Self-administered Online Cognitive Tests: An Initial Validation and Sensitivity Study of the Auto-GEMS Platform in Burmese-English Bilingual Young Adults

Driven by digital innovation, neuropsychological assessment is moving rapidly from traditional in-person testing to web-based, self-administered tests. However, before that, such unsupervised digital platforms must establish cross-cultural validity and linguistic fairness before being implemented in diverse populations. Therefore, this study evaluated the previously mentioned characteristics of the web-based, self-administered Auto-GEMS cognitive testing platform. A cross-sectional, unsupervised online study was conducted with 37 Burmese-English bilingual young adults. Participants completed Auto-GEMS cognitive assessment together with the short Cognitive Reserve Index Questionnaire (s-CRIq) and English Proficiency Questionnaire (EPQ). It focuses on whether the English version of Auto-GEMS could assess cognitive performance fairly among Burmese-English bilingual young adults without the test result being substantially influenced by English language proficiency, whether individual differences in cognitive reserve affect Auto-GEMS accuracy and overall performance, and whether language proficiency has a stronger impact on verbal accuracy subtests compared to non-verbal reaction-time subtests (TMT-A and TMT-B). Participants demonstrated strong general performance across the test. General English proficiency showed little evidence of a significant association with overall cognitive scores, providing preliminary support that global test outcomes were relatively independent of second-language ability in this sample. Additionally, higher cognitive reserve was linked to better overall performance while subjective language confidence appeared to facilitate faster task-switching on the Trail Making Test Part B. These early findings provide tentative support for the usability and linguistic viability of Auto-GEMS in bilingual young adults, pointing toward the need for expanded normative and clinical follow-up studies.