Paediatric neuroscience and national develooment
Augustine Togonu-Bickersteth
Early life is the most crucial period for shaping the developing brain and represents a window of both vulnerability and opportunity.9 A failure to achieve early foundational cognitive skills may result in a permanent loss of opportunity to achieve full cognitive potential. Conversely, with appropriate intervention, it is a period during which there is an opportunity to disrupt the intergenerational transmission of inequity, particularly with regard to the developing brain.9
Cognitive function and the importance of social determinants
Cognitive function is a broad construct consisting of multiple domains, which can differ across literature and disciplines. Most definitions consistently refer to domains of learning, understanding, reasoning, problem solving, memory, language, attention, and decision making.10,11,12 There has been considerable debate in the literature regarding the measurement of cognitive functioning, but also regarding its representativeness of overall human functioning.13 While a thorough discussion of this debate is beyond the scope of this article, it is important to clearly acknowledge that childhood cognitive function is only one domain of overall child development. Other domains, including motor development, the development of positive social skills and emotional intelligence, and the establishment of appropriate behaviours are both intimately intertwined and of commensurate importance.14
For many children, particularly those exposed to adverse environmental conditions in early life, the true potential of their cognitive ability will never be reached. This gap between potential and actual ability brings with it significant implications for outcomes across multiple domains throughout the life course, including educational attainment,15 social mobility,16 financial well-being,17 and survival.18 Birth and pregnancy cohort studies have to date provided an evidence-base illustrating