Calendar of events
One-off WLNG Guest speaker: F1000: A “Whole Child Approach” to Early Brain Development, Dr Michelle Fernandes
F1000: A “Whole Child Approach” to Early Brain Development
Dr Michelle Fernandes, MBBS MRCPCH DPhil(Oxon)1,2,3
1F1000 Research Group, Department of Paediatrics, University of Oxford, Oxford
2Newborn Care Unit, John Radcliffe Hospital, Oxford
3Oxford Maternal & Perinatal Health Institute, NDWRH & Green Templeton College, University of Oxford, Oxford
ABSTRACT
Background
The first 1000 days of life (F1000), from conception to age 2, are foundational to brain development. During this period, the developing brain is highly sensitive to environmental influences, both positive and adverse, with lifecourse health and neurocognitive effects. >80% of developmental delays are preventable if identified early, however one in three children globally do not achieve their full developmental potential by 5 years, primarily due to delays in recognition and intervention.
Methods
My research employs a translational neuroscience strategy to neonatology and child health by applying a “whole-child approach” to early brain development (EBD). Using interdisciplinary methods and large international cohorts, I (i) investigate mechanistic pathways underpinning typical and atypical EBD; (ii) develop scalable, standardised tools for global identification of at-risk children; (iii) evaluate family-centred interventions; and (iv) build global capacity for EBD surveillance.
Results
Mechanistic findings from INTERGROWTH-21st (n=4,607 healthy, low-risk mothers and infants from 8 countries) and INTERBIO-21st (n=3,598 high and low risk mother-infant dyads from 6 countries) demonstrated <10% between-site variation in fetal brain and neurodevelopmental outcomes in healthy populations, supporting international standards. Five atypical fetal growth trajectories predictive of later neurodevelopmental delays were identified, alongside a normative digital atlas of fetal brain maturation. Methodological innovations include the INTER-NDA, a rapid, low-cost neurodevelopmental assessment toolkit now applied in >40,000 children across 26 countries, with companion newborn and infant toolkits (Neo-NBA and OX-NDA). Community-based trials in Grenada and Slovakia showed responsive caregiving interventions significantly improved outcomes in high-risk children, independent of health or nutritional inputs. Capacity building has included three regional EBD centres and training of >400 assessors worldwide.
Ongoing work and next steps
My current work, BRAINENDEVR, integrates metadata from >5,000 children across 13 countries to generate a point-of-care developmental risk-profiling calculator. Collectively, these efforts advance early identification, intervention, and global equity in child neurodevelopment.
Dr Michelle Fernandes, MBBS MRPCH DPhil(Oxon) is a Clinical Lecturer at the Oxford University Department of Paediatrics where she leads the F1000 Research Group. Her research applies cross-disciplinary methodologies to study brain growth, health and development during the first 1,000 days of life in at-risk and healthy children globally, with specific focus on mechanistic, measurement, intervention and implementation science research. She is the Director of Early Brain Science at the Oxford Maternal and Perinatal Health Institute.
Dr Fernandes has co-led a number of research projects (including INTERGROWTH-21st, INTERBIO-21st, and BRAINENDEVR) that have yielded novel mechanistic insights into pathways leading to typical and atypical brain development. She has developed three novel early child development (ECD) assessment toolkits, most notably the INTER-NDA, now implemented in >40,000 children across 26 countries; the first international ECD standards; and a normative fetal brain atlas. With international collaborators, she developed evidence-based interventions to rescue neurodevelopment in at-risk children, and is extending this work to NICU populations. She is passionate about ECD-focussed capacity development and advocacy having co-founded three regional ECD centres in Grenada, East Africa and the US, with ongoing work in Eastern Europe, India and Nigeria. She holds an MRC Clinical Research Training Fellowship for BRAINENDEVR, a multi-country project using advanced data science approaches for ECD risk-profiling at population level.
Michelle is a scientific advisor to the WHO Global Scales of Early Development Initiative; research lead of NeoTRIPS, and serves on the editorial committee of Archives of Disease in Childhood. She is a Fellow at Green Templeton College, Oxford and holds honorary research fellowships at the Universities of Turku and Southampton, and WINDREF, Grenada.
The impact of her work has been recognized internationally, including at the MRC Impact Prize Ceremony in 2024. She has received support from leading funders, including the MRC, NIHR, NIH, USAID, and the Gates Foundation and has authored over 80 peer-reviewed publications.
E: michelle.fernandes@paediatrics.ox.ac.uk
X: @Dr_MCFernandes
Linkedin: https://uk.linkedin.com/in/michelle-fernandes-17b6351a
W: https://www.paediatrics.ox.ac.uk/About/team/michelle-fernandes-1
W: https://www.paediatrics.ox.ac.uk/research/f1000-days