INTERGROWTH-21st Project international INTER-NDA standards for child development at 2 years of age: an international prospective population-based study

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;10

Permenent descriptor

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