Globally, an estimated 53 million children under 5 years have developmental disability, with approximately 95% living in low- and middle-income countries (LMICs). Appropriate neurodevelopmental assessment tools are often unavailable in these settings due to lack of validation, cost, and cultural-linguistic challenges. Delayed identification of developmental delay and neurodevelopmental impairment (DD/NDI) reduces access to key interventions at young ages, when brain plasticity and intervention effects are greatest.

The Child Observational Development (ChiDO) Study is a prospective cohort study is following  ~600 infants across the DD/NDI risk spectrum related to perinatal asphyxia/neonatal encephalopathy. Aim 1 is to evaluate the validity of several neurodevelopmental assessment tools, including the Prechtl General Movement Assessment (GMA) and the Hammersmith Infant Neurologic Examination (HINE). Both have shown high sensitivity and specificity for cerebral palsy and cognitive delays, but have limited validation in LMICs. This study will also preliminarily evaluate the Global Scales for Early Development (GSED), which were created as validated developmental assessment instruments for population-level and programmatic evaluation of children ages 0 to 3 years from culturally, linguistically and socioeconomically diverse populations. The ChiDO study will be the first to validate GSED’s use for individual-level assessment.