Why BRAIN ENDEVR?
Over 250 million children under 5 years, globally, are at risk of developmental delay. A disadvantaged start in life limits children's abilities to benefit from education leading to lower productivity and social consequences that affect not only present but also future generations.
It is well established that large proportion of developmental problems are driven by environmental factors (such as poverty, exposure to infections, undernutrition and poor mental stimulation) rather than biological factors (such as genetic abnormalities or disorders of metabolism). This means that a large proportion of developmental problems are, potentially, preventable if a child's exposure to these environmental stressors is mitigated. Indeed, research has shown that at least 80% of these delays are preventable through early interventions, if administered during the first 2 years of life. Brain stimulation interventions during this critical period of brain development, particularly, have shown enduring positive effects if children at risk are identified, using standardized assessments, and receive such interventions, within this window.
The first step, therefore, in tackling this problem is to identify children at risk of delay so as to target these interventions appropriately.
However, current developmental testing for young children is simply too resource-intensive to be universal. This has led to progress in ECD lagging behind improvements in other indicators (such as child survival, breastfeeding, child growth and vaccination rates) essential to the achievement of the UN's Sustainable Development Goals (SDGs).
Unfortunately, challenges in ECD measurement at population-level have meant that the 0-24 month age group of children (which overlaps exactly with the critically sensitive window of brain development when negative influences maybe reversed and positive influences have enduring effects) have been excluded from the SDG goal specific to ECD (Goal 4, indicator 4.2.1).
It is well established that large proportion of developmental problems are driven by environmental factors (such as poverty, exposure to infections, undernutrition and poor mental stimulation) rather than biological factors (such as genetic abnormalities or disorders of metabolism). This means that a large proportion of developmental problems are, potentially, preventable if a child's exposure to these environmental stressors is mitigated. Indeed, research has shown that at least 80% of these delays are preventable through early interventions, if administered during the first 2 years of life. Brain stimulation interventions during this critical period of brain development, particularly, have shown enduring positive effects if children at risk are identified, using standardized assessments, and receive such interventions, within this window.
The first step, therefore, in tackling this problem is to identify children at risk of delay so as to target these interventions appropriately.
However, current developmental testing for young children is simply too resource-intensive to be universal. This has led to progress in ECD lagging behind improvements in other indicators (such as child survival, breastfeeding, child growth and vaccination rates) essential to the achievement of the UN's Sustainable Development Goals (SDGs).
Unfortunately, challenges in ECD measurement at population-level have meant that the 0-24 month age group of children (which overlaps exactly with the critically sensitive window of brain development when negative influences maybe reversed and positive influences have enduring effects) have been excluded from the SDG goal specific to ECD (Goal 4, indicator 4.2.1).
Our approach
Our research aims to address this gap by developing a low-cost, potentially scalable strategy to identify children at risk of delay as early as possible.
To do this, we will bring together already-collected early life data from 9 cohorts, representing just over 8000 children from 13 countries. Using multiple analytical techniques, we will examine all the early life factors driving neurodevelopmental delay in this unique metadata and validate the resultant models on independent cohorts of children from different countries.
By doing so we hope to develop and validate a 'developmental delay risk estimator' through which which health professionals and scientists may input risk factor data, at birth and at 1 year, for a child, and obtain a development delay risk score by which to identify those at risk. This 'estimator' will be freely available in multiple languages as an online calculator and therefore easily accessible for all those involved in mother and child health services to derive a 'development delay risk score' for babies before hospital discharge.
It is our hope that the risk for developmental delay will be recorded for every child, ideally, at the time of measuring birth weight, length and head circumference and at the time of the child's 1-year vaccinations. This will enable healthcare professionals to trigger the appropriate local healthcare pathways for the management of these children.
By helping with the early identification of children at risk of development delay, we hope to prevent treatment delays while simultaneously capitalising on the brain's plasticity during its most sensitive window of development so as to obtain the best possible outcomes for each child.
To do this, we will bring together already-collected early life data from 9 cohorts, representing just over 8000 children from 13 countries. Using multiple analytical techniques, we will examine all the early life factors driving neurodevelopmental delay in this unique metadata and validate the resultant models on independent cohorts of children from different countries.
By doing so we hope to develop and validate a 'developmental delay risk estimator' through which which health professionals and scientists may input risk factor data, at birth and at 1 year, for a child, and obtain a development delay risk score by which to identify those at risk. This 'estimator' will be freely available in multiple languages as an online calculator and therefore easily accessible for all those involved in mother and child health services to derive a 'development delay risk score' for babies before hospital discharge.
It is our hope that the risk for developmental delay will be recorded for every child, ideally, at the time of measuring birth weight, length and head circumference and at the time of the child's 1-year vaccinations. This will enable healthcare professionals to trigger the appropriate local healthcare pathways for the management of these children.
By helping with the early identification of children at risk of development delay, we hope to prevent treatment delays while simultaneously capitalising on the brain's plasticity during its most sensitive window of development so as to obtain the best possible outcomes for each child.
Our values
Our deliverables
We are working to impact the enormous and devastating challenge of developmental delay in young children on a global scale.
Our project deliverables include:
While we recognize that interventions are very important, developing recommendations for these with sustainable implementation strategies are beyond the scope of this Project but will feature as a key aspect of our future work.
Our project deliverables include:
- The first ever international early child development meta-dataset containing detailed information on birth, health, growth, family and social environment, and neurodevelopment outcomes in children from 13 countries.
- New typology to classify risk of developmental delay according to the child's growth, nutrition, health and socio-environmental characteristics.
- An in-depth assessment of factors impacting child development across the countries
- A new tool to estimate a child's risk of developmental delay, at birth and at 1 year, from these risk factors
- Recommendations on screening all children for risk of delay, at birth and at 1 year, with sustainable implementation strategies.
While we recognize that interventions are very important, developing recommendations for these with sustainable implementation strategies are beyond the scope of this Project but will feature as a key aspect of our future work.
