A Bio-Social Model during the First 1000 Days Optimizes Healthcare for Children with Developmental Disabilities

Abstract

Most children with developmental disabilities (DD) live in resource-limited countries (LMIC) or high-income country medical deserts (HICMD). A social contract between healthcare providers and families advocates for accurate diagnoses and effective interventions to treat diseases and toxic stressors. This bio-social model emphasizes reproductive health of women with trimester-specific maternal and pediatric healthcare interactions. Lifelong neuronal connectivity is more likely established across 80% of brain circuitries during the first 1000 days. Maladaptive gene-environment (G x E) interactions begin before conception later presenting as maternal-placental-fetal (MPF) triad, neonatal, or childhood neurologic disorders. Synergy between obstetrical and pediatric healthcare providers can reduce neurologic morbidities. Partnerships between healthcare providers and families should begin during the first 1000 days to address diseases more effectively to moderate maternal and childhood adverse effects. This bio-social model lowers the incidence and lessens the severity of sequalae such as DD. Access to genetic-metabolomic, neurophysiologic and neuroimaging evaluations enhances clinical decision-making for more effective interventions before full expression of neurologic dysfunction. Diagnostic accuracy facilitates developmental interventions for effective preschool planning. A description of a mother-child pair in a HIC emphasizes the time-sensitive importance for early interventions that influenced brain health throughout childhood. Partnership by her parents with healthcare providers and educators provided effective healthcare and lessened adverse effects. Effective educational interventions were later offered through her high school graduation. Healthcare disparities in LMIC and HICMD require that this bio-social model of care begin before the first 1000 days to effectively treat the most vulnerable women and children. Prioritizing family planning followed by prenatal, neonatal and child healthcare improves wellness and brain health. Familiarity with educational neuroscience for teachers applies neurologic diagnoses for effective individual educational plans. Integrating diversity and inclusion into medical and educational services cross socioeconomic, ethnic, racial, and cultural barriers with life-course benefits. Families require knowledge to recognize risks for their children and motivation to sustain relationships with providers and educators for optimal outcomes. The WHO sustainable development goals promote brain health before conception through the first 1000 days. Improved education, employment, and social engagement for all persons will have intergenerational and transgenerational benefits for communities and nations.

Attitude, Perception, and Utilisation of Complementary and Alternative Medicine among Caregivers of the Mentally Challenged Persons in Ebonyi State: A Cross-Sectional Study

“…Nonetheless, some mentally ill people have a high propensity to somatize their psychological symptoms and frequently see non-psychiatric healthcare providers before they visit psychiatric clinics or hospitals (Ashmore & Turner, 2020). This approach is consistent with the global decision to treat mental disorders according to the medical model to reduce stigma (Scher, 2022). The National Survey of Mental Disorders in Nigeria estimated that 14.93% of the adult population under study had mental disorders.…”

Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation

“…It is advocated as an important way to improve early childhood development and mitigate the effect of early life adversity [16,20,21,23–27]. Although no one would deny its importance, the question is how to reach children living in the most vulnerable contexts, at what point in time to address their social and biological embedded regulation problems, how to timeously address (self-)regulation and other problems before they become persistent [18,35,47] and how to set realistic expectations in infant with special needs [15 ▪ ,210].…”

“…The promotion of optimal neurobehavioral development with respect for both typically developing and neurodiverse individuals ultimately is the responsibility of regional governments (including legislation, guided by updated guidelines of global health organization [175,228–232]), which in turn need input from (progress made in) science [19]. It is proposed that public health policy and pediatric [16,20,233,234] and obstetrical care [15 ▪ ,235] jointly address the first 1001 critical days. However, this challenging task can only be achieved when responsibility is shared not only by governments, global health organizations and science but within and between groups of healthcare professionals (in primary, secondary and tertiary care), parents and other stakeholders, research communities, health and social policy leaders and the general public [28 ▪▪ ,195].…”

“…Within science, integration from diverse disciplines and building transdisciplinary evidence is critical to address the challenge of promoting neurobehavioral development globally. That researchers have an important responsibility in perinatal mental healthcare and in communicating results concerning perinatal environmental exposure, neurodevelopment, and interventions is emphasized in several fields [15 ▪ ,118,154,193,205,208,230,240–251,257 ▪ ]. Community-oriented participatory research with key stakeholders [252], and community engagement [238] to gather ‘bottom-up’ concerns from parents and practitioners [253] is needed, and may contribute to advocacy [239,253].…”

“…Conceptual models and empirical studies have laid the foundation for the view that understanding the diverse perinatal developmental origins of neurodevelopment – especially factors that are potentially modifiable – is important for optimizing parental mental health and offspring neurodevelopment [14 ▪▪ ,15 ▪ ,16–19]. Several professional organizations and task forces, e.g.…”