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The INTERGROWTH-21st Project Neurodevelopment Package: a novel method for the multi-dimensional assessment of
Michelle Fernandes1, Alan Stein2, Charles R Newton3
1Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
Insights
The INTERGROWTH-21st Neurodevelopment Package offers a comprehensive, multi-dimensional assessment for early child development. This tool aids researchers and surveillance programs in evaluating preschooler neurodevelopment globally.
Area of Science:
- Pediatric Neurodevelopment
- Child Psychology
- Global Health Research
Background:
- The International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) Project studies early growth in healthy mother-newborn cohorts.
- Neurodevelopmental outcomes are assessed at 24 months using the INTERGROWTH-21st Neurodevelopment Package.
- This paper details the development of preschooler neurodevelopment tools within the Package.
Purpose of the Study:
- To describe the neurodevelopment tools developed for preschoolers within the INTERGROWTH-21st Project.
- To outline the systematic approach used in creating a multi-dimensional neurodevelopmental assessment package.
- To present a standardized method for evaluating early child development in international populations.
Main Methods:
- An advisory panel defined criteria for neurodevelopmental instruments, prioritizing multi-dimensionality and international suitability.
- A literature review identified 47 potential tools, but none met all project criteria.
- A package-based approach was adopted, categorizing outcomes, setting domain-specific criteria, and selecting optimal measures.
Main Results:
- The INTERGROWTH-21st Neurodevelopment Package assesses vision, auditory processing, cognition, language, behavior, motor skills, and attention within 35-45 minutes.
- It incorporates tablet-based applications, quality checks, and automated EEG for ease of use by non-specialist staff.
- The Package is currently deployed in Brazil, India, Italy, Kenya, and the United Kingdom.
Conclusions:
- The INTERGROWTH-21st Neurodevelopment Package is a validated, multi-dimensional instrument for assessing early child development (ECD).
- Its systematic development and practical administration make it valuable for large-scale ECD research and surveillance initiatives worldwide.
Background:
The International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) Project is a population-based, longitudinal study describing early growth and development in an optimally healthy cohort of 4607 mothers and newborns. At 24 months, children are assessed for neurodevelopmental outcomes with the INTERGROWTH-21st Neurodevelopment Package. This paper describes neurodevelopment tools for preschoolers and the systematic approach leading to the development of the Package.
Methods:
An advisory panel shortlisted project-specific criteria (such as multi-dimensional assessments and suitability for international populations) to be fulfilled by a neurodevelopment instrument. A literature review of well-established tools for preschoolers revealed 47 candidates, none of which fulfilled all the project's criteria. A multi-dimensional assessment was, therefore, compiled using a package-based approach by: (i) categorizing desired outcomes into domains, (ii) devising domain-specific criteria for tool selection, and (iii) selecting the most appropriate measure for each domain.
Results:
The Package measures vision (Cardiff tests); cortical auditory processing (auditory evoked potentials to a novelty oddball paradigm); and cognition, language skills, behavior, motor skills and attention (the INTERGROWTH-21st Neurodevelopment Assessment) in 35-45 minutes. Sleep-wake patterns (actigraphy) are also assessed. Tablet-based applications with integrated quality checks and automated, wireless electroencephalography make the Package easy to administer in the field by non-specialist staff. The Package is in use in Brazil, India, Italy, Kenya and the United Kingdom.
Conclusions:
The INTERGROWTH-21st Neurodevelopment Package is a multi-dimensional instrument measuring early child development (ECD). Its developmental approach may be useful to those involved in large-scale ECD research and surveillance efforts.
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