Neurodevelopment from infancy to early childhood in West Africa: the contribution of early markers and psychosocial factors to developmental outcomes
Lead Research Organisation:
University of Cambridge
Department Name: Psychology
Abstract
Over 200 million children under the age of 5 years in low-resource settings are exposed to adverse environmental factors, such as inadequate nutrition, physical illness and a lack of stimulation. This can have consequences for their ability to achieve important developmental milestones and, as a result, for subsequent school performance. While this is recognised as an important issue, there is very little research that aims to identify the earliest signs of risk and how it shapes development. Identifying early signs of risk in infancy is crucial for developing interventions to help children achieve optimal outcomes. It is also important to better understanding how specific aspects of a child's environment, such as nutrition and caregiving practices, contribute to their development. With this work, we will be better able to understand how certain risk factors impact on development and also how to best promote enriching elements within the family and broader community that can offset the impact of risk.
The aim of this research is to investigate the development of cognitive skills from infancy to preschool age among a group of children from a rural region of The Gambia, West Africa. The data for this project comes from the Brain Imaging for Global Health project (BRIGHT; globalfnirs.org), a study that has been following a group of children in The Gambia from the prenatal period to preschool age to measure their brain and cognitive development during early childhood.
The specific aims of this study are to:
(1) Examine cognitive development from infancy to preschool age among this group of children in the rural Gambian setting. Our goal is to study individual differences in development, which may help to identify children who show delayed development compared with the rest of the group.
(2) Investigate whether the ability to regulate attention and respond to social input during infancy predicts cognitive development during preschool age. We will use assessments of behavioural and neural responses to measure these skills in infancy and explore how they relate to outcomes during preschool age.
(3) To understand how both adverse and enriching elements of a child's environment contribute to their cognitive development. In particular we are interested in examining how exposure to adversity early in life impacts on development. The adverse factors that we will investigate are poverty, poorer physical growth and maternal mental health difficulties. We are also interested whether enriching factors, including maternal engagement and broader caregiver support, can promote healthy cognitive development and offset some of the impacts of risk.
(4) In addition to our research aims, we will also engage members of the Gambian community (parents, healthcare professionals) to ask for their input in our work. Moreover, we will establish a network of researchers from African institutions and across the globe, who study early childhood development in Africa, to share our findings and form collaborations.
Our work has the potential to have important impacts for research, as well as the development of interventions. Firstly, this study can help us better understand the general development of children in The Gambia. It can also help identify early signs and risk factors for developmental difficulties. Finally, our findings will help to identify and promote elements of the family and broader community that provide enrichment. With this work, we aim to make a lasting contribution to the research community and society in The Gambia and broader global health settings.
The aim of this research is to investigate the development of cognitive skills from infancy to preschool age among a group of children from a rural region of The Gambia, West Africa. The data for this project comes from the Brain Imaging for Global Health project (BRIGHT; globalfnirs.org), a study that has been following a group of children in The Gambia from the prenatal period to preschool age to measure their brain and cognitive development during early childhood.
The specific aims of this study are to:
(1) Examine cognitive development from infancy to preschool age among this group of children in the rural Gambian setting. Our goal is to study individual differences in development, which may help to identify children who show delayed development compared with the rest of the group.
(2) Investigate whether the ability to regulate attention and respond to social input during infancy predicts cognitive development during preschool age. We will use assessments of behavioural and neural responses to measure these skills in infancy and explore how they relate to outcomes during preschool age.
(3) To understand how both adverse and enriching elements of a child's environment contribute to their cognitive development. In particular we are interested in examining how exposure to adversity early in life impacts on development. The adverse factors that we will investigate are poverty, poorer physical growth and maternal mental health difficulties. We are also interested whether enriching factors, including maternal engagement and broader caregiver support, can promote healthy cognitive development and offset some of the impacts of risk.
(4) In addition to our research aims, we will also engage members of the Gambian community (parents, healthcare professionals) to ask for their input in our work. Moreover, we will establish a network of researchers from African institutions and across the globe, who study early childhood development in Africa, to share our findings and form collaborations.
Our work has the potential to have important impacts for research, as well as the development of interventions. Firstly, this study can help us better understand the general development of children in The Gambia. It can also help identify early signs and risk factors for developmental difficulties. Finally, our findings will help to identify and promote elements of the family and broader community that provide enrichment. With this work, we aim to make a lasting contribution to the research community and society in The Gambia and broader global health settings.
Organisations
- University of Cambridge (Lead Research Organisation)
- Medical Research Council (Co-funder)
- UNIVERSITY OF OXFORD (Collaboration)
- University of the Witwatersrand (Collaboration, Project Partner)
- Radboud University Nijmegen (Collaboration)
- University of Laval (Collaboration)
- University College London (Project Partner)
- University of Oxford (Project Partner)
- Catholic (Radboud) University Foundation (Project Partner)
- Harvard University (Project Partner)
- King's College London (Project Partner)
Publications
| Description | This grant aims to realise key research, engagement and capacity building aims. The primary aim of this work has been to use data from the Brain Imaging for Global Health (BRIGHT) project to characterise and map trajectories of cognitive development from infancy to preschool age among children in a rural area of The Gambia. Substantial steps have been made in achieving this research goal. In particular, we have focussed on characterising cognitive outcomes at preschool age in this sample, using a battery of measures that examine global cognitive development, executive functions (EFs) and adaptive skills. Analyses of this data have revealed distinct patterns of skill, depending on the domain measured. On average, children in this setting performed within expected ranges (or better) on the EF measures and showed generally good adaptive skills. However, there was substantial variation in domains related to literacy, numeracy, and working memory. Additionally, we are in the process of examining the development of cognitive skills from infancy to preschool age. Thus far, we have demonstrated significant associations between cognitive skills measured at 5-months of age with the outcomes measured at preschool age. This work has been presented at the International Congress of Infant Studies (ICIS) meeting in July 2022. We are now in the process of creating growth curve models to map the developmental trajectories of cognitive skills during this time frame. We have also capitalised on our collaboration with project partners from the University of the Witwatersrand (South Africa) and Oxford (UK) to combine data collected from their study in South Africa with equivalent data that we have from the BRIGHT project. In particular, both studies have used the same EF assessments among age-matched pre-school age children. We examined the contribution of socioeconomic factors and interactions with caregivers to EFs, within each setting. We found that children in both settings performed within age-expectation on these tasks, challenging the widely held notion that growing in low-income settings predisposes children to having poorer EFs. Furthermore, we did not find associations with socioeconomic factors, but a relationship between EFs and engagement in enriching activities with caregivers emerged in the Gambian sample. This work is one of the few studies that examined EF skills and their shared and distinct predictors in two majority world settings. A manuscript describing these findings is currently under review in the Developmental Science special issue "Towards a Globalized Developmental Science". Finally, we have established a network (the African Brain and Cognitive Development Network [AfriBCD]) aimed at bringing together researchers who conduct child development research in Africa, with a strong focus on inviting researchers based at African institutions. AfriBCD currently has over 60 members in sixteen countries in Africa, Europe, and North America. We have held two virtual meetings, which had approximately 30-40 attendees each and planning for an in-person meeting in September 2023 is underway. Through this network, we have formed a collaboration with researchers who have established a community of practice aimed at developing cognitive tools that are culturally and contextually appropriate for use in the African context. |
| Exploitation Route | The research findings to date are an important contribution to the field, as we are one of the few studies that have examined cognitive development over such an extensive developmental time frame and across distinct cognitive domains, in a low-resource community in the Global South. As such, we expect that this work will help guide future researchers in characterising cognitive outcomes and identifying domains that are critical to focus on in the context of poverty. The work demonstrating good EF skills in The Gambia and South Africa also opens avenues for looking at areas where children in these contexts show strength. This is important as most prior work in majority world settings is heavily focussed on risk and deficit models. The engagement work that has been undertaken has shown that there is growing interest in assessing neurocognitive development in Africa. Future funds could be used to additional host in-person meetings, particularly in African based academic institutions. Funds are needed to support the creation of platforms to support researchers from Africa, the Global South and the Global North to form collaborations and to network. |
| Sectors | Education,Healthcare |
| Description | The engagement work done by this grant has extended beyond working with academic stakeholders and we have started to engage with non-academic partners as well. We currently have a number of members of the AfriBCD network who work in education and healthcare in African settings. Furthermore, within The Gambia specifically, we have established contact with representatives from educational and healthcare facilities in the area where the community is based. We are in the process of organising a stakeholder engagement event in The Gambia. At the present time, the extent of our impact has been to engage these distinct stakeholders in research. This is particularly important as it gives us an opportunity to disseminate research findings to stakeholders who work directly with the community in question. It also gives us an opportunity to learn from them about how to contextualise and implement our research findings further. |
| First Year Of Impact | 2022 |
| Sector | Education,Healthcare |
| Impact Types | Policy & public services |
| Description | Catalyzing Cognition Research in Africa Community of Practice |
| Organisation | University of Laval |
| Country | Canada |
| Sector | Academic/University |
| PI Contribution | I have teamed up with a group of researchers who are creating a community of practice to develop measures of cognitive assessment that are suitable for use with African populations. I have recently set up my own research network and have invited the researchers from this community of practice to present their work, thus attracting potential members for their community or practice. I have also shared information about this community of practice via the mailing list of my network to help them attract members. |
| Collaborator Contribution | These partners have presented at my African research network virtual meeting. We are currently discussing setting up a joint website. |
| Impact | There are currently no outputs. |
| Start Year | 2022 |
| Description | Catalyzing Cognition Research in Africa Community of Practice |
| Organisation | University of the Witwatersrand |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | I have teamed up with a group of researchers who are creating a community of practice to develop measures of cognitive assessment that are suitable for use with African populations. I have recently set up my own research network and have invited the researchers from this community of practice to present their work, thus attracting potential members for their community or practice. I have also shared information about this community of practice via the mailing list of my network to help them attract members. |
| Collaborator Contribution | These partners have presented at my African research network virtual meeting. We are currently discussing setting up a joint website. |
| Impact | There are currently no outputs. |
| Start Year | 2022 |
| Description | Collaboration with Rogier Kievit at Donder's Institute in The Netherlands |
| Organisation | Radboud University Nijmegen |
| Department | Donders Institute for Brain, Cognition and Behaviour |
| Country | Netherlands |
| Sector | Academic/University |
| PI Contribution | The primary goal of my work with Professor Kievit is to learn statistical modelling methods from him. However, during my visit to his research group, I did several presentations for his lab group and department, telling them about the BRIGHT project and my work. We hope to extend our collaboration and share data with this team in the future. |
| Collaborator Contribution | Professor Rogier Kievit is a project partner on this grant. I visited him and his research group for two weeks. During this time, we worked on data analyses. In particular, we worked on creating longitudinal models of cognitive development in the sample of children from The Gambia, who were participants in the BRIGHT project. He has also supported my analyses of perinatal mental health data from the same study. Professor Kievit taught me several key analytical methods and oversaw my work on these analyses. This work is ongoing and we hope to submit a manuscript with the results later this year. |
| Impact | There are currently no outputs but we are in the process of preparing two manuscripts, which we hope to submit in the coming months. |
| Start Year | 2022 |
| Description | Collaboration with South African research team |
| Organisation | University of Oxford |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | I received data collected from a study in South Africa. I combined this with data from the Brain Imaging for Global Health (BRIGHT) project, which is the data collected from The Gambia being used in this grant. I conducted data analyses on the data sets from these two studies and combined them for a joint publication, on which I am listed as first author and both of these partners are included as authors. This is currently under review in the journal "Developmental Science". |
| Collaborator Contribution | Dr Catherine Draper (University of the Witwatersrand) and Professor Gaia Scerif (University of Oxford) are two project partners on this grant. They ran a study that collected data on executive functioning among low-income preschool aged children in South Africa. The measures used and age of participants in the study were the same as those in the Brain Imaging for Global Health (BRIGHT) project, which is the data being used in this grant. Therefore, they shared data collected from their study with me for a joint publication for a special issue on "Child Development in a Global Context" in Developmental Science. |
| Impact | A manuscript that arose from this collaboration is currently under review in Developmental Science. Milosavljevic, B., Cook, C., Fadera, T., Ghillia, G., Howard, S.J., Makaula., H., Mbye, E., McCann, S., Merkley, R., Mshudulu, M., Saidykhan, M., Touray, E., Tshetu, N., Elwell, C., Moore, S.E., Scerif, G., Draper, C.E., & Lloyd-Fox, S. (Under review). Executive functioning skills and their environmental predictors among pre-school aged children in South Africa and The Gambia. Developmental Science. |
| Start Year | 2022 |
| Description | Collaboration with South African research team |
| Organisation | University of the Witwatersrand |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | I received data collected from a study in South Africa. I combined this with data from the Brain Imaging for Global Health (BRIGHT) project, which is the data collected from The Gambia being used in this grant. I conducted data analyses on the data sets from these two studies and combined them for a joint publication, on which I am listed as first author and both of these partners are included as authors. This is currently under review in the journal "Developmental Science". |
| Collaborator Contribution | Dr Catherine Draper (University of the Witwatersrand) and Professor Gaia Scerif (University of Oxford) are two project partners on this grant. They ran a study that collected data on executive functioning among low-income preschool aged children in South Africa. The measures used and age of participants in the study were the same as those in the Brain Imaging for Global Health (BRIGHT) project, which is the data being used in this grant. Therefore, they shared data collected from their study with me for a joint publication for a special issue on "Child Development in a Global Context" in Developmental Science. |
| Impact | A manuscript that arose from this collaboration is currently under review in Developmental Science. Milosavljevic, B., Cook, C., Fadera, T., Ghillia, G., Howard, S.J., Makaula., H., Mbye, E., McCann, S., Merkley, R., Mshudulu, M., Saidykhan, M., Touray, E., Tshetu, N., Elwell, C., Moore, S.E., Scerif, G., Draper, C.E., & Lloyd-Fox, S. (Under review). Executive functioning skills and their environmental predictors among pre-school aged children in South Africa and The Gambia. Developmental Science. |
| Start Year | 2022 |
| Description | African Brain and Cognitive Development (AfriBCD) Network virtual meetings |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | We have established a network for stakeholders involved in child development research in Africa. We have currently hosted two virtual meetings, which has approximately 30-40 attendees each. Attendees included researchers, as well as postgraduate students, educators and healthcare staff. Both meeting sparked discussion about important matters such as how to better support African based researchers and the types of resources needed. There was also discussion about the use of cognitive assessment tools in Africa and this network led to a collaboration with researchers who have established a community or practice to create culturally and contextually sensitive cognitive assessment tools. |
| Year(s) Of Engagement Activity | 2022,2023 |