Neurodevelopmental disorders (NDDs) include cerebral palsy, autism, attention deficit hyperactivity disorder, epilepsy, and intellectual disability. NDDs affect 1 in 13 children under 5 years globally, the majority living in low- and middle-income countries (LMICs). Early brain development is influenced by biological and environmental factors, including infection, birth trauma, prematurity, and malnutrition. However, the causes and number of children with NDDs in LMICs are unknown and detection is low.  

Current tools to identify NDDs are expensive, time-intensive, and require extensive training, making it challenging to diagnose NDDs in LMICs, offering limited opportunities to intervene. A new tablet-based neurodevelopmental assessment tool has been developed by the STREAM study team for use by non-specialists in LMICs but not tested for its ability to predict future NDDs and functioning. 

The PreNDD study team are conducting diagnostic and functional assessments for NDDs in 430 children aged 5-8.5 years who were previously assessed in the STREAM study at 2.5-6 years. We will estimate the proportion of early school age children in a peri-urban setting in Malawi with NDDs and model predictors, including scores on the STREAM tool. We are conducting in-depth interviews to explore caregiver perceptions of barriers and facilitators to functioning for children with NDDs in Malawi.