. 2014 Nov 25;9(11):e113360.

doi: 10.1371/journal.pone.0113360. eCollection 2014.

The INTERGROWTH-21st Project Neurodevelopment Package: a novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children

Michelle Fernandes¹, Alan Stein², Charles R Newton³, Leila Cheikh-Ismail¹, Michael Kihara⁴, Katharina Wulff⁵, Enrique de León Quintana⁶, Luis Aranzeta⁶, Aureli Soria-Frisch⁷, Javier Acedo⁷, David Ibanez⁷, Amina Abubakar⁸, Francesca Giuliani⁹, Tamsin Lewis¹, Stephen Kennedy¹, Jose Villar¹; International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st)

Collaborators, Affiliations

Collaborators

International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st):
M Katz, M K Bhan, C Garza, S Zaidi, A Langer, P M Rothwell, D Weatherall, Z A Bhutta, J Villar, S Kennedy, D G Altman, F C Barros, E Bertino, F Burton, M Carvalho, L Cheikh Ismail, W C Chumlea, M G Gravett, Y A Jaffer, A Lambert, P Lumbiganon, J A Noble, R Y Pang, A T Papageorghiou, M Purwar, J Rivera, C Victora, J Villar, D G Altman, Z A Bhutta, L Cheikh Ismail, S Kennedy, A Lambert, J A Noble, A T Papageorghiou, J Villar, S Kennedy, L Cheikh Ismail, A Lambert, A T Papageorghiou, M Shorten, L Hoch, H E Knight, E O Ohuma, C Cosgrove, I Blakey, D G Altman, E O Ohuma, J Villar, D G Altman, F Roseman, N Kunnawar, S H Gu, J H Wang, M H Wu, M Domingues, P Gilli, L Juodvirsiene, L Hoch, N Musee, H Al-Jabri, S Waller, C Cosgrove, E O Ohuma, D Yellappan, A Carter, D Muninzwa, D Reade, R Miller, A T Papageorghiou, L Salomon, A Leston, A Mitidieri, F Al-Aamri, W Paulsene, J Sande, W K S Al-Zadjali, C Batiuk, S Bornemeier, M Carvalho, M Dighe, P Gaglioti, N Jacinta, S Jaiswal, J A Noble, K Oas, M Oberto, E Olearo, M G Owende, J Shah, S Sohoni, T Todros, M Venkataraman, S Vinayak, L Wang, D Wilson, Q Q Wu, S Zaidi, Y Zhang, P Chamberlain, D Danelon, I Sarris, J Dhami, C Ioannou, C L Knight, R Napolitano, C Pace, V Mkrtychyan, L Cheikh Ismail, W C Chumlea, F Al-Habsi, Z A Bhutta, A Carter, M Alija, J M Jimenez-Bustos, J Kizidio, F Puglia, N Kunnawar, H Liu, S Lloyd, D Mota, R Ochieng, C Rossi, M Sanchez Luna, Y J Shen, H E Knight, D A Rocco, I O Frederick, Z A Bhutta, E Albernaz, M Batra, B A Bhat, E Bertino, P Di Nicola, F Giuliani, I Rovelli, K McCormick, R Ochieng, R Y Pang, V Paul, V Rajan, A Wilkinson, A Varalda, B Eskenazi, L A Corra, H Dolk, J Golding, A Matijasevich, T de Wet, J J Zhang, A Bradman, D Finkton, O Burnham, F Farhi, A Stein, M Fernandes, C Newton, M Kihara, A Abubakar, K Wulff, M de-Haan, A Soria-Frisch, J Acedo, D Ibanez, C Hogue, E de-Leon, L Aranzeta, T Lewis, A Varalda, I Rovelli, N Sudhir, D Muninzwa, J Kizidio, E Albernaz, F Giuliani, S Savini, E Murray, F C Barros, M Domingues, S Fonseca, A Leston, A Mitidieri, D Mota, I K Sclowitz, M F da Silveira, R Y Pang, Y P He, Y Pan, Y J Shen, M H Wu, Q Q Wu, J H Wang, Y Yuan, Y Zhang, M Purwar, A Choudhary, S Choudhary, S Deshmukh, D Dongaonkar, M Ketkar, V Khedikar, N Kunnawar, C Mahorkar, I Mulik, K Saboo, C Shembekar, A Singh, V Taori, K Tayade, A Somani, E Bertino, P Di Nicola, M Frigerio, G Gilli, P Gilli, M Giolito, F Giuliani, M Oberto, L Occhi, C Rossi, I Rovelli, F Signorile, T Todros, M Carvalho, J Kizidio, R Ochieng, J Shah, W Stones, S Vinayak, N Musee, C Kisiang, D Muninzwa, Y A Jaffer, J Al-Abri, J Al-Abduwani, F M Al-Habsi, H Al-Lawatiya, B Al-Rashidiya, W K S Al-Zadjali, F R Juangco, M Venkataraman, H Al-Jabri, D Yellappan, S Kennedy, L Cheikh Ismail, A T Papageorghiou, F Roseman, A Lambert, S Lloyd, R Napolitano, C Ioannou, I Sarris, M G Gravett, C Batiuk, M Batra, S Bornemeier, M Dighe, K Oas, W Paulsene, D Wilson, I O Frederick, H F Andersen, S E Abbott, A A Carter, H Algren, D A Rocco, T K Sorensen, D Enquobahrie, S Waller

Affiliations

¹ Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
² Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom.
³ Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
⁴ Department of Psychology, United States International University, Nairobi, Kenya; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
⁵ Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
⁶ Centro de Tecnología e Innovación, Mexico City, Mexico.
⁷ Neuroscience Business Unit, Starlab Barcelona, SL, Barcelona, Spain.
⁸ Department of Psychology, Lancaster University, Lancaster, United Kingdom; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
⁹ Dipartimento di Scienze Pediatriche e dell' Adolescenza, SCDU Neonatologia, Università di Torino, Turin, Italy.

PMID: 25423589
PMCID: PMC4244160
DOI: 10.1371/journal.pone.0113360

The INTERGROWTH-21st Project Neurodevelopment Package: a novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children

Michelle Fernandes et al. PLoS One. 2014.

. 2014 Nov 25;9(11):e113360.

doi: 10.1371/journal.pone.0113360. eCollection 2014.

Authors

Collaborators

International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st):
M Katz, M K Bhan, C Garza, S Zaidi, A Langer, P M Rothwell, D Weatherall, Z A Bhutta, J Villar, S Kennedy, D G Altman, F C Barros, E Bertino, F Burton, M Carvalho, L Cheikh Ismail, W C Chumlea, M G Gravett, Y A Jaffer, A Lambert, P Lumbiganon, J A Noble, R Y Pang, A T Papageorghiou, M Purwar, J Rivera, C Victora, J Villar, D G Altman, Z A Bhutta, L Cheikh Ismail, S Kennedy, A Lambert, J A Noble, A T Papageorghiou, J Villar, S Kennedy, L Cheikh Ismail, A Lambert, A T Papageorghiou, M Shorten, L Hoch, H E Knight, E O Ohuma, C Cosgrove, I Blakey, D G Altman, E O Ohuma, J Villar, D G Altman, F Roseman, N Kunnawar, S H Gu, J H Wang, M H Wu, M Domingues, P Gilli, L Juodvirsiene, L Hoch, N Musee, H Al-Jabri, S Waller, C Cosgrove, E O Ohuma, D Yellappan, A Carter, D Muninzwa, D Reade, R Miller, A T Papageorghiou, L Salomon, A Leston, A Mitidieri, F Al-Aamri, W Paulsene, J Sande, W K S Al-Zadjali, C Batiuk, S Bornemeier, M Carvalho, M Dighe, P Gaglioti, N Jacinta, S Jaiswal, J A Noble, K Oas, M Oberto, E Olearo, M G Owende, J Shah, S Sohoni, T Todros, M Venkataraman, S Vinayak, L Wang, D Wilson, Q Q Wu, S Zaidi, Y Zhang, P Chamberlain, D Danelon, I Sarris, J Dhami, C Ioannou, C L Knight, R Napolitano, C Pace, V Mkrtychyan, L Cheikh Ismail, W C Chumlea, F Al-Habsi, Z A Bhutta, A Carter, M Alija, J M Jimenez-Bustos, J Kizidio, F Puglia, N Kunnawar, H Liu, S Lloyd, D Mota, R Ochieng, C Rossi, M Sanchez Luna, Y J Shen, H E Knight, D A Rocco, I O Frederick, Z A Bhutta, E Albernaz, M Batra, B A Bhat, E Bertino, P Di Nicola, F Giuliani, I Rovelli, K McCormick, R Ochieng, R Y Pang, V Paul, V Rajan, A Wilkinson, A Varalda, B Eskenazi, L A Corra, H Dolk, J Golding, A Matijasevich, T de Wet, J J Zhang, A Bradman, D Finkton, O Burnham, F Farhi, A Stein, M Fernandes, C Newton, M Kihara, A Abubakar, K Wulff, M de-Haan, A Soria-Frisch, J Acedo, D Ibanez, C Hogue, E de-Leon, L Aranzeta, T Lewis, A Varalda, I Rovelli, N Sudhir, D Muninzwa, J Kizidio, E Albernaz, F Giuliani, S Savini, E Murray, F C Barros, M Domingues, S Fonseca, A Leston, A Mitidieri, D Mota, I K Sclowitz, M F da Silveira, R Y Pang, Y P He, Y Pan, Y J Shen, M H Wu, Q Q Wu, J H Wang, Y Yuan, Y Zhang, M Purwar, A Choudhary, S Choudhary, S Deshmukh, D Dongaonkar, M Ketkar, V Khedikar, N Kunnawar, C Mahorkar, I Mulik, K Saboo, C Shembekar, A Singh, V Taori, K Tayade, A Somani, E Bertino, P Di Nicola, M Frigerio, G Gilli, P Gilli, M Giolito, F Giuliani, M Oberto, L Occhi, C Rossi, I Rovelli, F Signorile, T Todros, M Carvalho, J Kizidio, R Ochieng, J Shah, W Stones, S Vinayak, N Musee, C Kisiang, D Muninzwa, Y A Jaffer, J Al-Abri, J Al-Abduwani, F M Al-Habsi, H Al-Lawatiya, B Al-Rashidiya, W K S Al-Zadjali, F R Juangco, M Venkataraman, H Al-Jabri, D Yellappan, S Kennedy, L Cheikh Ismail, A T Papageorghiou, F Roseman, A Lambert, S Lloyd, R Napolitano, C Ioannou, I Sarris, M G Gravett, C Batiuk, M Batra, S Bornemeier, M Dighe, K Oas, W Paulsene, D Wilson, I O Frederick, H F Andersen, S E Abbott, A A Carter, H Algren, D A Rocco, T K Sorensen, D Enquobahrie, S Waller

Affiliations

¹ Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
² Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom.
³ Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
⁴ Department of Psychology, United States International University, Nairobi, Kenya; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
⁵ Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
⁶ Centro de Tecnología e Innovación, Mexico City, Mexico.
⁷ Neuroscience Business Unit, Starlab Barcelona, SL, Barcelona, Spain.
⁸ Department of Psychology, Lancaster University, Lancaster, United Kingdom; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
⁹ Dipartimento di Scienze Pediatriche e dell' Adolescenza, SCDU Neonatologia, Università di Torino, Turin, Italy.

PMID: 25423589
PMCID: PMC4244160
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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Conflict of interest statement

Competing Interests: The authors have read the Journal's policy and the authors of this manuscript have the following competing interests: Aureli Soria-Frisch, David Ibanez and Javier Acedo are employed by Neuroscience Business Unit, Starlab, Spain. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

**Figure 1. Distribution of the prevalence of severe neurodevelopmental impairment per 1,000 children in select countries.**
Distribution of prevalence of severe neurodevelopmental impairment per 1,000 children in select countries. Taken from Durkin, The Epidemiology of Developmental Disabilities in Low-Income Countries, Mental Retardation and Developmental Disabilities Research Reviews p. 207 (2002) .

**Figure 2. Conceptual and methodological challenges in the assessment of early child development in the context of the INTERGROWTH-21^st Project.**
Conceptual and methodological challenges in the multi-dimensional assessment of early childhood neurodevelopment across low-, middle- and high-income settings (black boxes) and the unique opportunity provided by the INTERGROWTH-21^st Project to explore some of these issues (red boxes).

**Figure 3. Components of the INTERGROWTH-21^st Neurodevelopment Package.**

See this image and copyright information in PMC

References

1. First LR, Palfrey JS (1994) The Infant or young child with developmental delay. The New England Journal of Medicine 330:478–483. - PubMed
1. Durkin M (2002) The epidemiology of developmental disabilities in low-income countries. Mental Retardation and Developmental Disabilities Research Reviews 8:206–211. - PubMed
1. Olness K (2003) Effects on Brain Development Leading to Cognitive Impairment: A Worldwide Epidemic. Journal of Developmental & Behavioral Pediatrics 24:120–130. - PubMed
1. Rutter M, Kim-Cohen J, Maughan B (2006) Continuities and discontinuities in psychopathology between childhood and adult life. Journal of Child Psychology and Psychiatry 47:276–295. - PubMed
1. Mannuzza S, Klein RG (2000) Long-term prognosis in attention-deficit/hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America 9:711–726. - PubMed

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The INTERGROWTH-21st Project Neurodevelopment Package: a novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children

Collaborators

Affiliations

The INTERGROWTH-21st Project Neurodevelopment Package: a novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources