Neurodevelopmental milestones and associated behaviours are similar among healthy children across diverse geographical locations

José Villar, Michelle Fernandes, Manorama Purwar, Eleonora Staines-Urias, Paola Di Nicola, Leila Cheikh Ismail, Roseline Ochieng, Fernando Barros, Elaine Albernaz, Cesar Victora, Naina Kunnawar, Sophie Temple, Francesca Giuliani, Tamsin Sandells, Maria Carvalho, Eric Ohuma, Yasmin Jaffer, Alison Noble, Michael Gravett, Ruyan PangAnn Lambert, Enrico Bertino, Aris Papageorghiou, Cutberto Garza, Alan Stein, Zulfiqar Bhutta, Stephen Kennedy

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


It is unclear whether early child development is, like skeletal growth, similar across diverse regions with adequate health and nutrition. We prospectively assessed 1307 healthy, well-nourished 2-year-old children of educated mothers, enrolled in early pregnancy from urban areas without major socioeconomic or environmental constraints, in Brazil, India, Italy, Kenya and UK. We used a specially developed psychometric tool, WHO motor milestones and visual tests. Similarities across sites were measured using variance components analysis and standardised site differences (SSD). In 14 of the 16 domains, the percentage of total variance explained by between-site differences ranged from 1.3% (cognitive score) to 9.2% (behaviour score). Of the 80 SSD comparisons, only six were >±0.50 units of the pooled SD for the corresponding item. The sequence and timing of attainment of neurodevelopmental milestones and associated behaviours in early childhood are, therefore, likely innate and universal, as long as nutritional and health needs are met.

Original languageEnglish
Article number511
JournalNature Communications
Issue number1
Publication statusPublished - 1 Dec 2019
Externally publishedYes


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