of pilots were conducted on 29 children aged 3 to 18 years old and 23 adults to produce an adapted version of the SS16 suitable for Brazilian children (SS16-Child). A final version was applied to 51 children alongside a picture identification test (PIT-SS16-Child) to access cognitive abilities involved in the smell identification task. In addition 20 adults performed the same tasks as a comparison group.

Results: The final adapted SS16-Child was applied to 51 children with a mean age of 9.9 years (range 3-18 years, SD=4.25 years), of which 68.3% were girls. There was an independent effect of age (p<0.05) and PIT-SS16-Child (p<0.001) on the performance on the SS16-Child, and older children reached the ceiling for scoring in the cognitive and olfactory test. Pre-school children had difficulties identifying items of the test.

Discussion/conclusions: A cross-culturally adapted version of the SS16 can be used to test olfaction in children but interpretation of the results must take age and cognitive abilities into consideration.

Fig 1. Correlations between SS16-Child, PIT-SS16-Child and age.

SS16-Child: New version of Sniffin' Sticks smell test, adapted to Brazilian children; PIT-SS16-Child: Picture Identification Test, adapted for use with SS16-Child; *** highly significant association (p<0.001). A) r² = 0.482 indicating that the variation in age explains roughly 42% of the variation in the score of the test; B) r² = 0.436 indicating that 43% of the PIT-SS16-Child variation can be explained by the variation in age; C) This relationship explains roughly 74% of the variation in the SS16-Child data (r² = 0.74) and is highly significant.