The INTERGROWTH-21^st project neurodevelopment package: A novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children

Fernandes, M., Stein, A., Newton, C.R., Cheikh-Ismail, L., Kihara, M., Wulff, K., De Quintana, E.L., Aranzeta, L., Soria-Frisch, A., Acedo, J., Ibanez, David, Abubakar, A., Giuliani, F., Lewis, T., Kennedy, S. and Villar, J. (2014) The INTERGROWTH-21^st project neurodevelopment package: A novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children. PLoS ONE, 9 (11), [e113360]. (doi:10.1371/journal.pone.0113360).

Abstract

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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Contributors

Author: M. Fernandes

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