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NDD-ECHO: A standardised digital assessment tool to capture early life environmental and inflammatory factors for

Shrujna Patel1,2, Velda X Han1,2, Brooke A Keating1

  • 1Kids Neuroscience Centre, The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, NSW, Australia.

Brain, Behavior, & Immunity - Health
|June 9, 2025
PubMed

Insights

A new tool, NDD-ECHO, systematically collects environmental and clinical histories for neurodevelopmental disorders (NDDs). It helps identify environmental triggers and enhances personalized care for children with NDDs.

Area of Science:

  • Neuroscience
  • Genetics
  • Environmental Health

Background:

  • Neurodevelopmental disorders (NDDs) are influenced by genetic and environmental factors.
  • The maternal immune activation (MIA) hypothesis links prenatal inflammation to increased NDD risk.
  • Current clinical practice has limitations in capturing detailed early life environmental data.

Purpose of the Study:

  • To develop and pilot NDD-ECHO, a standardized digital tool for collecting maternal and child environmental histories.
  • To systematically gather neurodevelopmental symptom profiles alongside environmental exposures.
  • To facilitate the identification of environmental triggers for NDDs.

Main Methods:

  • Development of NDD-ECHO, a survey tool on the REDCap platform.
  • Collaborative data collection from caregivers and clinicians.
  • Pilot study in 161 children with complex NDDs at a tertiary clinic.

Main Results:

  • Nearly 80% of children experienced loss of developmental skills.
  • Infections and stress were identified as triggers for symptom exacerbations in many children.
  • The tool demonstrated utility in collecting comprehensive environmental and clinical data.

Conclusions:

  • Environmental factors play a significant role in NDD symptomatology.
  • NDD-ECHO advances research by improving environmental risk factor data collection.
  • The tool enhances personalized care for children with NDDs by identifying triggers.

Keywords:
Autism spectrum disorderEpigeneticExposomeMaternal immune activationObsessive-compulsive disorderTourette syndrome

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