Fernandes M
Villar J
Stein A
Staines Urias E
Garza C
Victora CG
Barros FC
Bertino E
Purwar M
Carvalho M
Giuliani F
Wulff K
Abubakar AA
Kihara M
Cheikh Ismail L
Aranzeta L
Albernaz E
Kunnawar N
Di Nicola P
Ochieng R
Sandells T
Savini S
Temple S
Murray E
Ohuma EO
Gravett MG
Pang R
Jaffer YA
Noble JA
Winsey A
Lambert A
Papageorghiou AT
Bhutta Z
Kennedy S
BMJ Open. 2020;10e035258
OBJECTIVES: To describe the construction of the international INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) standards for child development at 2 years by reporting the cognitive, language, motor and behaviour outcomes in optimally healthy and nourished children in the INTERGROWTH-21st Project. DESIGN: Population-based cohort study, the INTERGROWTH-21st Project. SETTING: Brazil, India, Italy, Kenya and the UK. PARTICIPANTS: 1181 children prospectively recruited from early fetal life according to the prescriptive WHO approach, and confirmed to be at low risk of adverse perinatal and postnatal outcomes. PRIMARY MEASURES: Scaled INTER-NDA domain scores for cognition, language, fine and gross motor skills and behaviour; vision outcomes measured on the Cardiff tests; attentional problems and emotional reactivity measured on the respective subscales of the preschool Child Behaviour Checklist; and the age of acquisition of the WHO gross motor milestones. RESULTS: Scaled INTER-NDA domain scores are presented as centiles, which were constructed according to the prescriptive WHO approach and excluded children born preterm and those with significant postnatal/neurological morbidity. For all domains, except negative behaviour, higher scores reflect better outcomes and the threshold for normality was defined as >/=10th centile. For the INTER-NDA's cognitive, fine motor, gross motor, language and positive behaviour domains these are >/=38.5, >/=25.7, >/=51.7, >/=17.8 and >/=51.4, respectively. The threshold for normality for the INTER-NDA's negative behaviour domain is
