SINDA: Standardized Infant NeuroDevelopmental Assessment An Instrument for Early Detection of Neurodevelopmental Disorders Edited by MijnaHadders‐AlgraUtaTackeJoachimPietzHeikePhilippiLondon: Mac Keith Press, 2022 £45.00 (Paperback), pp 200 ISBN: 9781911612612

This new offering from the Mac Keith Press Practical Guides series is a fantastic resource. In my opinion as a paediatrician practicing in the field of paediatric development and disability for over 30 years, all health practitioners working with infants under 1 year old should invest in this manual. The Standardized Infant NeuroDevelopmental Assessment (SINDA) is exactly that: a standardized infant neurodevelopmental assessment tool that not only assesses and quantifies neurodevelopmental status, but also highlights those infants at risk of neurodevelopmental conditions such as cerebral palsy, autism, and intellectual developmental disability (learning disability). The great thing about this manual – and the SINDA itself – is its accessibility. The manual is highly readable and easy to follow, rich with photographs and videos to illustrate all aspects of the assessment tool and how to use and interpret the various domains. Indeed, as a resource it is a masterclass in infant neurological and developmental assessment. While we still might be debating the utility of early intervention in terms of improving outcomes, the manual clearly emphasizes how the window of opportunity of early brain plasticity can be used to maximize potential and guide parents as to how best to encourage their infant’s functioning and development across domains. The authors are clear that the SINDA is not designed to treat or prevent specific diagnoses, rather to assist infants at high risk of neurodevelopmental conditions in their daily lives. The target age group for the SINDA is 6 weeks to 12 months corrected for gestational age. Any health professional can use it. All that is required is the manual, a handful of easily obtainable toys, and time to practice. There is no requirement to attend a training course, which makes the tool very accessible across settings. The SINDA comprises three scales: neurological, developmental, and socio-emotional. The neurological assessment takes around 10 minutes, including 5 minutes to clinically observe and assess spontaneous, self-generated movements. Assessment is clinical rather than needing video as for other assessment tools of general movements. Scoring is age independent, thus does not include age-dependent responses such as Moro, palmar and plantar grasp, or parachute reactions. The developmental scale covers cognition, communication, and fine and gross motor development. Of the 113 items in the developmental scale, only 15 correspond with the infant’s corrected age. If the scores are atypical, items at a lower age can also be completed, to provide an indication of the degree of developmental difference for age. For older infants nearer 1 year, the developmental scale takes a little longer to administer, up to 10 to 15 minutes. The socio-emotional scale evaluates interaction, emotionality, self-regulation, and reactivity. Overall, after a couple of weeks of practice, it should be possible to complete the SINDA in around 30 minutes. The psychometric properties of the scales have been evaluated in two clinical studies which are described in detail in Chapter 3, where there is also a helpful section on implementation of the SINDA in clinical practice, including the importance of the infant’s behavioural state, the role of the parents, and the conditions during the assessment. Essentially, the infant needs to be awake, alert, and moving most of the time for the assessment to be most accurate and should not be crying or sleeping. Chapters 4 to 6 describe in detail how to carry out and score the neurological, developmental, and socio-emotional components respectively, all clearly explained and well-illustrated with photographs and videos to evidence age-typical as well as atypical responses. Chapter 7 discusses the significance of the SINDA findings and quantifies the predictive properties of the scores in the setting of an outpatient clinic of high-risk infants. The authors are careful to emphasize that ‘at risk’ does not imply certainty, that things may change with time, and that ongoing assessments are crucial. The importance of providing early intervention to best support the development of the infant and to empower parents to interact with their infant and best promote positive development are also clearly articulated. The SINDA does not result in a specific neurodevelopmental diagnosis, rather it informs the need for further specific assessments, including over time, recognising the remarkable plasticity of the infant brain. Any practitioner who wants to hone their skills in infant neurological and developmental assessment would be well advised to acquire this manual and learn all that the SINDA has to offer. Hopefully the tool will be of practical benefit for neonatologists and child development teams in their clinical work across settings, as well as adding a validated tool for research.