Brief Description of the PRECISE-DYAD Neurodevelopmental Assessment

Neurodevelopmental outcomes in children enrolled in the PRECISE-DYAD cohort are assessed using a comprehensive battery of well-validated measures. Children are assessed during 4 scheduled visits (at 6 weeks to 6 months, 12, 24, and 36 months).

The child’s general movement and development are scored during the first visit using Prechtl’s General Movements Assessment at 12 to 16 weeks. In all 4 visits, four main developmental domains including gross motor, fine motor, language, and social emotional are assessed using the Malawi Developmental Assessment Tool (MDAT) and the Developmental Milestones Checklist (DMC-III) over a telephone interview (in Kenya). Additionally, the quality of parent-child interactions is assessed using the observation for maternal-child interaction (OMCI) tool. Additionally, the quality of home stimulation and learning opportunities for children is assessed using the family care indicators questionnaire from visits 2 to 4.

The children’s vision, hearing, communication, cognitive, and motor impairment is evaluated using a parent-report questionnaire, the Neurodevelopmental Screening Tool (NDST) at visits 3 and 4. Children who screen positive on the MDAT or NDST during visits 3 and 4 are further assessed for the risk of autism spectrum disorder using the Modified Checklist for Autism in Toddlers (M-CHAT), their visual ability is assessed using the CARDIFF visual acuity and contrast sensitivity cards. While the PedsQL Family Impact Module is used to test for the general family functioning and quality of life of families with children living with neurodevelopmental disorders.

During the third and fourth visits, children are also screened for epilepsy, and if they screen positive, a further questionnaire on the history of epilepsy is administered to the caregiver.

At the end of the assessment, the caregivers are provided with feedback and advice on the development of their children. Children who screen positive for developmental delays are referred for further evaluation and intervention.

 

Summary of the Trainings done so far

Visits 1 and 2 trainings focused on the OMCI and MDAT. These trainings were done virtually in both the sites in The Gambia and Kenya. The trainings included both the theory and practical sessions.

The visits 3 and 4 trainings focused on different tools including MDAT, NDST, M-chart, PedsQL, epilepsy screening and full questionnaire, and CARDIFF visual acuity and sensitivity tests. The trainings were attended physically and involved an introduction to neurodevelopmental disorders and practical sessions.

Plans for the future

Plans are underway to conduct the quality control reliability assessments. The inter-rater assessments will be done in every 20 neurodevelopmental assessments for visits 3 and 4. At any given time, the double scoring will be conducted with each of the assessors.