Anxiety and depression are highly prevalent among Syrian refugees. Anxiety and depression during pregnancy may impair infant neurodevelopment. This study evaluated whether potential maternal anxiety and depression in Syrian refugee and native Turkish mothers were associated with less favourable neonatal neurodevelopment. Cross-sectional study. Turkish (n = 64) and Syrian (n = 17) term-born infants (37–41 weeks’ gestation) referred to a level II-III neonatal intensive care unit in Izmir were assessed shortly after birth (median 5 days) together with their mothers. The Test of Infant Motor Performance (TIMP) was the primary outcome measure. In addition, we evaluated crying behaviour during the TIMP-assessment and performed General Movements Assessment (GMA). Mothers completed Beck Anxiety and Beck Depression Inventories in their native languages. Univariate and multivariate statistics were applied. Perinatal social characteristics of both groups were similar. TIMP scores of Syrian infants were significantly lower than those of Turkish infants (45.53 (SD 7.10) vs. 51.59 (SD 8.59), respectively (p = 0.009)). Sixteen Turkish infants (25

AimWhile deformational plagiocephaly (DP) is suspected to be associated with comorbidities, their nature and prevalence are unclear. This scoping review aims to report DP comorbidities occurring until the age of 2 years, their prevalence and whether they depend on the child's age and sex.MethodsRelevant studies were identified by searching the Cochrane, MEDLINE, EMBASE, PubMed and EBSCO databases from 1992 to 30 April 2021. Data on study characteristics, comorbidities and assessment instruments were extracted and qualitatively synthesised. Risk of bias was assessed and studies with high risk of bias were excluded.ResultsStudies meeting selection criteria (n = 27) often evaluated groups from tertiary clinics, implying selection bias. Studies reported on developmental delay (n = 16), limited speech production (n = 1), auditory (n = 3), visual (n = 3), mandibular (n = 3) and neurological impairments (n = 1). The data did not allow prevalence calculation or modifying effect of sex. Due to biased data, the review provided no evidence on DP comorbidities. Weak evidence suggested that in the selective samples, DP was associated with motor and language delays in the first year.ConclusionDue to biased data, no evidence on comorbidity in infants with DP was available. Our study underlined the need of risk of bias assessment in scoping reviews.

Developmental Coordination Disorder (DCD) means the presence of motor problems interfering with daily activities in the absence of evident neurological pathology.1 It affects 5–6% of children and it is often accompanied by other neurodevelopmental disorders, such as attention deficit hyperactivity disorder or autism spectrum disorder.1 It often has been suggested that DCD runs in families, but only recently some evidence of a possible genetic background of DCD has been presented.2 The Dutch Lifelines Cohort study3 offered the opportunity to address the question of whether the risk of DCD runs in families. Lifelines is a multi-disciplinary prospective population-based cohort study examining in a unique three-generation design the health and health-related behaviours of 167 729 persons living in the North of the Netherlands. It employs a broad range of investigative procedures in assessing the biomedical, socio-demographic, behavioural, physical and psychological factors which contribute to the health and disease of the general population, with a special focus on multi-morbidity and complex genetics.3 The Lifelines Cohort study has been approved by the ethical committee of the University Medical Center Groningen, the Netherlands (METC 2007/152). In 2017 all parents participating in Lifelines, with children aged 5–12 years (n = 5479) received the Dutch translation of the DCD Questionnaire 2007.4 This is a widely used instrument to screen for DCD with 15 questions addressing control during movement, fine motor activities, including handwriting, and general coordination. We used available age-based percentiles to classify children as at risk of DCD (rDCD).4 Children with diagnoses not compatible with DCD, for example, cerebral palsy, were excluded from the analysis, resulting in a total of adequately completed questionnaires on 1722 children (31.4%), coming from 1255 different families (each having 1–4 children in the sample; see Table 1 and Appendix S1). From the 1722 children, 223 were classified as rDCD. The proportion of rDCD in children with no siblings in the data set was 13.38% (see Appendix S1). We calculated the probability of observing the number of children classified as rDCD and non-rDCD in each of the 418 families with two or more children present in our data under the assumption of rDCD not running in the family. That is, we tested whether the probability of a child having rDCD was independent of having a sibling with rDCD. For mathematical details on the statistical approach and the use of one-sample Chi-square tests to arrive at an overall p-value for this probability, we refer to Appendix S1. Our analysis resulted in an overall probability of rDCD occurring independently in our data of p = 0.008. This is a very small p-value, implying that our data do not support the assumed hypothesis of rDCD occurring independently within families. As our data show a tendency towards observing more rDCD children within families than expected, we conclude that our data suggest being at risk of DCD runs in families. This means that our data support evidence of the existence of familial predisposition to DCD, which might include genetic variants playing a pathogenetic role.2 In other words, genetic susceptibility for motor impairment may be one of the steps in the multifactorial pathway of DCD. Well-known risk factors in the aetiological pathway are male gender and pre-term birth.5 Conceivably, the multifactorial pathway varies among children with DCD, a diagnosis that by itself is an umbrella term covering children with various types of motor problems, for example, fine motor impairments or balance problems.1 The strength of our study is its two-generation design and the use of a large population-based cohort. However, the study also has limitations. First, our response rate was 31.4%, which reduces the generalizability of the findings. We cannot rule out the potential effect of selection bias either, although the direction of its effect on our conclusion is not clear. In general, parents may be more inclined to respond when already suspecting their offspring to be at risk for DCD. This would increase the observed proportion of children with rDCD overall in the data. However, this effect would simultaneously imply that the benchmark of 13.38% against which we tested our hypothesis of independence would be positively biased as well, which in turn would make it harder to reach a significant result in our test. Lastly, we did not diagnose DCD but only were able to evaluate whether children were at risk of DCD. In conclusion, our findings support emerging evidence that the risk of DCD may run in families. Sacha la Bastide-Van Gemert: Writing – original draft; formal analysis; methodology; writing – review and editing. Jessika F. van Hoorn: Data curation; writing – review and editing; resources; project administration; conceptualization. Johannes G. M. Burgerhof: Formal analysis; writing – review and editing; methodology. Marina M. Schoemaker: Conceptualization; project administration; data curation; resources; writing – review and editing. Corry K. van der Sluis: Conceptualization; project administration; data curation; resources; writing – review and editing. Mijna Hadders-Algra: Conceptualization; project administration; data curation; resources; writing – review and editing. The Lifelines initiative has been made possible by a subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG), Groningen University and the Provinces in the North of the Netherlands (Drenthe, Friesland, Groningen). No conflicts of interest to disclose. Appendix S1. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

BACKGROUND:Early detection of developmental problems is important as it allows for early intervention. Previous studies, in high-risk infants, found high predictive values of atypical scores on the Standardized Infant NeuroDevelopmental Assessment (SINDA) for later neurodevelopmental disorders (i.e., cerebral palsy, intellectual disability). AIMS:The present study explored SINDA's predictive values to identify risk of developmental delay at 4-5 years. STUDY DESIGN:Cohort study. SUBJECTS:786 low-risk Dutch children (367 boys; median gestational age: 40 (27-42) weeks; mean birth weight: 3455 (SD 577) grams). OUTCOME MEASURES:The SINDA was assessed at 2-12 months and risk of developmental delay was assessed using the Ages and Stages Questionnaire (ASQ) at 4-5 years. SINDA's predictive values were determined for five ASQ domains and the total ASQ score for children at risk of marked (all ASQ domains deviant) and any (one or more ASQ domains deviant) developmental delay. RESULTS:Presence of one atypical SINDA scale score showed low to moderate sensitivities (12-88 %, depending on the SINDA scale and ASQ domain involved), moderate to high specificities (66-94 %), low positive predictive values (PPVs; 3-16 %), and high negative predictive values (NPVs; 95-100 %) for children at risk of marked and any developmental. Presence of multiple atypical SINDA scale scores predicted deviant ASQ domains slightly better (sensitivities = 11-62 %, specificities = 90-98 %, PPVs = 6-30 %, and NPVs = 95-100 %). CONCLUSIONS:In low-risk infants, SINDA's predictive value is low for detecting children at risk of marked and any developmental delay at 4-5 years, as reflected by the low sensitivities. One of the explanations is the relatively low prevalence of developmental delay in low-risk populations. This might have consequences for the application of the SINDA in general healthcare settings (e.g. child health clinics), but further studies are needed to draw this conclusion.

AIM:To compare the predictive values of the General Movements Assessment (GMA) and the Standardized Infant NeuroDevelopmental Assessment (SINDA) neurological scale for atypical neurodevelopmental outcome in 3-month-old at-risk infants. METHOD:A total of 109 infants (gestational age 30 weeks; range: 24-41; 52 males) attending a non-academic outpatient clinic were assessed with the GMA and the SINDA at 3 (2-4) months corrected age. The GMA pays attention to the complexity of general movements and presence of fidgety movements. Atypical neurodevelopmental outcome at 24 months corrected age (and older) implied cerebral palsy (CP) or a Bayley Mental Development Index or Bayley Psychomotor Development Index lower than 70. RESULTS:At 24 months corrected (and older) age, 16 children had an atypical outcome, including 14 children with CP. Regarding markedly reduced general movement complexity in combination with absent or sporadic fidgety movements, the GMA predicted an atypical outcome with specificity, positive, and negative predictive values greater than 0.900, and sensitivity of 0.687 (95% confidence interval [CI] = 0.460-0.915). SINDA predicted an atypical outcome with sensitivity, specificity, and negative predictive value greater than 0.900 and a positive predictive value of 0.652 (95% CI = 0.457-0.847). Regarding absent fidgety movements only or markedly reduced general movement complexity, the GMA predicted the outcome less well than both general movement criteria. INTERPRETATION:The SINDA and GMA both predict neurodevelopmental outcome well, but SINDA is easier to learn than the GMA; being a non-video-based assessment, it allows caregiver feedback during the consultation whereas the GMA usually does not. WHAT THIS PAPER ADDS:The General Movements Assessment (GMA) and Standardized Infant NeuroDevelopmental Assessment (SINDA) neurological scale predict atypical neurodevelopmental outcome equally well. The GMA and SINDA neurological scale predict CP and atypical neurodevelopmental outcome well. The GMA works best to predict neurodevelopmental outcome when based on both general movement complexity and fidgety movements.

Early childhood is foundational for optimal and inclusive lifelong learning, health and well-being. Young children with disabilities face substantial risks of sub-optimal early childhood development (ECD), requiring targeted support to ensure equitable access to lifelong learning opportunities, especially in low- and middle-income countries. Although the Sustainable Development Goals, 2015–2030 (SDGs) emphasise inclusive education for children under 5 years with disabilities, there is no global strategy for achieving this goal since the launch of the SDGs. This paper explores a global ECD framework for children with disabilities based on a review of national ECD programmes from different world regions and relevant global ECD reports published since 2015. Available evidence suggests that any ECD strategy for young children with disabilities should consists of a twin-track approach, strong legislative support, guidelines for early intervention, family involvement, designated coordinating agencies, performance indicators, workforce recruitment and training, as well as explicit funding mechanisms and monitoring systems. This approach reinforces parental rights and liberty to choose appropriate support pathway for their children. We conclude that without a global disability-focussed ECD strategy that incorporates these key features under a dedicated global leadership, the SDGs vision and commitment for the world’s children with disabilities are unlikely to be realised.

The English version of this invited editorial is available at: https://doi.org/10.1111/dmcn.15452.

Infants at high biological risk of or with a neurodevelopmental disorder run a high risk of delayed school readiness. This is especially true for infants in low- and middle-income countries (LMICs). This perspective paper first summarizes evidence on intervention elements that are effective in promoting family well-being and child development in infants at high biological risk in high income countries. Crucial elements are family centeredness, goal orientation, a home setting, focus on activity and participation, and challenging the infant to explore the world and the own body by means of self-produced movements. The studies revealed that coaching as applied in COPCA (COPing and CAring for infants with special needs) is a pivotal element determining the success of intervention.The paper continues by describing COPCA and its coaching. Next, we report on two pilot studies addressing COPCA's implementation in Brazil. Finally, we discuss why COPCA is a promising early intervention program for infants at high biological risk of neurodisability in LMICs: COPCA is adapted to the families' strengths and needs, it empowers families and promotes child development therewith facilitating school readiness. Moreover, it may be delivered by tele-coaching therewith eliminating families' burden to travel to distant intervention clinics.

BACKGROUND:Infants with complex congenital heart disease are at increased risk of impaired fetal brain growth, brain injury, and developmental impairments. The General Movement Assessment (GMA) is a valid and reliable tool to predict cerebral palsy (CP), especially in preterm infants. Predictive properties of the GMA in infants with complex congenital heart disease (CCHD) are unknown. AIM:To evaluate predictive properties of the GMA to predict developmental outcomes, including cerebral palsy (CP), at 18-months corrected age (CA) in children with CCHD undergoing heart surgery in the first month of life. METHODS:A prospective cohort of 56 infants with CCHD (35 males, 21 females) was assessed with GMA at writhing age (0-6 weeks CA) and fidgety age (7-17 weeks CA) and the Bayley Scales of Infant Development at 18 months. GMA focused on markedly reduced GM-variation and complexity (definitely abnormal (DA) GM-complexity) and fidgety movements. Predictive values of GMA for specific cognitive, language and motor delay (composite scores <85th percentile) and general developmental delay (delay in all domains) were calculated at 18 months. RESULTS:At fidgety age, all infants had fidgety movements and no child was diagnosed with CP. DA GM-complexity at fidgety age predicted general developmental delay at 18 months (71 % sensitivity, 90 % specificity), but predicted specific developmental delay less robustly. DA GM-complexity at writhing age did not predict developmental delay, nor did it improve prediction based on DA GM-complexity at fidgety age. CONCLUSIONS:In infants with CCHD and fidgety movements, DA GM-complexity at fidgety age predicted general developmental delay.

On Nov 20, 2022, we celebrate World Children's Day and the theme this year is inclusion, for every child. However, children with disabilities have received little attention from global health and development stakeholders.

Prior to the launch of the United Nations' Sustainable Development Goals (SDGs) in 2015, childhood disability was rarely considered an important subject in global health. The SDGs till 2030 now require that children under 5 years who are at risk of not benefitting from inclusive quality education are identified, monitored, and promptly supported. A new tool for identifying children who are not developmentally on track has been developed by UNICEF but has limited sensitivity for detecting children with disabilities due to reliance on parental assessment of child behavior in certain everyday situations. In this paper, we identified conditions that are commonly associated with developmental disabilities based on the International Classification of Diseases (ICD) codes and clarified the concept of "developmentally on track" as it relates to children with developmental disabilities and developmental delays. We summarized the latest evidence on the global burden of developmental disabilities in children under 5 years based on the diagnostic and functional approaches for measuring disabilities at the population level. We highlighted the global health context for addressing the needs of children with developmental disabilities and provided an overview of the opportunities and the role of pediatric caregivers in supporting children with developmental disabilities.

Purpose This commentary examines the provisions for early childhood development (ECD) in the global action plan for rehabilitation published by the World Health Organisation (WHO) within the context of the United Nations' Sustainable Development Goal (SDG) for inclusive education. Methods The meeting reports of the WHO Rehabilitation 2030 for 2017 and 2019 and the related documents were reviewed along with ECD policy documents from WHO, UNICEF, UNESCO, and the World Bank. Results The importance of a life-course approach to rehabilitation for the health and wellbeing of persons with disabilities was highlighted in the Rehabilitation 2030. However, the critical and foundational role of rehabilitation in ECD for children with disabilities to facilitate inclusive education, especially in low- and middle-income countries as envisioned by the SDG 4.2, was not clearly addressed. Children under 5 years with developmental delays and disabilities who are not developmentally on track in health and psychosocial wellbeing require timely rehabilitation to ensure that they benefit from inclusive education. Conclusions The culture and practice of rehabilitation should be nurtured from infancy as an indispensable component of ECD to adequately prepare children with developmental disabilities for inclusive education and ensure effective rehabilitation services over the life course.

Motor skills and movement-related functioning significantly shape how children experience and interact with the world around them. Among infants and young children, developmental motor disorders contribute to delays with motor, cognitive, and psychosocial development. Early and accurate identification of these disorders is necessary to facilitate timely access to therapeutic interventions that minimize the long-term effects of disability on everyday activities and participation. In the United States, motor assessments commonly used among children 0 to 3 years focus on completion of specific motor skills at a single point in time, which provides only a part of the greater picture that is a child's motor and movement-related functioning. Video-capture methods, like the General Movements Assessment (GMA) and the Infant Motor Profile (IMP), offer greater accuracy and predictive power to (1) identify motor deficits in young children and (2) facilitate early access to supportive, therapeutic intervention.

In September, 2023, the second global summit on the Sustainable Development Goals (SDGs) will be held during the annual UN General Assembly for the midpoint appraisal of the 2015–30 Agenda for Sustainable Development.1 The summit will review the global progress in implementing the SDGs, consider new challenges that arose since 2015, provide updated policy guidance, and mobilise action to accelerate progress towards achieving the SDGs. This occasion provides a rare and timely opportunity to review the global commitment on early childhood development (ECD) for children younger than 5 years, and to leave no one behind (SDG 4.2).

We, the members of the Global Research on Developmental Disabilities Collaborators (GRDDC)—a diverse, cross-cultural, and inclusive consortium of professionals, carers, and parents with and without lived experience of disabilities—are gratified by the launch of the UNICEF Disability Inclusion Policy and Strategy 2022–30.1 This landmark report covers several bold and cross-cutting commitments to partner with stakeholders, mobilise financial and technical resources, and provide overall leadership, coordination, and accountability on disability inclusion in global health.

UNICEF and other international bodies must produce a clear plan that prioritizes development and education for children with disabilities, especially in low- and middle-income settings, as required for achieving the United Nations Sustainable Development Goals.