A newborn baby’s brain grows about three times its size in the first year.
An adult brain uses 20% of blood glucose; a baby’s brain uses as much as 50% of blood glucose.
Evaluating neurodevelopment in different cultural settings is an integral component of early child development and is essential for observational and interventional studies focused on the first 1000 days of life.
The INTERGROWTH-21st Neurodevelopment Assessment Package was developed within the context of the INTERGROWTH-21st Project by Michelle Fernandes , Jose Villar and an Infant Development Scientific Advisory Panel led by Professors Alan Stein and Charles Newton. The Package employs recent technological advances and state-of-the-art neuroscience methodology in an easy-to-use, holistic evaluation of child development in the 22 to 26 month age group. Over 1000 children have been assessed to date in the study sites in Brazil, Kenya, India, Italy and the UK.
The Package assesses vision, cortical auditory processing, cognition, language skills, fine and gross motor skills, behaviour, attention, social-emotional reactivity, sleep, circadian rhythms and daytime physical activity in 35-45 minutes. It can be administered by non-specialists without previous training or experience in healthcare and therefore lends itself to scalability in the context of population based assessments of early child development.
The Package consists of four components:
1) An assessment of vision, i.e. viual acuity and contrast sensitivity, with the Cardiff tests.
2) An assessment of cortical auditory processing by measuring auditory evoked response potential to an auditory novelty oddball paradigm using a novel wireless, gel-free EEG recording system employing a ‘strap-and-click’ design.
3) An assessment of neuropsychological outcomes, i.e. cognition, language skills, motor skills, behaviour, attention and social-emotional reactivity, using the INTER-NDA.
4) An assessment of sleep, circadian rhythm and daytime physical activity using actigraphy and a sleep questionnaire.
The hall-marks of the implementation process are:
iii) Centralised data storage and processing.
All data (except EEG and actigraphy data) are collected via a tablet based application called the NeuroApp. The NeuroApp has an integrated manual, administration cues and quality checks to ensure that no data is missed or duplicated. EEG data uploads to the centralised server immediately and automatically following the termination of the recording.
Impact of our work
To date, the package has been adopted by Educación Inicial, Mexico City; the FinnBrain Project, Turku, Finland and Saving Brains Grenada, St.George’s University, Grenada.
In addition, discussions have started with the Oxford Academic Health Science Network and ISIS Innovation (University of Oxford) to test the package’s potential as a community‐based screening assessment for all children born preterm in the Thames Valley Region with a view to its wider roll‐out as a screening measure for early child development across the NHS.