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

在资源匮乏的环境中，有2亿5岁以下的儿童面临不利的环境因素，如营养不足、身体疾病和缺乏刺激。这可能会对他们实现重要发展里程碑的能力产生影响，从而影响随后的学校表现。虽然这被认为是一个重要的问题，但很少有研究旨在确定风险的最早迹象及其如何影响发展。确定婴儿期风险的早期迹象对于制定干预措施以帮助儿童实现最佳结果至关重要。同样重要的是，更好地了解儿童环境的具体方面，如营养和照料做法，如何有助于他们的发展。通过这项工作，我们将能够更好地了解某些风险因素如何影响发展，以及如何最好地在家庭和更广泛的社区内促进丰富要素，以抵消风险的影响。这项研究的目的是调查西非冈比亚农村地区的一群儿童从婴儿期到学龄前阶段认知技能的发展情况。该项目的数据来自全球健康大脑成像项目(BREAT；global alfnirs.org)，这项研究一直在跟踪冈比亚的一群儿童，从产前到学龄前，以测量他们在童年早期的大脑和认知发展。这项研究的具体目的是：(1)考察冈比亚农村地区这群儿童从婴儿期到学龄前的认知发展。我们的目标是研究发育的个体差异，这可能有助于识别与群体其他成员相比表现出发育迟缓的儿童。(2)探讨婴儿期注意调节能力和对社会输入的反应能力是否能预测学龄前儿童的认知发展。我们将使用行为和神经反应的评估来衡量婴儿期的这些技能，并探索它们与学龄前儿童的结果之间的关系。(3)了解儿童环境中的不利因素和丰富因素如何促进他们的认知发展。我们尤其感兴趣的是研究早年遭遇逆境对发展的影响。我们将调查的不利因素是贫困、身体发育较差和母亲心理健康困难。我们还感兴趣的是，丰富的因素，包括母亲的参与和更广泛的照顾者支持，是否可以促进健康的认知发展，并抵消风险的一些影响。(4)除了我们的研究目标外，我们还将邀请冈比亚社区成员(父母、医疗保健专业人员)征求他们对我们工作的意见。此外，我们将建立一个由来自非洲机构和全球各地的研究人员组成的网络，他们研究非洲的早期儿童发展，以分享我们的发现并形成合作。我们的工作有可能对研究以及干预措施的发展产生重要影响。首先，这项研究可以帮助我们更好地了解冈比亚儿童的总体发展情况。它还可以帮助识别发育困难的早期迹象和风险因素。最后，我们的发现将有助于确定和促进家庭和更广泛的社区中提供丰富的元素。通过这项工作，我们的目标是为冈比亚的研究界和社会以及更广泛的全球卫生环境做出持久的贡献。

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.