title: The INTERGROWTH-21st Project Neurodevelopment Package: a novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children.
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.
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
authors.forename: Michelle
authors.initials: M
authors.lastname: Fernandes
authors.affiliation: Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Stein
authors.affiliation: Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Newton
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
authors.forename: Leila
authors.initials: L
authors.lastname: Cheikh-Ismail
authors.affiliation: Department of Psychology, United States International University, Nairobi, Kenya; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
authors.forename: Michael
authors.initials: M
authors.lastname: Kihara
authors.affiliation: Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
authors.forename: Katharina
authors.initials: K
authors.lastname: Wulff
authors.affiliation: Centro de Tecnología e Innovación, Mexico City, Mexico.
authors.forename: Enrique
authors.initials: E
authors.lastname: de León Quintana
authors.affiliation: Centro de Tecnología e Innovación, Mexico City, Mexico.
authors.forename: Luis
authors.initials: L
authors.lastname: Aranzeta
authors.affiliation: Neuroscience Business Unit, Starlab Barcelona, SL, Barcelona, Spain.
authors.forename: Aureli
authors.initials: A
authors.lastname: Soria-Frisch
authors.affiliation: Neuroscience Business Unit, Starlab Barcelona, SL, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Acedo
authors.affiliation: Neuroscience Business Unit, Starlab Barcelona, SL, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Ibanez
authors.affiliation: Department of Psychology, Lancaster University, Lancaster, United Kingdom; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
authors.forename: Amina
authors.initials: A
authors.lastname: Abubakar
authors.affiliation: Dipartimento di Scienze Pediatriche e dell' Adolescenza, SCDU Neonatologia, Università di Torino, Turin, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Giuliani
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
authors.forename: Tamsin
authors.initials: T
authors.lastname: Lewis
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kennedy
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, and Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom.
authors.forename: Jose
authors.initials: J
authors.lastname: Villar
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D006801:Humans; D009420:Nervous System / Q000254:growth & development*; D009483:Neuropsychological Tests