Abstract
We define neurodevelopment as the dynamic inter-relationship between genetic, brain, cognitive, emotional and behavioural processes across the developmental lifespan. Significant and persistent disruption to this dynamic process through environmental and genetic risk can lead to neurodevelopmental disorders and disability. Research designed to ameliorate neurodevelopmental disorders in low- and middle-income countries, as well as globally, will benefit enormously from the ongoing advances in understanding their genetic and epigenetic causes, as modified by environment and culture. We provide examples of advances in the prevention and treatment of, and the rehabilitation of those with, neurodevelopment disorders in low- and middle-income countries, along with opportunities for further strategic research initiatives. Our examples are not the only possibilities for strategic research, but they illustrate problems that, when solved, could have a considerable impact in low-resource settings. In each instance, research in low- and middle-income countries led to innovations in identification, surveillance and treatment of a neurodevelopmental disorder. These innovations have also been integrated with genotypic mapping of neurodevelopmental disorders, forming important preventative and rehabilitative interventions with the potential for high impact. These advances will ultimately allow us to understand how epigenetic influences shape neurodevelopmental risk and resilience over time and across populations. Clearly, the most strategic areas of research opportunity involve cross-disciplinary integration at the intersection between the environment, brain or behaviour neurodevelopment, and genetic and epigenetic science. At these junctions a robust integrative cross-disciplinary scientific approach is catalysing the creation of technologies and interventions for old problems. Such approaches will enable us to achieve and sustain the United Nations moral and legal mandate for child health and full development as a basic global human right.
Highlights
This article has not been written or reviewed by Nature editors
One evaluation of early childhood developmental status in lowand middle-income countries (LMICs) estimates that 15.7% of children are significantly delayed in their cognitive development, 26.3% in socioemotional development and 36.8% in either or both
In this Review, we describe several high-impact findings that have emerged from research in low-resource settings that pertain to the developmental milieu of the child, its relationship to the brain and behavioural neurodevelopmental integrity of the child, and the genetic and epigenetic underpinnings that can drive this relationship
Summary
Reducing neurodevelopmental disorders and disability through research and interventions Michael J. Research in low- and middle-income countries led to innovations in identification, surveillance and treatment of a neurodevelopmental disorder These innovations have been integrated with genotypic mapping of neurodevelopmental disorders, forming important preventative and rehabilitative interventions with the potential for high impact. The most strategic areas of research opportunity involve cross-disciplinary integration at the intersection between the environment, brain or behaviour neurodevelopment, and genetic and epigenetic science At these junctions a robust integrative cross-disciplinary scientific approach is catalysing the creation of technologies and interventions for old problems. In this Review, we describe several high-impact findings that have emerged from research in low-resource settings that pertain to the developmental milieu of the child, its relationship to the brain and behavioural neurodevelopmental integrity of the child (neurodevelopmental disorders), and the genetic and epigenetic underpinnings that can drive this relationship. We conclude by summarizing ways in which this model (environment, brain and gene) provides rich opportunities for a more global approach to child-development science, making it possible to achieve the UNICEF mandate of full child health and development for all[3,4]
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