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Volcanoes in Iceland: How it all started with SINDA

Volcanoes in Iceland: How it all started with SINDA

In this blog post, Mac Keith Press author, Mijna Hadders-Algra reflects on how her upcoming book, SINDA: Standardized Infant NeuroDevelopmental Assessment was conceived and how an Icelandic Volcano played a pivoted role.


In spring 2010 an international workshop on the Infant Neurological Assessment was planned in Groningen, the Netherlands. Front runners in the field of developmental neurology were invited from many countries, including myself. They were experts who used the existing infant assessments, such as the Hammersmith Infant Neurological Examination or the examinations according to Amiel-Tison and Touwen. The workshop was organized as a preconference event of the international meeting on early intervention “Impact of Intervention”.

The reason for the workshop was the increasing awareness of clinicians that the existing neurological scales mainly addressed muscle tone and reactions, whereas the general movement assessment had taught the field how important the quality of spontaneous movements is. Thus, it was generally felt that a new assessment tool was needed.

The workshop was well prepared, so that the participants knew which aspects of the infant exam they had to present and discuss. But then something unexpected happened: the Icelandic volcano Eyjafjallajökull erupted.

All air traffic to and within Europe was cancelled. For the workshop this meant that only the German participants were able to get to Groningen – they travelled by train. Though we were reduced in number, this did not dampen our spirits! The ‘left-over’ participants from Germany and the Netherlands decided to hold a mini-workshop. It became clear that the development of a new assessment tool would take much time and that it would be a project that would not easily receive funding. The colleagues who had not been in Groningen decided to hop off the project.

Eyjafjallajökull erupting in 2010, photo courtesy of Henrik Thorburn (https://bit.ly/3MiV2uu)

But the German-Dutch participants of the mini-workshop had been so inspired, that they continued the development of a new infant neurodevelopmental assessment. Our group embarked on a non-funded weekend project, in which the four members (Uta Tacke, Heike Philippi, Joachim Pietz and myself) met about twice a year and exchanged many emails and documents during the intervals. Gradually the Standardized Infant NeuroDevelopmental Assessment (SINDA) emerged. SINDA’s three scales, the neurological, developmental and socio-emotional scale, were clinically tested. Next SINDA was implemented in clinical practice and normative data were collected. SINDA turned out to be an instrument that is quick and easy to apply, is reliable and is a very good instrument assisting prediction of high risk of neurodevelopmental disorders and parental counseling. No expensive toolkit is required.   

And so here we are! The English language version of SINDA will be published by Mac Keith Press very shortly and it’s all thanks to great and steadfast collaboration, some hard work and (at least in part) to the eruption of an Icelandic volcano.


Mijna Hadders-Algra March 2022

Mijna Hadders-Algra is professor of Developmental Neurology.  Her research focuses on 1) early detection of developmental disabilities, 2) early intervention, 3) significance of minor neurological dysfunction (MND) in children with DCD, learning- and behavioural disorders, 4) pathophysiology of motor impairment in children with cerebral palsy or DCD. 

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An Interview with Mijna Hadders-Algra: 9 months post publication of Early Detection and Early Intervention in Developmental Motor Disorders

An Interview with Mijna Hadders-Algra: 9 months post publication of Early Detection and Early Intervention in Developmental Motor Disorders

Nine months on from publication, Early Detection and Early Intervention in Developmental Motor Disorders editor Mijna Hadders-Algra reflects on the key themes and insight from their book.

Early Detection and Early Intervention in Developmental Motor Disorders published in March 2021.

Mijna Hadders-Algra pictured above holding her book Early Detection and Early Intervention in Developmental Motor Disorders

What are the core themes of the book?

The core themes of the book are – as the book’s title indicates – early detection of and early intervention in developmental motor disorders. The book focuses on the first 1,000 days of life. It covers the prenatal period and the first two postnatal years when the brain undergoes rapid and dynamic developmental changes. Recently, there has been a stronger emphasis on identifying infants that will go on to have developmental disorders as early as possible, so that the proper guidance of infant and family can be started. In clinical practice, this can be difficult. The book aims to teach practitioners about the tools assisting early detection, the strategies associated with better outcomes, and the potential opportunities and challenges imposed by the developing brain.

How is the book structured?

The book has seven parts. Part I sets the scene. Part II addresses the young brain’s neurodevelopmental mechanisms, as the brain’s dynamic developmental changes have major consequences for early detection and early intervention. The developmental changes impose challenges on early detection and its neuroplasticity offers excellent opportunities for early intervention. In order to understand the principles of early detection and early intervention, parts III and IV first discuss typical and atypical motor development, respectively. Also sensory, language, cognitive, and socio-emotional development are addressed, as development in the various domains is highly interrelated. Part V deals with early detection; it systematically discusses the most common and valid methods. Part VI describes early intervention; it pays specific attention to the family and to environmental adaptations.

Why did you write the book / why is it needed now?

During my teaching on early detection and early intervention I realized that a book that overviewed early detection and early intervention was lacking. Presumably this lack was due to the limited knowledge in the field in last century. But recently knowledge increased rapidly. It was clear: it was time for this book, that covers the whole range from developmental neuroscience to the participation of child and family in daily life.

“But recently knowledge increased rapidly. It was clear: it was time for this book”

Mijna Hadders-Algra

Who will benefit most from reading the book?

All health professionals involved in the care of infants may profit. This pertains to professionals working in the care of high risk infants, both in the hospital and in outpatient clinics, and to those working in primary care settings. This means that the book is intended for (neuro)paediatricians, child neurologists, neonatologists, paediatric rehabilitation doctors, paediatric physiotherapists, occupational therapists, speech-language therapists, nurses working in the care of infants, educationalists, and researchers.

What was the main highlight or experience you had whilst writing this book?

During the writing of the book, I once again realized how much I had learned from the families that allowed me to do embedded research. The families had an infant with a major lesion of the brain that resulted in the diagnosis of CP. They allowed me to be present in their home during major parts of many days during their child’s development. Observation of the daily care giving practices and the conversations with the family members about the many aspects associated with raising a child with a developmental motor disorder, including grief, joy and the many hassles and time consuming daily practicalities, formed the basis of this book.


Mijna Hadders-Algra December 2021

Mijna Hadders-Algra is professor of Developmental Neurology.  Her research focuses on 1) early detection of developmental disabilities, 2) early intervention, 3) significance of minor neurological dysfunction (MND) in children with DCD, learning- and behavioural disorders, 4) pathophysiology of motor impairment in children with cerebral palsy or DCD.