Neurocognitive development in context of exposure to poverty-related risk factors.

Lead Research Organisation: University of Cambridge
Department Name: Psychology

Abstract

Many children growing up in poverty do not meet their milestones with regard to their brain and cognitive development. It is not well understood why the brain is affected in this way, but we suspect that a combination of factors such as poor quality food, reduced access to running water and sanitary facilities, frequent infections and difficulty in obtaining healthcare all affect the developing brain in such a way that children experience difficulties sustaining attention, remembering information or forming lasting social relationships, thus resulting in adverse outcomes for individuals and societies.

My primary aim for this fellowship is to plan further investigations into the role poverty plays in shaping brain development. To this end, I plan to use methods established in my previous research that measure the brain directly, and implement them across a range of settings worldwide. Such an application is vital to understand processes that generalise across settings and might therefore constitute a starting point for the implementation of targeted, effective interventions.

In my previous research I investigated infant brain development in The Gambia, West Africa. In this work, I pioneered the use of different neuroimaging methods in this setting to study memory development, by measuring electric signals (using electroencephalography, or EEG) and blood flow in the brain (using functional near infrared
spectroscopy, or fNIRS). These methods are highly objective and therefore particularly useful for research across different cultural settings.

Having established that these methods can be used to map out longitudinal trajectories of brain development in a low income country, I now plan to implement them across a range of different settings, by collaborating with the Evidence for better Lives Study (EBLS), which will be following large cohorts in Ghana, Jamaica, Pakistan, Romania, South Africa, Sri Lanka, the Philippines and Vietnam. At each site, a unique set of environmental risk and protective factors play a role (i.e. neighbourhood characteristics, parenting practices, prenatal exposures). If successful, this fellowship would allow me to contribute my expertise on brain development and lead the neuroimaging studies of this project. This would be a natural progression from my PhD research and allow me to establish myself as a leading researcher in the field of global child development within a multidisciplinary team.

A second goal is to assess whether the neuroimaging markers I obtained in my Gambian infant cohort predict cognitive abilities later on. I therefore aim to draw on the EBLS protocol, and implement a subset of its tasks aimed to study cognitive development in young children for a follow up of my Gambian participant cohort. Additionally, I plan to use the fellowship to disseminate my prior research within the academic community through the publication of papers and attendance of conferences. Lastly, I would like to use this fellowship to communicate aspects of my research beyond the academic community, with the aim of sensitising the public at the different study sites to the importance of healthy brain development. To this end, I plan to produce a video explaining how the methods we use to study the brain work. I further aim to assemble an 'Explain-the-Brain' kit, consisting of materials for a range of interactive workshops related to brain development, which I aim to disseminate across EBLS sites.

The integration of my previous work in The Gambia with the EBLS represents an exceptional opportunity to bring together two unique study cohorts. I anticipate that by the end of this fellowship, I will be in an ideal position towards becoming a leading researcher in the field of global neuroscience. This fellowship represents the ideal stepping stone for me to make accessible findings from my prior research and lay the foundations for future research.

Publications

10 25 50

 
Description During the first months of this award, one paper has been published which describes brain imaging results for infant cohorts in rural Gambia over the first five months of live. The brain measures we identified were found to predict developmental outcome within our cohort (Katus et al., 2020, NeuroImage). This is a continuation of the award holder's doctoral research. Furthermore, a systematic review has been submitted for publication, which details the utility of brain imaging and eye tracking measures to study early prosocial development. This work was conducted in collaboration with a new research group, who the award holder is affiliated with through this grant.

Due to the covid-19 pandemic, data collection had to be suspended. Instead, projects reliant on secondary data were persued. These led to three further publications which are currently under review or being revised. The first manuscript describes associations between responses on two neuroimaging methods (electroencephalography and functional near-infrared spectroscopy). This is important, as different measures might show differential sensitivity to underlying neural processes across age. Our paper finds that it is indeed possible to extract common neurodevelopmental markers across different assessment modalities, and associations are strongest at age point of known developmental change. The second manuscript investigates the measurement equivalence of a commonly used measure of stress (Perceived Stress Scale) across eight low- and middle-income countries. We find that while the scale can be used to robustly measure stress across diverse settings, it is not suitable to make comparisons of mean scores across sites. Lastly, together with Prof Claire Hughes and Dr Lucy Cragg, I first-authored a text book on the development of executive functions, which reviewers have indicated will make a welcome addition to their teaching and supervision.
Exploitation Route Findings from the first publication associated with this award (Katus et al., 2020, NeuroImage, see link) are the proof of principle that electrophysiological measures can be obtained from young infants in sub-Saharan Africa to evaluate their developmental outcome. This will be of utility to other scientists and clinicians interested in early-identification to aid intervention. Indeed, the findings from this publication have led to a collaboration with researchers based in Melbourne, Australia, who are using a similar marker in context of a randomised controlled trial on iron supplementation to evaluate brain development.
Sectors Education

Healthcare

Security and Diplomacy

 
Description This award has begun to make an impact across three key areas: 1. Highlighting the importance of infancy and gestation as a crucial time for life-long development Research conducted as part of this fellowship has shown that impacts of growing up in a high-risk environment on the developing brain can be measured from early infancy, through the use of neuroimaging. While previous studies have primarily started to measure the impact of adversity around preschool age, our methodological approach can be used opens a window for interventions, targeting at-risk infants in early life during a crucial point in their development. 2. Sparking further research in the emerging field of global neurodevelopment By demonstrating the utility of electroencephalography to study infants in a low-resource setting in rural Gambia, we were able to adapt the method in such a way that allows for wider use across setting sin sub-Saharan Africa and beyond. This ground-work has sparked several new collaborations using a similar methodological set up, which has expanded our line of work to Malawi and Tanzania, and also fed into two randomised controlled trials (one completed, one being planned) for nutritional supplementation in rural Bangladesh. 3. Challenging perceptions about normative child development By diversifying the populations which we can access as neurodevelopmental researcher, we are now better able than ever to update developmental theories to include a broader cross-section of the global population. This ultimately will allow us to get a more representative view on human development.
First Year Of Impact 2021
Sector Education
Impact Types Cultural

Societal

 
Description Impact of maternal experience of intimate partner violence on infant emotion processing
Amount £5,965 (GBP)
Organisation University of Cambridge 
Department Isaac Newton Trust
Sector Academic/University
Country United Kingdom
Start 03/2020 
End 09/2020
 
Description Mother knows best: exploring new mothers' narratives about their child and links with perinatal adversity across five low- and middle-income countries.
Amount £4,925 (GBP)
Organisation University of Cambridge 
Sector Academic/University
Country United Kingdom
Start 12/2021 
End 07/2022
 
Description Neurodevelopmental biomarkers of attention and memory: exploring the mediating roles of undernutrition and environmental adversity
Amount £22,785 (GBP)
Organisation University of Cambridge 
Sector Academic/University
Country United Kingdom
Start 09/2021 
End 03/2022
 
Description BRIGHT IMPACT 
Organisation University of Cambridge
Country United Kingdom 
Sector Academic/University 
PI Contribution Co-investigator on new wave of secondary data analysis for the Brain Imaging for Global Health (BRIGHT) project. I am currently acting as theme lead in identifying early neural and behavioural predcitors for later developmental outcomes.
Collaborator Contribution To date, our funded work (via BMGF and other successful grants from the lead Co-PIs and BRIGHT researchers) has allowed us to identify a number of key relationships between brain biomarkers, exposure variables and later measures of development and cognition. The ultimate objective of BRIGHT IMPACT is the identification and validation of a marker, or "fingerprint" combination of brain function markers, that predict the contribution of exposure phenotypes (i.e. undernutrition / caregiving context) to the substantive variation in developmental outcomes seen in infants born into a low income setting, such as rural Gambia. This central objective strategically aligns with the Foundation's goals to establish the generalizability of existing highincome- country (HIC) generated neurodevelopmental models of early life in low-middle-income-countries (LMICs), develop accessible, scalable, lower-density neuroimaging systems, which can be used in a range of settings and identify new and modifiable targets of intervention. Aligning with the goals of the Foundation, we will use the neural fingerprinting biomarkers to identify primary targets of intervention and through this work will be able to deliver a scalable developmental toolkit (including optimized designs for accessible lower-density NIRS and EEG systems and a battery of cognitive behavioural tasks). Clare Elwell, Sophie Moore and Sarah Lloyd-Fox (lead PIs) will assemble and lead a team of multidisciplinary scientists with expertise in longitudinal analysis techniques and psychometric modelling (Kievit, McCormick, McCann), advanced signal processing in neuroimaging data (Emberson, Eggebrecht, Katus), optimization of neuroimaging hardware/software for developmental populations (Blasi) and developmental outcome assessments in LMICs (Milosavljevic, Scerif) to achieve these objectives. Innovative modelling and analytic approaches will be applied to allow us to address the following aims: Aim 1: To employ feature extraction and time varying parameter modelling to identify the most reliable "neural fingerprinting" biomarkers (from fNIRS and EEG) of longitudinal developmental cortical specialization. Aim 2: To create a profile of metrics across developmental outcomes in later childhood (executive function, language, general cognitive development, adaptive skills) at the group level and identify latent classes that sub-group individuals into developmental profiles of pre-academic skills. Aim 3: To expand our predictive models of longitudinal fNIRS and EEG trajectories of early developing brain networks (0- 2 years) to determine which age points and "fingerprint" of biomarkers are the most consistent and reliable predictors of developmental outcomes of language, pre-academic skills and functional brain specialization in later childhood (3-5 years). Aim 4: To model exposure phenotypes and establish health, social and environmental risk and resilience determinants of developmental trajectories from birth to preschool which associate with early biomarkers of development, to identify primary targets of intervention. Outputs: (A) Establish the generalizability of key statistical and conceptual developmental models for explaining early life brain and cognitive trajectories in relation to determinants of risk and resilience. (B) Identification of primary targets of intervention; biological (i.e. nutritional), social and environmental. (C) Delivery of a scalable developmental toolkit which captures key predictive biomarkers of cognitive domains related to determinants of risk and resilience.
Impact Katus, L., Crespo-Llado, M. M., Milosavljevic, B., Saidykhan, M., Njie, O., Fadera, T., ... & BRIGHT Project Team. (2024). It takes a village: Caregiver diversity and language contingency in the UK and rural Gambia. Infant Behavior and Development, 74, 101913.
Start Year 2023
 
Description Development of executive functions 
Organisation University of Nottingham
Country United Kingdom 
Sector Academic/University 
PI Contribution Together with Dr Lucy Cragg from the University of Nottingham and Prof Claire Hughes, I co-authored a textbook on the development of executive functions which is currently under review at Oxford University Press.
Collaborator Contribution Dr Cragg and Prof Hughes each contributed two chapters to this volume.
Impact Katus L, Cragg L, Hughes C (under review). Executive functions in infancy, childhood and adolescence: Development, individual differences and real-life importance. Book commissioned as part of Oxford Primer series, Oxford University Press.
Start Year 2019
 
Description Evidence for Better Lives - collaboration across five low- and middle-income study sites 
Organisation Babes-Bolyai University
Country Romania 
Sector Academic/University 
PI Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Collaborator Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Impact Data collection is currently under way, a submission to a special issue of Developmental Science based on data gathered in this project is planned for September 2022.
Start Year 2019
 
Description Evidence for Better Lives - collaboration across five low- and middle-income study sites 
Organisation Hue University
Country Viet Nam 
Sector Academic/University 
PI Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Collaborator Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Impact Data collection is currently under way, a submission to a special issue of Developmental Science based on data gathered in this project is planned for September 2022.
Start Year 2019
 
Description Evidence for Better Lives - collaboration across five low- and middle-income study sites 
Organisation University of Ghana
Country Ghana 
Sector Academic/University 
PI Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Collaborator Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Impact Data collection is currently under way, a submission to a special issue of Developmental Science based on data gathered in this project is planned for September 2022.
Start Year 2019
 
Description Evidence for Better Lives - collaboration across five low- and middle-income study sites 
Organisation University of Kelaniya
Country Sri Lanka 
Sector Academic/University 
PI Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Collaborator Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Impact Data collection is currently under way, a submission to a special issue of Developmental Science based on data gathered in this project is planned for September 2022.
Start Year 2019
 
Description Evidence for Better Lives - collaboration across five low- and middle-income study sites 
Organisation University of the Philippines
Department Philippines Genome Center
Country Philippines 
Sector Academic/University 
PI Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Collaborator Contribution Collaborators at these institutions have collected longitudinal data during an additional assessment wave for the Evidence for Better Lives Study, which I coordianted as part of my ESRC postdoctoral fellowship.
Impact Data collection is currently under way, a submission to a special issue of Developmental Science based on data gathered in this project is planned for September 2022.
Start Year 2019
 
Description Prenatal iodine supplementation and infant neurodevelopmental outcomes in Bangladesh 
Organisation Boston University
Country United States 
Sector Academic/University 
PI Contribution During my fellowship, I established links with a newly established group led by Professor Elizabeth Pearce at Boston University. As part of this collaboration I am named as key personnel on a grant proposal seeking to examine the impact of iodione supplementation in early gestation on children's neurodevelopmental outcome as part of a large-scale RCT. If funded, my role will be to implement, analyse and disseminate the resulting electrophysiological data.
Collaborator Contribution Prof Pearce and her team are leading the trial, and are overseeing the coordination of data collection.
Impact Submission of grant proposal to NIH.
Start Year 2020
 
Description Cambridge Science Festival 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact I contributed a stall to the Cambridge Science Festival, with an activity of early infant development. In addition, we discuss questions on global health and psychological science more generally.
Year(s) Of Engagement Activity 2020
URL https://www.sciencefestival.cam.ac.uk/events/how-i-grew-see-world
 
Description Institutional host, in2science 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact Two students identified by their school as coming from under priviledged backgrounds were allocared to me for a placement with me as part of the in2science scheme. The student attended in 2019 has since moved on to study Psychology at City University London.
Year(s) Of Engagement Activity 2019,2022
URL https://in2scienceuk.org/
 
Description Native Scientist 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact 50 secondary school students attended a workshop at the Goethe Institut, London, to talk to scientists about their research in their second language.
Year(s) Of Engagement Activity 2019
URL https://www.goethe.de/ins/gb/en/spr/eng/pas/akt/min.html
 
Description Skype a Scientist 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Schools
Results and Impact After discussion with their English teacher, I skyped with a class of secondary school English-learning students from Spain. They had prepared questions about my work and we discussed what is like to be scientist researching brain development.
Year(s) Of Engagement Activity 2019,2020