BRIGHT is growing up!

The pre-school age (approximately 3-5 years) is an important period in a child’s development, where rapid progress is seen in a number of neurocognitive domains, such as language, social skills and executive functions1,2. While the initial focus of the BRIGHT project was to measure development during the first 1000 days of life, many of the outcomes associated with early risk start to become observable later in childhood3, when social demands and expectations of a child’s skills gradually increase.

“BRIGHT Kids” is a follow up of the main cohort of the BRIGHT families from The Gambia, who have been enrolled in the study from pregnancy to the age of 24-months. We are going to see them for an additional study visit at the age of 3-5 years. This follow-up has three main aims:

  • to assess broader, age appropriate cognitive outcomes in this sample
  • to examine further developmental trajectories of measures that have been administered since infancy
  • to examine the associations between infant markers, early risk and protective factors, and neurocognitive outcomes at pre-school age.

What are we studying?


One of our objectives is to continue using the key neuroimaging techniques, fNIRS and EEG, that have been foundational throughout the BRIGHT project. With these tools, we will measure neural activity related to social processing, processing of auditory stimuli and functional connectivity between neural networks. These constructs have been measured in this sample since infancy and will allow us to establish trajectories in neural development from early in infancy to the pre-school period. Likewise, we will be able to examine the association between neural functioning and behavioural measures of cognitive skills.

Cognitive, attentional, and executive functioning skills

Our goal is to capture cognitive development across a broad range of domains to provide a rich picture of outcomes within this sample. In particular, we are measuring global cognitive development using a population-specific adapted version of the Mullen Scales of Early Learning (MSEL).

Eye-tracking has been another foundational technique from the onset of the BRIGHT project and we will continue to use it to measure development in attentional skills at this age. In particular, we will use this technique to assess language comprehension, attentional flexibility, cognitive control and social attention.

Finally, we are implementing a tablet-based assessment of executive functioning skills to assess cognitive flexibility, inhibitory control and working memory. This is a novel assessment for BRIGHT and we are excited to contribute to a growing body of research showing the utility of tablet-based technology in low-resource settings4.

The home and caregiving environment

In addition to assessing the child’s development, we will collect measures that relate to the home and caregiving environment. Maternal wellbeing is an important contributor to child development and we will measure maternal mental health. We have teamed up with the PRECISE-DYAD study to translate and adapt two widely used measures of depression and anxiety for use in The Gambia.

Additionally, we will collect information about the broader caregiving environment. For example, we are interested which caregivers the children spend their time with, what kinds of activities they do, and the types of play materials available in the home.

Nutrition, Physical Growth, and Gross Motor Development

As in the previous phases of BRIGHT, we will continue to administer anthropometric measures to assess child height, weight and head circumference. We will also ask the families for information about their dietary intake and household food security.

We will also measure age-appropriate gross motor skills using the Test of Gross Motor Development (TGMD).



1 Asaridou, S. S., Demir-Lira, Ö. E., Goldin-Meadow, S., & Small, S. L. (2017). The pace of vocabulary growth during preschool predicts cortical structure at school age. Neuropsychologia, 98, 13–23.

2 Hendry, A., Jones, E. J. H., & Charman, T. (2016). Executive function in the first three years of life: Precursors, predictors and patterns. Developmental Review, 42, 1–33.

3 McCoy, D. C., Peet, E. D., Ezzati, M., Danaei, G., Black, M. M., Sudfeld, C. R., Fawzi, W., & Fink, G. (2016). Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling. PLOS Medicine, 13(6), 1–18.

4 Howard, S. J., Cook, C. J., Everts, L., Melhuish, E., Scerif, G., Norris, S., … Draper, C. E. (2020). Challenging socioeconomic status: A cross‐cultural comparison of early executive function. Developmental Science, 23(1).