NOTES – Neuro Developmental Outcomes of Twins from ESPRiT

The NOTES Study is a follow-up study to the ESPRiT Study, investigating Neurodevelopmental outcomes in twins at age 2. This project, funded through an award from the Crumlin Medical Research Foundation, provides a unique opportunity for a multi-centre, multi-disciplinary collaborative project. The successful outcome of the funding application was received in June 2010 and the NOTES study is now complete.

Study Design 

The NOTES Study (Neuro-Developmental Outcome for Twins of The ESPRIT Study) had 2 phases. Phase one which involved a standardised developmental questionnaire which parents fill out (ASQ-3, The Ages and Stages Questionnaire) is nearly complete with only a few remaining questionnaires to be sent out.
Phase 2 involved a detailed neuro-developmental assessment at 2-3 years of age (Bayley Scales Assessment of Infant and Toddler Development) on certain groups of twins:
1. Growth discordant twins (20% or more growth discordance)
2. High risk concordant twins (identified through the ASQ-3 questionnaire)
3. Control group (chosen randomly from the concordant group of twins after matching for gestation)

Overall, close to 500 Bayley Scales Assessment tests were performed.

Dissemination of Research

Preliminary analysis of our data began earlier this year with subsequent presentation of the NOTES finding at upcoming paediatric conferences. A number of major publications are currently in preparation.

Developmental Outcomes in a Large Cohort of Growth discordant Twins: The NOTES Study- currently under editing for submission to Fetal and Neonatal Edition of Archives of Disease in Childhood

Oral and Poster Presentations


  • Growth Discordance and Development: Is the Smaller Twin at Risk? Poster Presentation, C. Halling, PAS meeting, Washington DC, USA, April 2013

  • Prematurity versus Growth Discordance: Impact on Cognition in a Cohort of Twins- Poster Presentation, C. Halling, PAS meeting, Washington DC, USA, April 2013

  • The Use of the ASQ as a Developmental Screening Tool in an Irish Population, oral presentation, C. Halling, EAPS meeting- European Academies of Paediatric Societies- Istanbul, Turkey October 2012

  • “Late Premature Twins: Are They at A Developmental Disadvantage?” , C. Halling, ESPR meeting, Newcastle, October 2011