Neurodevelopment from infancy to early childhood in West Africa: the contribution of early markers and psychosocial factors to developmental outcomes

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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.