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Number
YearTitleAuthorsJournalPeer-reviewed?OrganizationType of paperCountriesLanguage usedAge groupsSample sizeForm usedModes of deliveryAbstractCREDI UseCREDI evidenceCREDI Psychometric EvidenceLink
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12017Development and validation of an early childhood development scale for use in low-resourced settingsDana Charles McCoy, Christopher R. Sudfeld, David C. Bellinger, Alfa Muhihi, Geofrey Ashery, Taylor E. Weary, Wafaie Fawzi & Günther FinkPopulation Health MetricsYesHarvard UniversityvalidationTanzania (Morogoro region)Swahili18-36 months 2481long formhousehold interviews, clinic visitsLow-cost, cross-culturally comparable measures of the motor, cognitive, and socioemotional skills of children under 3 years remain scarce. In the present paper, we aim to develop a new caregiver-reported early childhood development (ECD) scale designed to be implemented as part of household surveys in low-resourced settings. We evaluate the acceptability, test-retest reliability, internal consistency, and discriminant validity of the new ECD items, subscales, and full scale in a sample of 2481 18- to 36-month-old children from peri-urban and rural Tanzania. We also compare total and subscale scores with performance on the Bayley Scales of Infant Development (BSID-III) in a subsample of 1036 children. Qualitative interviews from 10 mothers and 10 field workers are used to inform quantitative data. Adequate levels of acceptability and internal consistency were found for the new scale and its motor, cognitive, and socioemotional subscales. Correlations between the new scale and the BSID-III were high (r > .50) for the motor and cognitive subscales, but low (r < .20) for the socioemotional subscale. The new scale discriminated between children’s skills based on age, stunting status, caregiver-reported disability, and adult stimulation. Test-retest reliability scores were variable among a subset of items tested.for validation purposeCorrelations between the new scale and the BSID-III were high (r > .50) for the motor and cognitive subscales, but low (r < .20) for the socioemotional subscale. CREDI was able to clearly discriminate between the skills of younger versus older children, children with adequate versus low nutritional status, disabled versus non-disabled children, and children from more versus less cognitively stimulating households, while showing evidence for equality across gender and maternal education within a large quantitative sample.https://doi.org/10.1186/s12963-017-0122-8
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22017Effect of maternal vitamin D3 supplementation on maternal health, birth outcomes, and infant growth among HIV-infected Tanzanian pregnant women: study protocol for a randomized controlled trialSudfeld, C.R., Manji, K.P., Duggan, C.P. et al.BMCNoHarvard T.H. Chan School of Public HealthRCT protocolTanzania0-12 months2300long formhome visitsThe Trial of Vitamins-5 (ToV5) is an individually randomized, double-blind, placebo-controlled trial of maternal vitamin D3 (cholecalciferol) supplementation conducted among 2300 HIV-infected pregnant women receiving triple-drug ART under Option B+ in Dar es Salaam, Tanzania. HIV-infected pregnant women of 12–27 weeks gestation are randomized to either: 1) 3000 IU vitamin D3 taken daily from randomization in pregnancy until trial discharge at 12 months postpartum; or 2) a matching placebo regimen. Maternal participants are followed-up at monthly clinic visits during pregnancy, at delivery, and then with their children at monthly postpartum clinic visits. The primary efficacy outcomes of the trial are: 1) maternal HIV disease progression or death; 2) risk of small-for-gestational age (SGA) births; and 3) risk of infant stunting at 1 year of age. The primary safety outcome of the trial is incident maternal hypercalcemia. Secondary outcomes include a range of clinical and biological maternal and child health outcomes.as an outcome of an intervention evaluating the effects of vitamin D supplement https://doi-org.ezp-prod1.hul.harvard.edu/10.1186/s13063-017-2157-3
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32018Measuring early childhood development at a global scale: Evidence from the Caregiver-Reported Early Development InstrumentsDana Charles McCoya, Marcus Waldmana, CREDI Field Team1, Günther FinkEarly Childhood Research QuarterlyYesHarvard Universityvalidation17 countrieslocal languages0-35 months8022short formin-person interviews, online surveyDespite global interest in supporting and monitoring early childhood development (ECD), few valid and reliable tools exist for capturing ECD at scale across cultural contexts. This study describes the development and validation of the Caregiver Reported Early Development Instruments (CREDI) short form, a new tool for measuring the motor, cognitive, language, social–emotional, and mental health skills of children under age three in culturally diverse settings. Results from 8022 children living in 17 low-, middle-, and high-income countries suggest that the CREDI short form is valid, reliable, and acceptable for measuring population-level ECD. Data highlight differences in CREDI scores within and across countries based on maternal education, child nutritional status, and household stimulation practices. Implications for ECD policy and practice are described.for validation purposeAverage CREDI scores varied substantially across country sitesThe average test–retest reliability for the final set of selected items was kappa = .62. The internal consistency (Cronbach’s alpha) of the CREDI was .89 for 0–5 mo, .86 for 6–11 mo, .84 for 12–17 mo, .86 for 18–23 mo, .84 for 24–29 mo, and .80 for 30–35 mo. Fewer items were selected by our statistical (information-maximizing) model from the social–emotional and mental health domains compared to the motor, cognitive, and language domains.https://doi.org/10.1016/j.ecresq.2018.05.002
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42018The impact of integrated nutrition-sensitive interventions on nutrition and health of children and women in rural Tanzania: study protocol for a cluster-randomized controlled trialMosha, D., Canavan, C.R., Bellows, A.L. et al. TheBMC NutritionNoAfrica Academy for Public Health, Dar es Salaam, TanzaniaRCT study protocolRufiji district, Tanzania6–36 months1006 householdshousehold visitsThis is a cluster-randomized community-based prospective study set in Rufiji district, a rural area in Eastern Tanzania. Ten randomly selected villages within the Rufiji Health and Demographic Surveillance Site (HDSS) in Eastern-Tanzania were paired and randomly assigned to the intervention or control arm. The Rufiji HDSS dataset was used to randomly sample households with women of reproductive age and children 6–36 months. The intervention includes provision of small agricultural inputs, garden training support, and nutrition and health counseling. This is delivered by community health workers and agriculture extension workers through home visits and farmer field schools. There are three time points for data collection: baseline, midline, and endline. Primary outcomes are women’s and children’s dietary diversity, maternal and child anemia status and growth (child stunting, child wasting, women’s BMI, and women and child hemoglobin).as an outcome of an intervention to reduce under-nutrition and disease in women and childrenhttps://doi.org/10.1186/s40795-018-0238-7

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52018Protocol to develop sustainable day care
for children aged 1–4 years in
disadvantaged urban communities in
Dhaka, Bangladesh
Das M, Elsey H, Shawon RA, et al. BMJ OpenNoNuffield Institute for
International Health and
Development, Leeds University
study protocolDhaka, BangladeshN/A
under 3 years old
expecting 193 householdsN/AconsideringChildren living in slums are at high risk of poor early development and holistic, sustainable interventions are needed to address ECD in these contexts. This study will be undertaken in Dhaka, Bangladesh, a city where over 8.5 million inhabitants live in slums. In collaboration with government, non-governmental organisations and communities, we are developing and testing a sustainable day-care model for low-income communities in Dhaka. A sequential mixed methods approach is being used in the study, with qualitative work exploring quantitative findings. Two hundred households with children under-5 will be surveyed to determine day-care needs and to assess ECD (parent-reported and direct assessment). The feasibility of four ECD measuring tools Caregiver-Reported Early Development Index, Measuring Early Learning Quality and Outcomes, The Early Human Capability Index and International Development and Early Learning Assessment will be assessed quantitatively and qualitatively. Qualitative methods will help understand demand and perceptions of day care while mothers work. Participatory action research will be used to develop a locally appropriate and potentially sustainable model of day care for under-5 children. A ward in the south of Dhaka has been selected for the study as this typifies communities with slum and non-slum households living next to each other, allowing us to explore potential for better-off household to subsidise day care for poorer households.
as an outcome for evaluation of a child day-care model https://doi.org/10.1136/bmjopen-2018-024101
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62018Improving early childhood development in rural
Ghana through scalable low-cost community-run play
schemes: Baseline report
Amadu, Salifu et al. Institute for Fiscal StudiesNoThe Institute for Fiscal Studies, Innovations for Poverty Action, GhanaRCT reportGhana
under 3 years old
6,446 target childrenshort formhousehold visitsThis report presents a detailed overview of the baseline data collection activities as part of
the project “Improving early childhood development in rural Ghana through scalable low-cost
community-run play schemes”.
as an outcome for siblings of targeted children for evaluation of a low-cost community-run
play schemes (Lively Minds)
Raw CREDI score for sibling of control vs. treatment group: 8.69( 4.53) vs. 9.51(4.55), p<0.01http://hdl.handle.net/10419/201784
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72018Maternal education and socioeconomic status of family as predictors of early
childhood development in Armenia
Hakob KarapetyandisserationNoGerald & Patricia Turpanjian School of Public Health,
American University of Armenia
descriptiveAmernia (Yerevan)Armenian10-36 months225long formin-person household interviewsEarly childhood development (ECD) is a period of life from prenatal to 8 years of age. It is a time when children undergo significant growth and development that affect their lives into adulthood. Many risk factors can affect ECD. The most important phase of brain growth and development in children occurs during the first 1000 days of life; therefore, early interventions are critical. Studies from developing countries highlighted the significant association between socioeconomic status (SES) of the family and children’s developmental outcomes. Literature also indicated the importance of high maternal educational level for normal early childhood development. Aim: The primary goal of the study was to assess the relationship between ECD outcome of children under 3 years old and the main independent variables chosen for this study: family SES and maternal educational level. Methods: The study applied a cross-sectional survey design. The study targeted children under 3 years of age and their mothers residing in Yerevan, Armenia. Face-to-face interviews with mothers of children under 3 years of age were conducted. CREDI assessment tool was selected to measure early childhood development. In total, 225 children were selected in Yerevan, Armenia, using multi-stage cluster sampling technique. By descriptive and univariate analysis of selected covariates, the study identified confounding variables for ECD outcome and SES relationship as well as for ECD outcome and maternal education relationship, to control for in multivariable linear regression analyses of the associations of interest. Results: After adjusting for the identified confounders, the multivariable linear regression analysis showed a statistically significant dose-response relation between maternal education level and ECD score: compared to Primary/secondary/specialized education group, β coefficient was 7.23 (95% CI 4.34-10.13) for the Bachelor group and 9.45 (95% CI 6.32-12.57) for the Master/Phd group. The association between family SES and ECD score controlled for the identified confounders also showed significantly higher ECD outcome among children in high SES group (β=4.48, 95% CI 1.46-4.49) compared to those in low SES group. Conclusion: The results of this study are consistent with the global evidence that maternal education is primary predicting factor for early childhood development, and higher maternal education is one of the predicting factors for better early developmental outcomes. The study obtained similar results on the effect of SES level on childhood development, and highlighted that children have better ECD outcomes in families having high socioeconomic status. The study recommendations included developing educational programs on parenting, early childhood care and development, specifically targeting parents in low educational groups, and piloting cash transfer programs among families with low SES status in Armenia.as an outcome in a descriptive study assessing the relationship between ECD outcome of
children under 3 years old and family SES and maternal educational level.
The mean CREDI percent score for the total sample was 81.8 (9.20 SD). It was significantly
higher in the high SES group: 85.5 (8.40 SD), compared with middle SES group: 81.1 (8.50 SD)
and low SES group: 78.4 (10.10 SD)
https://dspace.aua.am/xmlui/handle/123456789/1598
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82018Prenatal nutrition, stimulation, and exposure to punishment are associated with early child motor, cognitive, language, and socioemotional development in Dar es Salaam, TanzaniaPitchik, H. O., Fawzi, W. W., McCoy, D. C., Darling, A. M., Abioye, A. I., Tesha, F., ... & Sudfeld, C. R.Child: care, heath and developmentYesSchool of Public Health, University of California, Berkeley, California, Harvard T.H. Chan School of Public Health, the National Institute of Medical Research, and Muhumbili University for Health and Allied SciencesevaluationTanzaniaSwahili18–36 months608 childrenlong formin-person interview using Android tabletDespite growing evidence that early life experiences and exposures can impact child development, there is limited research on how prenatal and early life nutrition and early life parenting practices predict specific domains of child development in resource-limited settings. This study examines the association between prenatal factors, birth outcomes, and early life characteristics with motor, cognitive/language, and socioemotional development in Tanzania.

Methods
We assessed motor, cognitive/language, and socioemotional development among a cohort of 198 children aged 20–39 months in Dar es Salaam, Tanzania, whose mothers were previously enrolled in a randomized, placebo-controlled trial of prenatal vitamin A and zinc supplementation. Linear regression models were used to assess standardized mean differences in child development scores for randomized prenatal regimen and pregnancy, delivery, and early childhood factors.

Prenatal vitamin A supplements in a setting with low levels of vitamin A deficiency may not provide child development benefits. However, integrated environmental, educational, parenting, and stimulation interventions may have large positive effects across child development domains in resource-limited settings.
as an outcome for evaluation of a randomized-controlled trial of prenatal vitamin A and zinc supplementationChildren born to mothers randomized to prenatal vitamin A had significantly lower reported motor scores in minimally adjusted and multivariate analyses, −0.29 SD, 95% CI [−0.54, −0.04], p = 0.03, as compared with children whose mothers did not receive vitamin A. There was no significant effect of randomized prenatal zinc on any development domain. Greater caregiver–child stimulation was associated with 0.38 SD, 95% CI [0.14, 0.63], p < 0.01, better cognitive/language scores, whereas children who experienced both verbal and physical punishment had 0.29 SD, 95% CI [−0.52, −0.05], p = 0.02, lower scores in socioemotional development. Maternal completion of primary school was associated with higher reported motor and cognitive/language development. Further, children of mothers who were <155 cm tall had lower cognitive and language scores.https://doi-org.ezp-prod1.hul.harvard.edu/10.1111/cch.12605
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92018Positive parenting as a critical element in child development: The Philippine experienceMaria Perlita E. de Leon, Catherine A. Manzano, Whimcy Luck C. SagpangconferenceNoSave the ChildrenPhilipinesN/A0 to 4 yearsN/AN/AN/ASave the Children is at the frontline in teaching positive discipline among child carers.
First Read project, through its Home-based Mentoring on Emergent Literacy and
Numeracy (HoME) sessions, aligned with the nurturing care framework, teaches positive
caregiving techniques and creating a worthwhile routine to enhance learning outcomes and
positive socio-emotional development of children. Key messages such as “do not hit your
child” and “praise and encourage your child” are what we aspire as their key take-away
after the sessions. Thus far, qualitative feedback from the communities include parents
adopting a more caring and nurturing parenting style. The midline conducted in 2017
validated this showing that parents who exercise positive parenting have more sociallyadjusted children. Studies have shown that children who are socially- and emotionallysecure are more likely to succeed in school.
as an outcome of an intervention: Impact of First Read (FR) Project, a home-based program that supports emergent literacy and numeracy of children zero to four years.Midline evaluation shows that children who no longer experience negative emotional and physical violence, have improved scores in the socio-emotional development domain of the CREDIhttps://www.researchgate.net/profile/Phil-De-Leon-2/publication/327792667_Positive_parenting_as_a_critical_element_in_child_development_The_Philippine_experience/links/5fcceaf592851c00f854e65d/Positive-parenting-as-a-critical-element-in-child-development-The-Philippine-experience.pdf
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102019A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countriesMarlow, Servili & TomlinsonAutism ResearchYesStellenbosch University, South Africasystematic reviewN/AN/AN/AN/AN/AN/AWithout intervention, developmental delay (DD) and autism spectrum disorders (ASDs) severely restrict children from reaching their developmental potential. Monitoring child development through the use of screening tools can help identify children who need further assessment or intervention. Screening has been widely encouraged to identify children with ASD or DD, and a large variety of screening instruments are suggested in the literature. There is a lack of consensus around which screening tools are most effective, especially where tools are used in cultures other than those in which they were created. We conducted a review of the literature for screening tools for DD and autism to make recommendations for tool selection and use in low- and middle-income countries (LMIC). We included 99 screening tools in the review and created profiles for each tool to evaluate their properties and determine which tools could be effectively used in various LMIC. Our review identified a substantial number (35 for DD and 6 for ASD) of screening tools from LMIC. We identified 10 tools which show promise for use across settings; these tools are brief, low-cost and can be implemented by paraprofessionals or lay community health workers. Routine screening is an important first step toward addressing the need for services in LMIC, but high-quality tools take time to be conceptualized, developed, piloted, and validated, before implementation can happen. A focus on improving the scientific rigor of early detection approaches and on enhancing the reach to underserved populations should be prioritized.https://doi-org.ezp-prod1.hul.harvard.edu/10.1002/aur.2033
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112019Trial of thiamine supplementation in CambodiaWhitfield, K. et al.NoDepartment of Applied Human Nutrition
Mount Saint Vincent University
RCT protocolKampong Thom province, Cambodia0-13 months192 womenlong forminterviewsObjectives: 1. To conduct a dose response supplementation trial among lactating Cambodian women to
determine the lowest dose of thiamine that yields the maximum increase in human milk
thiamine.
2. To assess rural Cambodian households’ usual salt intake using a household salt disappearance
study.
3. To assess cognitive development of infants aged 2 weeks – 12 months to mothers consuming
varying thiamine doses using a small battery of cognitive assessme
as an outcome on cognitive assessments at 2, 12, 24, and 52 weeks postnatal of an intervention on thiamine doseshttps://classic.clinicaltrials.gov/ProvidedDocs/88/NCT03616288/Prot_SAP_001.pdf
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122019Contextual variation in young children’s acquisition of social-emotional skillsDana C. McCoy, Jorge Cuartas, Marcus Waldman, Günther FinkPLOS OneYesHarvard Universitydescriptive11 sites across 10 countriescountry-dependent0 to 35 months5,447 infants’ and toddlers’long formThis study examined variation in the timing of 5,447 infants’ and toddlers’ reported acquisition of 12 basic social-emotional skills across and within 11 developing and developed country sites. Although children differed significantly across sites in when they attained social-emotional skills on average (e.g., M age Brazil = 20.50 months vs. M age India = 26.92 months), there was also substantial heterogeneity across skills. For example, children in Pakistan were reported to demonstrate sympathy on average seven months earlier than their peers in Ghana, whereas the opposite was true for sharing. Overall, country-level health and education were strongly associated (r > .60) with earlier site-level skill attainment. In addition to heterogeneity across sites, we also observed notable within-site variability in skill development (ICCs = .03 to .38). Future research is needed to identify sources of variability and how to promote skills that matter within a given context.as social-emotional outcomes for cross-country comparisionThe site with the earliest median age of reported attainment across the 12 selected social-emotional skills was Brazil (M = 20.50 months; SD = 6.35), and the site with the latest median age of attainment was India (M = 26.92 months; SD = 5.02). The social-emotional skill with the least variation across sites was impulse control, which demonstrated a SD of 1.78 months across sites and a six-month median age difference between the earliest site (Guatemala; M = 28 months) and the latest site (Pakistan; M = 34 months). The skill with the most variation was greeting others, which showed a SD of 6.00 months across sites and ranged from a median age of attainment of 17 months in the Filipino site to 34 months in the Ghanaian site. In the case of several skills–including sharing, switching between activities, concentrating, and greeting neighbors–there was on average more than a year of difference between when children in the 25th versus 75th percentile were reported to attain these skills. Each of the selected 12 items showed few (<10%) “don’t know” responses, were well understood by caregivers during cognitive interviews, and, with the exception of one item (“usually follows rules and obeys adults”), demonstrated adequate test-retest reliability over the course of 7 to 10 days (kappa of > .4; excepted item = .35). Differential item functioning (DIF) analysis showed evidence for measurement invariance of all 12 items across country income groups (i.e., high, middle, and low income countries)https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223056
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132020Measuring early childhood development in Brazil: validation of the Caregiver Reported Early Development Instruments (CREDI)Elisa Rachel Pisani Altafim, Dana Charles McCoy, Alexandra Brentani,
Ana Maria de Ulhôa Escobar, Sandra J.F.E. Grisi, Günther Fink

Jornal de Pediatria (Versão em Português)
YesIVEPESPvalidationBrazilPortuguese0-35 months1,265short formin-person interviews, online surveyThe present study aims to analyze the psychometric properties and general validity of the Caregiver Reported Early Development Instruments (CREDI) short form for the population‐level assessment of early childhood development for Brazilian children under age 3. The study analyzed the acceptability, test‐retest reliability, internal consistency and discriminant validity of the CREDI short‐form tool. The study also analyzed the concurrent validity of the CREDI with a direct observational measure (Inter‐American Development Bank's Regional Project on Child Development Indicators; PRIDI). The full sample includes 1,265 Brazilian caregivers of children from 0 to 35 months (678 of which comprising an in‐person sample and 587 an online sample).Internal consistency of (α > 0.80) for the CREDI within each of the six age group. Scores on the CREDI were significantly correlated with overall PRIDI scores within the in‐person sample at r = 0.46. A significant proportion of the variance in CREDI scores could be explained by child gender and family characteristicshttps://doi.org/10.1016/j.jpedp.2018.11.001
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142020Assessing the performance of the Caregiver Reported Early Development Instruments (CREDI) in rural IndiaHarold Alderman, Jed Friedman, Paula Ganga, Mohini Kak, Marta Rubio-CodinaAnnals of the New York Academy of Sciences
YesInternational Food Policy Research Institute, World Bank, Columbia UniversityvalidationIndia (Madhya Pradesh)Hindi22–35 months994long formhousehold interviewsAlthough many education and health programs aim to improve early childhood development, it is challenging to assess developmental levels of infants and small children through large household surveys. The Caregiver Reported Early Development Instruments (CREDI) has been proposed as an adaptable, practical, and low-cost instrument for measuring the developmental status of children under 3 years of age at scale, as it is relatively short and collected by caregiver report. This study employed the CREDI to measure the development of a sample of 994 children ages 22–35 months in rural India and compared the results to those obtained using the Bayley Scales of Infant and Toddler Development (Bayley-III), a reliable and widely used instrument, albeit one not always suited to large-scale data collection efforts given its length, cost, and complexity of administration. The CREDI validation exercise showed that caregivers can provide assessments in keeping with the more interactive (hence more time-consuming and training-intensive) Bayley-III instrument. Noteworthy, there was no indication that concordance of the instruments differed by education of the caregiver. This is important as it points to alternate feasible tools to measure child development outcomes through large-scale surveys.The internal consistency of any domain either approaches or exceeds the conventional cutoff of 0. e Pearson correlation (age-adjusted) between CREDI and Bayley-III is 0.212 for cognitive scores, 0.199 for motor scores, and 0.332 for language scores.https://doi-org.ezp-prod1.hul.harvard.edu/10.1111/nyas.14543
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152020Reliability and validity of the Caregiver Reported Early Development Instruments (CREDI) in impoverished regions of ChinaYing Li, Lei Tang, Yu Bai, Shuhang Zhao & Yaojiang Shi BMC PediatricsYesMinzu University of China, China Institute for Vitalizing Border Areas and Enriching the PeoplevalidationChinaChinese5–36 months946long formverbal interviewsThere is a great need in low- and middle- income countries for sound qualitative and monitoring tools assessing early childhood development outcomes. Although there are many instruments to measure the developmental status of infants and toddlers, their use in large scale studies is still limited because of high costs in both time and money. The Caregiver Reported Early Development Instruments (CREDI), however, were designed to serve as a population-level measure of early childhood development for children from birth to age three, and have been used in 17 low- and middle-income countries. This study aimed to examine the reliability and validity of the CREDI in China, which is still unknown.Cronbach’s α coefficients of each subscale ranged from .92 to .97. When the examined by age group, Cronbach’s α coefficients of each subscale decreased accordingly, but remained relatively high. The correlation between the CREDI and the Bayley-III was strong before 18 months but was relatively weak at 18 to 23 months, and was moderate after 24 months. Higher the home stimulation, the higher the CREDI cognitive scores; and the CREDI cognitive scores increased with the child’s age; CREDI is highly consistent with previous widely used instruments in predicting home stimulation).https://doi.org/10.1186/s12887-020-02367-4
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162020Relationship between docohexaenoid acid in breastmilk and development scores at infant 18–23 months of ageKarmila Sarih, Saifuddin Sirajuddin, Tahir Abdullah et al.Enfermería ClínicaYesHasanuddin University, IndonesiadescriptiveTanzaniaNA
18 and 23 months
64long formN/AThis study was conducted to evaluate the relationship between DHA and development of motoric, cognitive, and socioemotional (DMCS) at infant 18---23 months of age.
Methods: This was a cohort study following a supplementation to pregnant and lactating mothers with Moringa oleifera leaf (MOL) or iron folic acid (IFA). DHA in breastmilk was measured at
6 months of age (n = 64). DMCS was measured at their age 18---23 months using CREDI (Caregiver
Reported Early Childhood Development Index). All measurements were assessed by trained field
workers using a standard questionnaire and data was analyzed using Spearman Correlation.
Results: Majority of mothers were between 20 and 35yr old (71.9%), less than 12yr of education
(71.9%), household wife (84.4%), and from farmers family (40.6%). There were borderline significant relationships between DHA levels and cognitive and motoric score (p = 0.096, r = 0.210
and p = 0.064, r = 0.233 respectively for cognitive and motoric). However, there was a significant
relationship between DHA and socioemotional score (p = 0.049, r = 0.247).
Conclusion: We conclude that DHA in breastmilk 6 months would predict the development of
motoric, cognitive, and socioemotional of infant at the period of 18---23 months of age.
No significant differences for motor and cognitive scores in the exclusive and non-exclusive breastfeeding groups. but
significant difference in socioemotional score.
https://doi.org/10.1016/j.enfcli.2019.10.066
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172020Evaluating the Effects of a Child-focused Water, Sanitation, and Hygiene (WASH) Intervention in LaosWright, Dorianne BN/ANo
Department of Psychology, Graduate School of the University of Oregon
dissertation, RCTLaos
Khmu, Hmong, or Lao
0-60 months145 childrenlong formelectronic tablets through one-on-one interviews with caregivers.Young children living in poverty in low- and middle-income countries are
more likely to experience undernutrition, infectious diseases, environmental
contaminants, and unstimulating surroundings. Exposure to such risks during the
first 1,000 days of life leads to significant inequalities in a child’s developmental
trajectory. Child-focused water, sanitation, and hygiene (WASH) interventions have
the potential to help create improved environmental conditions that are necessary
for children to thrive. The current study examined the effects of a low-cost, easily
scalable child-focused WASH intervention (targeting children ages 0-3) that was
delivered in a single session to caregivers in Laos, a lower-middle income country in
Southeast Asia. Specifically, we examined the effects of the child-focused WASH
intervention on caregiver and child outcomes when the intervention was delivered
independently, and in combination with a similarly efficient intervention focused on
responsive caregiver stimulation. Although the primary focus of this paper was to
document the effects of the child-focused WASH intervention, we also examined
synergistic effects related to the combination of the child-focused WASH and
responsive stimulation interventions. Our results support the overall effectiveness of the WASH intervention on a
number of important dimensions. First, caregivers found the WASH intervention to
be beneficial to themselves and their children, and most believed that child-focused
WASH behaviors would be easy to put into practice. Second, the WASH intervention
had significant benefits with large effect sizes on caregiver WASH knowledge and
self-reported WASH practices at one month post-intervention. The WASH
intervention did not, however, appear to influence child physical growth outcomes
or cognitive/language development by one month post-intervention. Nevertheless,
children were less likely to experience a diarrheal episode post-intervention if their
caregivers received the WASH intervention in addition to a responsive stimulation
intervention. Together, these findings suggest that even a brief, single-session of a
child-focused WASH intervention can produce short-term measurable effects on
caregiver and child outcomes, especially when combined with a similarly efficient
responsive stimulation intervention
as an outcome of an intervention on water and hygienehttp://search.proquest.com.ezp-prod1.hul.harvard.edu/dissertations-theses/evaluating-effects-child-focused-water-sanitation/docview/2436411993/se-2
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182021Measuring early childhood development: considerations and evidence regarding the Caregiver Reported Early Development InstrumentsDana Charles McCoy, Jonathan Seiden, Marcus Waldman, Günther FinkHarvard UniversitycommentaryReflecting a burgeoning political interest in supporting young children around the world, global demand for reliable, valid, and scalable assessments of early childhood development (ECD) is on the rise. One of the more popular sets of tools for measuring the ECD of children under age 3 is the Caregiver Reported Early Development Instruments (CREDI), which includes both a long form for research and evaluation and a short form for population-level monitoring. In this commentary, we describe the goals and limitations of the CREDI, research to support its use as a population-level ECD instrument, as well as the major gaps in its evidence base. We also discuss how the work of Alderman and colleagues (in this issue) addresses some of these outstanding gaps, highlighting several critical areas for future research. https://doi-org.ezp-prod1.hul.harvard.edu/10.1111/nyas.14598
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192021Validation of motor, cognitive, language, and socio-emotional subscales using the Caregiver Reported Early Development Instruments: An application of multidimensional item factor analysisWaldman, M., McCoy, D. C., Seiden, J., Cuartas, J., & Fink, G.International Journal of Behavioral DevelopmentYesHarvard Universityvalidation17 high- and LMICsmultiple0-36 months14,113 caregiver reports long formN/AThe Caregiver Reported Early Development Instruments (CREDI) are assessments tools for measuring the development of children under age three in global contexts. The present study describes the construction and psychometric properties of the motor, cognitive, language, and socio-emotional subscales from the CREDI’s long form. Multidimensional item factor analysis was employed, allowing indicators of child development to simultaneously load onto multiple factors representing distinct developmental domains. A total of 14,113 caregiver reports representing 17 low-, middle-, and high-income countries were analyzed. Criterion-related validity of the constructed subscales was tested in a subset of participants using data from previously established instruments, anthropometric data, and a measure of child stimulation. We also report internal-consistency reliability and test–retest reliability statistics. Results from our analysis suggest that the CREDI subscales display adequate reliability for population-level measurement, as well as evidence of validity.https://doi.org/10.1177/01650254211005560
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202021Psychometric properties of the Child Development Assessment Questionnaire (QAD-PIPAS) for use in population studies involving Brazilian children aged 0-59 monthsVenancio, S. et al. Jornal de PediatriaYes São Paulo State Department of Healthvalidation for another instrumentBrazilPortuguese0-36 months2005 childrenshort formInterviews through clinic visitsThis methodological study was comprised of two axes. The first one aimed to analyze the instrument's construct validity (discriminant and concurrent validity) and internal consistency, and the second one examined test-retest reliability, involving two different samples and procedures. For construct validity and internal consistency, the sample was recruited in Embu das Artes-SP, Brasilia-DF and Recife-PE during the immunization campaign in 2017, involving caregivers of 2005 children under 60 months of age (1295 under 36 and 710 from 37 to 59 months). For the test-retest analysis the sample consisted of 30 children aged 0–59 months old that attended daycare centers in Embu das Artes-SP in 2018.
Multivariate analyses of construct validity showed that the QAD-PIPAS was able to identify the association between the outcome (suspected child development delays) and expected risk and protective factors based on Nurturing Care Framework (OMS/UNICEF). A significant positive correlation was achieved between the scores of the QAD-PIPAS and CREDI in six of the eight age groups analyzed, with the most significant correlations being in the age groups from 25 to 30 and 31–36 months. Acceptable internal consistencies were identified in all age groups, with better performance above 36 months of age (Cronbach’s alpha between 0.61 to 0.80). We also found an adequate test-retest reliability (global Kappa 0.81).
The QAD-PIPAS showed evidence of construct validity and reliability to be used in population studies involving children aged 0–59 months during multi-vaccination campaigns in Brazil.
A significant positive correlation was achieved between the scores of the QAD-PIPAS and CREDI in six of the eight age groups analyzed, with the most significant correlations being in the age groups from 25 to 30 and 31–36 months. A significant positive correlation was achieved between the scores of the QAD-PIPAS and CREDI in six of the eight age groups analyzed, with the most significant correlations being in the age groups from 25 to 30 and 31–36 months. https://doi.org/10.1016/j.jped.2021.01.003
22
212021Effects of a Government-Led Parenting Programme on Early Child Development Outcomes in Rural China: A Cluster-Randomised Controlled TrialBai, Yu et al.International Association of Agricultural Economists ConferenceNoCenter of Experimental Economics in Education (CEEE), Shaanxi Normal Universityevaluationrural ChinaChinese6-27 months621long formphone interviewsOver ten million children below the age of three in poor, rural areas of China are delayed in their
cognitive development. Parenting programmes are promising tools to improve opportunities for child
development. We evaluate a cluster-randomised controlled trial to assess the impacts of a government-led,
stimulation-based parenting programme on psychosocial development of children in rural China. In addition, we
test how monthly developmental feedbacks affect compliance and programme impacts.

Methods: We implemented a non-masked cluster-randomised controlled trial in a selected poverty county in rural
China. All 6-to 36-month-old children living in the 18 communities of the county and their primary caregivers
were enrolled. In February 2018, we randomly assigned communities to intervention or control. In communities
assigned to intervention, ECD centres with open play areas were installed where community workers provided
parenting training sessions over a period of 9 months from July 2018 until March 2019. If caregivers were unable
to frequent a centre (e.g., due to illness or distant living location), then home-based parenting training was offered.
In control group communities, no ECD centres were installed nor training sessions delivered. Furthermore, we
assigned half of the treatment group to receive monthly developmental feedback on top of the parenting training
programme. The primary outcomes are measures of child development (i.e., the subscales of the Caregiver-
Reported Early Development Instruments). We registered the trial with the ISRCTN registry, number
ISRCTN16736104.

Findings: Between June 21 and July 2, 2018, 956 children in the intervention county were screened and enrolled
for the intervention. After randomisation, we assigned 9 clusters to treatment (473 caregiver-child dyads) and 9
to control (483 caregiver-child dyads). Follow-up data were collected for 811 caregiver-child dyads between April
9 and April 21, 2019. All children below age 3 at follow-up (i.e., all children for whom the CREDI provide age-
appropriate measures, n=621) were included in the evaluation sample. First, intention-to-treat (ITT) effect shows
that the intervention led to an improvement in children’s cognition scores (effect size 0·16 SD, 95% CI <0·01-
0·34; p=0·05). Treatment effects for compliers were larger (effect size 0·23 SD, 95% CI <0·01-0·47; p=0·05).
Second, we observe that developmental feedbacks raise programme impacts on child cognition and parental
investment for disadvantaged children–negative feedback is effective at raising compensating parental investment.
Third, we find that centre-based service delivery leads to gains in cost-effectiveness, but home-based delivery
may be important for inclusiveness.

Interpretation: A government-led parenting training programme focusing on child psychosocial stimulation can
improve child cognitive development after 9 months of intervention. Centre-based delivery benefits cost-
effectivenes, while home visitation is important to maintain inclusiveness for the most disadvantaged children.
Developmental feedback is a promising way to provide the most disadvantaged ones with an opportunity to catch
up by encouraging compensating parental engagement in cognitively stimulating parenting practices.
as an outcome for evaluation of ECD centres with open play areas in high-poverty countiesParenting programme increased child’s CREDI cognition scores by 0·16 SD (p=0·06). The delivery of monthly developmental feedback in addition to the parenting training programme, led to significantly larger treatment effects on CREDI cognition and social-emotional z- scores (p<0·10). Cognition, language, and social-emotional z-scores increased by 0·23 SD, 0·16 SD, and 0·19 SD compared to that of the control group, respectively (p<0·05)CREDI outperformed the ASQ-3 in terms of validity and reliability. https://doi.org/10.22004/ag.econ.315366
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222021A home visit-based early childhood stimulation programme in Brazil—a randomized controlled trialBrentani, A. et al.Health Policy and PlanningYesDepartment of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP)evaluationBrazilN/A9–15 months900 childrenlong formHousehold interviewsHome visiting programmes are increasingly recognized as one of the most effective interventions to improve child health and development in low-income settings. However, the best platforms to deliver such programmes remain unclear. We conducted a randomized controlled trial to test the relative effectiveness of child development agents (CDAs) and community health workers (CHWs) as two possible delivery platforms for early childhood development (ECD) focused home visiting intervention in São Paulo, Brazil. A total of 900 children aged 9–15 months were screened for potential study inclusion between January and March 2015. Children who did not attend crèches at enrolment were included in the trial. Children were randomly assigned to control or to receive biweekly home visits either through a CHW in the areas covered by the Brazilian Family Health Strategy (FHS) or by a newly hired cadre of CDAs in the areas not covered by the FHS. The primary study outcome was children’s development (cognition, motor, language and social emotional skills) assessed after 12 months of intervention with the PRIDI and Caregiver-Reported Early Development Instruments tools. A total of 826 mother-child dyads were enrolled in the trial. In intention-to-treat analysis, neither intervention arm improved study outcomes. In per-protocol (PP) analysis, the CDA programme resulted in a 0.22 standard deviation increase in children’s development (95% confidence interval [0.01–0.43]). The results presented in this study suggest that home visiting programmes have the potential to improve child development among poor urban families in Brazil. However, delivering home visiting interventions through already active CHWs may not be feasible in the Brazilian context and coordination across sectors is essential to effective ECD policies.as an outcome for evaluating the effectiveness of child development agents and community health workers as two possible delivery platforms for early childhood development focused home visiting intervention. CDA programme resulted in a 0.22 standard deviation increase in children’s development (95% confidence interval [0.01–0.43])https://doi-org.ezp-prod1.hul.harvard.edu/10.1093/heapol/czaa195
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232021Effects of Two Early Childhood Interventions on the Developmental Outcomes of
Children in Post-Earthquake Nepal
Seiden, J. et al.Journal on Education in EmergenciesYesSave the ChildrenevaluationNepalNepali0-24 months 363 childrenlong formHousehold interviewsNatural disasters pose immense challenges to young children by exposing them to a high degree of adversity during a critical period. Interventions designed to build resilience in the aftermath of natural disasters may help buffer the negative consequences of these adverse experiences. In this article, we report the results of our quasi-experimental evaluations of two interventions designed by Save the Children to improve children’s developmental outcomes and parental engagement. These interventions provided resources across eco-developmental levels to young survivors of the 2015 earthquake in Nepal’s Sindhupalchowk district. The first was a caregiver-focused intervention aimed at improving early stimulation, responsive caregiving, and positive parenting skills for children ages 0-3; the other was an ECD center and facilitator-focused intervention aimed at improving the quality of learning environments, family engagement, and psychosocial supports for children 3-6 years old. We found that the interventions had a mixed impact. The age 0-3 components had no detectable effect on developmental outcomes. The age 3-6 components had a positive impact on children’s early learning and development, particularly their preacademic skills. Neither intervention improved parental engagement. We highlight the challenges of implementing family-focused interventions in emergency contexts and the importance of the delivery agents in ECD programs. These evaluations demonstrate that bolstering the quality of early learning environments and the skills of ECD facilitators can have a meaningful impact on child-level outcomes, even in postdisaster and emergency settings.as an outcome for evaluations
of two interventions building resilience after the earthquake
as measured by CREDI, the intervention did not have meaningfully large positive or negative effects on children’s developmental status. The age 0-3 components had
no detectable effect on developmental outcomes, whereas the age 3-6 components
had a positive impact on children’s early learning and development
https://doi.org/10.33682/te08-ce5p
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242021Breastfeeding, Physical Growth, and Cognitive DevelopmentWallenborn, J. et al.PediatricsYesDepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of BaseldescriptiveSão Paulo, BrazilNANA2288NANABreastfeeding is an evidence-based recommendation for all countries, but breastfeeding rates have been declining in many middle-income settings. One reason behind this decline is the perception that breastfeeding may not be necessary in modern urban settings, where clean water is available and alternative foods are abundant. We investigate the importance of breastfeeding for early childhood development in the modern urban context of São Paulo, Brazil.

METHODS:
In our study, we used data from the ongoing prospective Western Region Birth cohort in São Paulo, Brazil. Children were recruited at birth and managed for 3 years. Durations of exclusive and mixed breastfeeding were our primary independent variables. Our secondary independent variable was an indicator for compliance with World Health Organization (WHO) breastfeeding recommendations. Our primary outcomes of interest were indicators of children’s physical, cognitive, language, and social-emotional development at 3 years of age. Adjusted estimates and 95% confidence intervals were calculated by using linear and logistic regression.

RESULTS:
Complying with WHO recommendations to exclusively breastfeed for 6 months followed by complementary feeding until 2 years of age was associated with a 0.4-SD increase in overall child development (β: .38; confidence limit = 0.23 to 0.53), a 0.6-SD increase in height-for-age z score (β: .55; confidence limit = 0.31 to 0.79), and a 67% decrease in the odds of stunting (odds ratio = 0.33; 95% confidence interval = 0.20 to 0.54)
CONCLUSIONS:
Our results suggest that even in settings with easy access to complementary foods, complying with WHO breastfeeding recommendations is important for healthy physical growth and cognitive development.
breastfeed for 6 months followed by complementary feeding until 2 years of age was associated with a 0.4-SD increase in overall child development "In our a priori data analysis plan, we specified an additional secondary outcome: the Caregiver Reported Early Development Instruments (CREDI). However, CREDI was dropped as a secondary outcome because of the high rate of missing information (67.4%; n = 1542) and potential biases created by parents reporting on their own children."https://DOI.org/10.1542/peds.2020-008029
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252021A multi-center longitudinal study on responsive breastfeeding in China from the perspective of health equity: research protocolShu, W. et al.International Journal for Equity in HealthYesDepartment of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, ChinaRCT protocolChinaChinese700 mothers (estimating)short formonline questionnaireThe aim of this article is to present a protocol of an ongoing longitudinal cohort study investigating factors associated with responsive breastfeeding behaviors, and the child’s behavioral and cognitive development from birth to12 months post-partum in five centers in China. The study seeks to identify breastfeeding barriers and facilitators from a health equity perspective.

Methods
We are enrolling 700 women and their singleton full term infants in Chongqing, Huizhou and Guangzhou urban and rural areas. The study questionnaires will be administrated within 72 h, 30 days, 3, 6, 9, and 12 months post-partum during the baby’s vaccination visits. We will investigate the difference between urban and rural areas sociodemographic characteristics, breastfeeding knowledge, attitudes and practice, postnatal depression, maternal emotion regulation and parenting stress, and anthropometric and cognitive development indicators of the infants at each time-point.

Conclusion
Our article illustrates how a cohort study can be designed to understand the barriers and facilitators of responsive breastfeeding taking equity principles into account to help promote infants’ growth and development in China.
as an outcome in a longitudinal cohort study investigating factors associated with responsive breastfeeding behaviors, and the child’s behavioral and cognitive development from birth to 12 monthshttps://doi.org/10.1186/s12939-021-01430-5
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262021Neurodevelopmental outcomes of being born during the COVID-19 pandemic and the role of early tactile experiencesAntunes, Joana Carolina SimõesdissertationNoUniversity of MinhodescriptivePortugalPortugese0-12 months524 motherslong formonline questionnaireRecent findings suggest that increased levels of distress during the perinatal period have been experienced during the COVID-19 pandemic, which can lead to negative repercussions on infants’ neurodevelopmental outcomes. Early tactile experiences, such as skin-to-skin contact, might have a particular relevance on buffering the effects of maternal distress during the context of COVID-19 pandemic, through its effects on infants’ physiological regulation and its supporting role in the neurodevelopmental trajectory. To address the interplay between neurodevelopmental outcomes and affective touch during the COVID-19 pandemic, two studies were conducted. The first study consisted of the BabiesDuringCOVID online survey, administered to mothers (n = 524) that gave birth during the COVID-19 pandemic. It aimed to characterize the developmental and temperamental outcomes of infants exposed to the COVID-19 environment and to explore the moderating role of early tactile experiences on the relationship between COVID-19-related perinatal distress and infants’ developmental trajectory. A second face-to-face study was conducted to compare the neurodevelopmental outcomes of infants exposed in utero to SARS-CoV-2 (n = 29), whose mothers were diagnosed with COVID-19 at delivery, against a control group (n = 36) of infants also born during the pandemic. Our findings suggest that infants exposed to the pandemic environment presented a similar developmental pattern compared to a cross-cultural reference sample assessed prior to the COVID-19 pandemic. No significant differences emerged between infants exposed in utero to SARS-CoV-2 and the control group in terms of development, temperament, touch sensory processing, and power spectral density for the alpha and theta bands, assessed through resting-state electroencephalogram. The exception was a significant higher positive affectivity reported for the control group infants, albeit close to the significance threshold. COVID-19-related perinatal distress was associated to lower socio-emotional ability and higher negative emotionality. Our results also suggest that COVID-19 harmed the early tactile experiences between mother-newborn during hospitalization, with possible impairments in infants’ outcomes. Mother-newborn separation, which prevents touch experiences, revealed a moderating effect on the relationship between COVID-19-related perinatal distress and infants’ socio-emotional development. Based on our findings, we also propose to consider mothers’ own tactile experiences to better understand the effect of affective touch on infants’ neurodevelopmental trajectories.For all developmental domains, more than 50% of infants revealed scores inside the reference-group standard deviation. The social-emotional domain revealed the higher mean (M =.107; SD = .684), and the motor domain the lowest mean (M = .010; SD = .545). Only 5% of infants presented a z-score bellow -.534 in the overall development, with more than 50% of the sample positioning itself at a level equivalent to the upper mean of the reference sample. No gender-related significant differences emerged for all developmental domains. No significant differences emerged regarding infant’s development as assessed by Griffiths Mental Development Scales for 0 to 2 years old ( face-to-face observation) for all developmental domains, as well as for the general
development. No differences were also observed regarding the domains of CREDI, which is completed through mother’s report of infant’s developmental acquisitions.
https://repositorium.sdum.uminho.pt/handle/1822/79551
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272022Caregiver parenting practices, dietary diversity knowledge, and association with early childhood development outcomes among children aged 18-29 months in Zanzibar, Tanzania: a cross-sectional surveyRussell, A.L., Hentschel, E., Fulcher, I. et al.BMC Public HealthYesD-tree International, Zanzibar, TanzaniadescriptiveZanzibar, TanzaniaKiswahili18-29 months499 children long formHousehold interviewsMany children in low- and middle-income countries fail to reach their cognitive potential, with experiences before age 3 critical in shaping long-term development. Zanzibar’s Jamii ni Afya program is the first national, digitally enabled community health volunteer (CHV) program promoting early childhood development (ECD) following the Nurturing Care Framework within an integrated maternal and child healthcare package. Using program baseline data, we explored home environment, caregivers’ parenting, health and nutrition knowledge and practices, and ECD outcomes in Zanzibar. We conducted a national household survey among 499 children aged 18-29 months using two-stage cluster sampling in February 2019. The primary outcome was child development score measured using the Caregiver Reported Early Developmental Index (CREDI), with higher scores representing higher levels of child development. We analyzed CREDI scores, along with MICS questions on parenting knowledge, practices, and characteristics of the home environment. We developed multivariate regression models to assess associations between caregiver-child interactions, knowledge of dietary diversity, and ECD. Ten percent of children had overall CREDI z-scores 2 standard deviations [SD] or more below the global reference population mean, with 28% of children at risk of developmental delay with z-scores 1 SD or more below the mean. Cognitive and language domains were of highest concern (10.2 and 12.7% with z-score < − 2 SD). In 3-day recall, 75% of children engaged in ≥4 early stimulating activities with all caregivers averaging 3 total hours of play. CREDI scores were positively associated with greater frequency of caregivers’ engagement (β = 0.036, p = 0.002, 95%CI = [0.014, 0.058]), and dietary diversity knowledge (β = 0.564, p < 0.001, 95%CI = [0.281, 0.846]). Our findings demonstrate a positive association between both the frequency of caregiver child interactions and knowledge of adequate dietary diversity, and ECD outcomes. This aligns with global evidence that promoting early stimulation, play and learning opportunities, and dietary diversity can improve developmental outcomes. Further study is needed to establish causal relationships and assess the impact of ECD programming in Zanzibar.an outcome for a descriptive study assessing associations between caregiver-child interactions, knowledge of dietary diversity, and ECD.In Zanzibar, 9.6% of sampled children fell into the area of significant developmental concern (i.e., z-score greater than or equal to 2 SD below the reference mean) for the overall CREDI developmental score. An additional 18.4% had CREDI z-scores between one and two SD below the reference mean. Mean z-scores ranged from − 0.116 (SD: 1.354, range: − 4.372 to 3.449) in the motor domain, to − 0.494 (SD: 1.309, range: − 5.275 to 3.199) in the language domain. https://doi.org/10.1186/s12889-022-13009-y
29
282022Parental locus of control and early childhood development: Evidence on parent and grandparent caregivers in rural ChinaYu Bai, Dorien Emmers, Ying Li & Lei Tang China Economic ReviewYesSchool of Economics, Minzu University of China,descriptiverural Shaanxi Province, ChinaMandarin6 to 36 months995 childrenlong formHousehold interviewsThis study investigates the relationship between caregivers' internal or external parental locus of control (PLOC) orientation and child development outcomes. We surveyed 995 children under age 3 and their primary caregivers in a rural study site in Western China. The empirical results show that a more internal PLOC orientation is reflected in higher levels of intergenerational investment in a stimulating home environment and improved child development outcomes. Grandparent caregivers have, on average, a more external PLOC orientation than do parent caregivers, which is associated with reduced engagement in interactive caregiver-child activities. This study provides evidence that PLOC orientation plays an important role in intergenerational human capital investment and early child development in non-Western, low-to-middle income settings.as an outcome for a descriptive study assessing its relationship with caregivers' internal or external parental locus of control orientationNo significant association emerged between mother
or infant diagnosis of COVID-19 and infants’ developmental and temperamental outcomes. Mother-newborn separation during long period was a significant moderator on the relationship between COVID-19 related perinatal distress and infants’ socio-emotional
development
https://doi.org/10.1016/j.chieco.2022.101814
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292022Association of Exposure to Intimate Partner Violence With Maternal Depressive Symptoms and Early Childhood Socioemotional Development Among Mothers and Children in Rural TanzaniaOliveira, C. et al.JAMA networkYes?School of Nursing, University of Nevada, Las Vegas, Harvard T. H. Chan School of Public Health, Ifakara Health Institute, Dar es Salaam, TanzaniadescriptiveTanzaniaN/A18-24 months388 children socioemotional scale in the long form (20 items)Household interviewsTo examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development.

Design, Setting, and Participants This study used cross-sectional follow-up data collected from February 19 to October 10, 2014, from a birth cohort of children aged 18 to 36 months who were enrolled in a randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation in the Morogoro region of Tanzania. Data analysis occurred between September 10, 2019, and January 20, 2020.

Exposures Lifetime experience of IPV was assessed using an abbreviated module of the Tanzania Demographic and Health Survey, maternal depressive symptoms were assessed with the Patient Health Questionnaire, and data on harsh child discipline and maternal stimulation of their children were collected using modules of the United Nations Children's Fund Multiple Indicator Cluster Survey.
negative association between maternal report of physical partner, maternal depressive symptoms and child socioemotional developmentinternal consistency for the socioemotional subscale of α = 0.68. The mean CREDI socioemotional development score was 0.73 (0.12).https://doi.org/10.1001/jamanetworkopen.2022.48836
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302022Risk and protective factors to early childhood development during the COVID-19 pandemicCosta, P. et al.Journal of School of Nursing, São PauloNoUniversidade Federal de São Paulo, BrazildescriptiveSão Paulo, BrazilN/A0 to 35 month108 guardians short formelectronic formObjective:
To analyze the risk and protective factors to the development of children under three years of age during the COVID-19 pandemic.

Method:
Cross-sectional, quantitative study carried out in three early childhood education centers in the city of São Paulo, Brazil, in October 2020. The data were collected with an online questionnaire. Risk and protection factors were measured with the Primeira Infância Para Adultos Saudáveis (Early Childhood For Healthy Adults) instrument and the children's development status was measured using the Caregiver Reported Early Development Instruments – CREDI.

Results:
The study included 108 parents and guardians of children up to three years of age. Living with grandparents and participating in cash transfer programs were protective factors for child development. The family being headed by a woman posed a significant risk factor for child development.

Conclusion:
Intersectoral actions to support families headed by women and access to cash transfer programs are essential for promoting equity opportunities for the development in early childhood.
family participation in cash transfer programs and child living with grandparents were protective factors to the development of children under three years of age during the COVID-19 pandemic. families headed by women were a risk condition to child development.https://doi.org/10.1590/1980-220X-REEUSP-2022-0196en
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312022Supporting Reading Aloud Beginning Prenatally and in Early Infancy: A Randomized Trial in BrazilPiccolo, Luciane R. et al.Journal of Developmental & Behavioral PediatricsYesInstituto de Medicina Integral Professor Fernando FigueiraevaluationBrazilPortugese0 to 24 months400 families long formhousehold interviews and phone interviews (during COVID)Women with low income who were either pregnant or with children aged 0 to 24 months were randomized to UBB or control groups. UBB consisted of monthly workshops focused on reading aloud complemented by a book-lending library. Participants were evaluated at baseline and approximately 11 months later (M = 11.0, SD = 0.4; range 9.9–12.2 months) on parenting (cognitive stimulation, beliefs about early reading, screen time, and discipline) and child development.
Four hundred families (n = 200 UBB) were randomized; 286 (71.5%; n = 150 UBB) received 11-month follow-up. UBB families showed increased cognitive stimulation (Cohen's d = 0.92) and awareness about the importance of early reading (d = 0.90) than controls, with no differences by parent literacy level. UBB was associated with reduced screen time and increased vocabulary, but only for families with low parent literacy. UBB effects on child outcomes were mediated by cognitive stimulation.
The findings support implementation of reading aloud programs beginning in pregnancy and early childhood.
as an outcome for evaluation of a reading aloud interventioCronbach's α in this sample was 0.80Cronbach's α in this sample was 0.80https://doi.org/10.1097/DBP.0000000000001118
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322022Cohort profile: maternal and child health and parenting practices during the COVID-19 pandemic in Ceará, Brazil: birth cohort study (Iracema-COVID)Castro, M. et al.BMJ OpenNoHarvard University T H Chan School of Public HealthdescriptiveBrazilPortugeseN/A351 motherslong formphone interviewsMaternal and child health and parenting practices during the COVID-19 pandemic in Ceará (Iracema-COVID) is a longitudinal, prospective population-based birth cohort designed to understand the effects of the pandemic and social withdrawal in maternal mental health, child development and parenting practices of mothers and families.
A sample of mothers who gave birth in July and August 2020 (n=351) was enrolled in the study in January 2021. Interviews were conducted by telephone. Data were collected through standardised questionnaires that, in addition to sociodemographic and economic data, collected information on breast feeding, mental health status and COVID-19.
Findings to date: Results from the first wave show that the majority of participants have 9–11 years of schooling (54.4%; 95% CI 61.0 to 70.9) and are of mixed race (71.5%; 95% CI 66.5 to 76.0). At the time of the survey, 27.9% of the participants were out of the labor force (95% CI 23.5 to 32.9) and 78.6% reported a decrease in family income after restrictions imposed due to the pandemic (95% CI 74.0 to 82.6). The prevalence of maternal common mental disorder symptoms was 32.5% (95% CI 27.8 to 37.6).
Future plans: Follow-up visits are planned to occur every 6 months for the next five years (2021–2025). Additional topics will be included in future waves (eg, food insecurity and parenting practices). Communication strategies for bonding, such as picture cards, pictures of mothers with their children and phone calls to the participants, will be used to minimise attrition. Results of this prospective cohort will generate novel knowledge on the impact of the COVID-19 pandemic on maternal and child health and parenting practices in a population of women and children living in fifth largest city of Brazil.
as an outcome for evaluation of pandemic effects on mother–child dyads in the first year of the child’s life.https://doi.org/10.1136/bmjopen-2022-060824
34
332022Effects of HIV Exposure, TB and HIV Treatment, and Isoniazid Preventive Therapy on Prognosis and Growth Trajectories of ChildrenCherkos, Ashenafi ShumeydissertationNoUniversity of WashingtonevaluationWestern KenyaN/A24-35 months400 mothersshort formstudy vitisThe goals of the study are to evaluate the effects of HIV exposure, TB-HIV treatment, and IPT on the prognosis and growth trajectories of children. The
project had four aims: Aim 1: To determine the effect of HIV and ART exposure in-utero on growth and
development of HEU infants. Aim 2. To determine the effect of maternal pregnancy versus postpartum
maternal IPT on growth faltering of HEU infants. Aim 3: To evaluate the impact of infant IPT on the rate
of growth of HEU infants. Aim 4: To determine the effect of TB-HIV co-treatment on the prognosis (viral
load suppression, immune reconstitution, and growth)
maternal BMI, educational level, infant’s sex, and breastfeeding were independently associated with overall development score for both HIV-exposed-uninfected and HIV unexposed children.http://search.proquest.com.ezp-prod1.hul.harvard.edu/dissertations-theses/effects-hiv-exposure-tb-treatment-isoniazid/docview/2717745104/se-2
35
342023Impact of a nutrition-sensitive agroecology program in Andhra Pradesh, India, on dietary diversity, nutritional status, and child developmentDurga, L. et al.medRxivNoHarvard T.H. Chan School of Public HealthRCT outcome evaluationAndhra Pradesh, IndiaN/A0-36 months3,511 householdsshort formNAA cross-sectional assessment was conducted in 2021-2022 of 50 intervention villages where the nutrition-sensitive agroecology program had been implemented since 2018 and 79 control villages where only the agroecology program had been implemented. Data on self-reported dietary intake, caregiver-reported early child development, anthropometric measurements, and hemoglobin concentrations were collected using standardized procedures by trained Nutrition Farming Fellows, who were also responsible for implementing the program.
A sample of 3,511 households (1,121 intervention and 2,390 control) participated in the survey. Dietary diversity scores (DDS) among women and men were mean (SD) 6.53 (±1.62) and 6.16 (±1.65), respectively, in intervention villages and 5.81 (±1.58) and 5.39 (±1.61), respectively, in control villages (p<0.01). DDS among children 6-24 months of age in intervention and control villages was 2.99 (±1.52) and 2.73 (±1.62), respectively (p<0.01). Children <2 years of age were less likely to be anemic in intervention versus control villages (59% versus 69%, p<0.01). Children 18-35 months age in intervention villages had higher child development scores than children in control villages (all p<0.05).
Nutrition-sensitive agroecological programs may be effective in improving diets, nutrition, and child development in rural India.
as an outcome for evaluation of a multi-component food-based nutrition interventionAmong children 18-23 months of age, those in intervention villages had significantly higher mean Z-scores compared to children in control villages (0.46 versus 0.24, respectively, p=0.02). Among children 24-29 months of age, those in intervention villages had significantly higher Z-scores compared to children in control villages (-0.14 versus -0.53 respectively, p<0.01). Among children 30-35 months of age, those in intervention villages had significantly higher Z-scores relative to children in control villages (-0.38 versus -0.91 respectively, p<0.01). Children <2 years of age were less likely to be anemic in intervention versus control villages (59% versus 69%, p<0.01). Children 18-35 months age in intervention villages had higher child development scores than children in control villages (all p<0.05).https://doi.org/10.1101/2023.05.16.23290036
36
352023Unmasking the Effect of Teachers’ Socio-Demographic Attributes on Promoting Early Childhood Development: Children’s Cognitive and Emotional Empathy into SchoolUl Hassan, M., Kouser, T., Hussain Chaudhary, A. et al.International Journal of Early ChildhoodYesDepartment of Education, The University of LahoredescriptivePunjab, IndiaNAfrom 2 years old3082 teachersshort formclassroom interview with teachers during class timeLifespan is a pool of stories that, in the beginning, sets the tone. It lays the foundation for students’ long-life learning, attitudes formation, behavioral modifications, and shapes the trajectories of students’ early childhood development (an important thread of United Nations Sustainable Development Goals Target 4.2 bedrock on “access to quality early childhood development, care pre-primary education” till 2030 with specific thread 4.2.1). Predominantly, a child’s healthy dynamics nail down to his/her cognitive development and emotional regulations are excogitated as a building block that gets a load on the teachers’ socio-demographic attributes. They are tossed around a supreme indicator and paramount countenance which works as an appetizer and nurtures infants’ cognitive and emotional empathy in schools. Knuckle down to the excellence of teachers’ socio-demographic attributes, the authors iced on the cake through quantitative ex-post-facto research leading to the positivist paradigm, on a sample of randomly selected 800 participants. The current research is planned in the sweat of the authors’ brow to ramify how teachers’ socio-demographic attributes prioritizes to promoting early childhood development and transitioning children’s cognitive and emotional empathy into school. After obtaining unfetter and unrestricted permission from the authors and ensuring ethical considerations, the researchers piloted a questionnaire to confirm Cronbach’s Alpha reliability statistics .798, .805, and .797. After applying the regression analysis technique, the researchers unmasked that teachers’ socio-demographic attributes affected 78.10% of children’s early childhood development, 59.70% of cognitive, and 72.40% of emotional development. Based on the results, the present research recommends that the Government of the Punjab has a lot on their plate through hiring experienced staff and providing them with induction and in-service training with good incentives to promote extra children’s social, emotional, cognitive and intellectual growth for empathy in schools. Moreover, the current quantifiable stumbling blocks might be examined through conducting qualitative and mixed-method research in public and private educational institutions; a burning dilemma neglected since independence and is a cause of concern for stakeholders.as an outcome in a descriptive study assessing the relationship between teachers’ socio-demographic attributes and early childhood development. Cronbach’s Alpha reliability statistics, CREDI, .804, cognitive aspect .795, and emotional aspect .801 https://doi-org.ezp-prod1.hul.harvard.edu/10.1007/s13158-023-00360-3
37
362023Intimate Partner Violence Against Brazilian Mothers is Associated With Their Children’s Lower Quality-of-Life Scores: A Cross-Sectional Study During the COVID-19 PandemicMélo, T. et al.Health Services InsightsYesFederal University of Paraná, BrazildescriptiveBrazilPortuguese0-36 months701 childrenshort formGoogle Forms, internet-basedThe COVID-19 pandemic led to family and routine reorganization, triggering social problems. Women were further exposed to domestic violence, especially intimate partner violence (IPV), with consequences to their and their children’s health. However, few Brazilian studies address the issue, especially considering the pandemic and its restrictive measures. The objective was to verify the relationship between mothers’/caregivers’ IPV and their children’s neuropsychomotor development (NPMD) and quality of life (QOL) during the pandemic. Seven hundred one female mothers/caregivers of children (0-12 years old) responded to the online epidemiological inquiry. NPMD was investigated with the Caregiver Reported Early Development Instruments (CREDI-short version); QOL, with the Pediatric Quality of Life Inventory (PedsQL™); and IPV, with the Composite Abuse Scale (CAS). The independence chi-square test was used, with Fisher’s exact statistics, in SPSS Statistics 27®. Children whose mothers were exposed to IPV were 2.68 times as likely to have a “low” QOL score (χ2(1) = 13.144, P < .001; φ = 0.137). This indicates a possible environmental influence on the children’s QOL, which may have been aggravated by strict social distancing during the COVID-19 pandemic.14.5% of children with a “lower” CREDI score than the rest of the sample. Children’s early development was not correlated with mothers’ exposure to intimate partner violencehttps://doi-org.ezp-prod1.hul.harvard.edu/10.1177/11786329231157550
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372023Associations Between Social Support and Symptoms of Antenatal Depression with Infant Growth and Development Among Mothers Living with HIV in TanzaniaSaleh, A. et al.AIDS and Behavior YesHarvard TH Chan School of Public Health,descriptiveTanzaniaN/A12 months1,312 infantslong formone-on-one interview with trained study nursesChildren born to mothers living with HIV may experience greater risk of poor growth and development outcomes than their HIV-unexposed peers. Few studies have examined the relationship between maternal depression and social support with infant growth and development in the context of HIV. We conducted a prospective cohort study of 2,298 pregnant women living with HIV in Dar es Salaam, Tanzania, assessing antenatal depression (Hopkins Symptoms Checklist-25) and social support (Duke–UNC Functional Social Support Questionnaire) at 12–27 weeks of gestation. At one-year age, infant anthropometry and caregiver-reported infant development were assessed. Generalized estimating equations were used to assess mean differences (MD) and relative risks (RR) for growth and developmental outcomes. Symptoms consistent with maternal antenatal depression had 67% prevalence and were associated with infant wasting (RR 2.61; 95% confidence interval (CI) 1.03–6.65; z = 2.02; p = 0.04), but no other growth or developmental outcomes. Greater maternal social support was not associated with infant growth outcomes. Greater affective support was associated with better cognitive (MD 0.18; CI 0.01–0.35; z = 2.14; p = 0.03) and motor (MD 0.16; CI 0.01–0.31; z = 2.04; p = 0.04) development scores. Greater instrumental support was associated with better cognitive (MD 0.26; CI 0.10–0.42; z = 3.15; p < 0.01), motor (MD 0.17; CI 0.02–0.33; z = 2.22; p = 0.03), and overall (MD 0.19; CI 0.03–0.35; z = 2.35; p = 0.02) development scores. Depressive symptoms were associated with greater risk of wasting, while social support was associated with better infant development scores. Strategies to improve mental health and social support for mothers living with HIV during the antenatal period may benefit infant growth and development.

the mean cognitive domain z-score was − 0.14 (SD: 1.15), the mean language domain z-score was − 0.18 (SD: 1.34), the mean motor domain z-score was 0.16 (SD: 1.07), and the mean overall developmental z-score was 0.12 (SD: 1.14). Affective support was associated with better cognitive development. Greater instrumental support was associated with better cognitive, motor, and overall development scoreshttps://doi-org.ezp-prod1.hul.harvard.edu/10.1007/s10461-023-04073-5
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382023Family-level factors of early childhood development: Evidence from rural ChinaMa, Y. et al.Infant Behavior and Development YesStanford Center on China’s Economy and Institutionsdescriptive Southwestern China 18–24 months77 householdslong formhousehold interview or hospital interviewFamily-level factors that characterize the home environment are critical inputs to early language and cognitive development, and potential mechanisms for improving developmental outcomes in vulnerable populations. Many studies conducted in high-income and Western settings highlight stimulating parenting, the home language environment, and parental self-efficacy as possible mechanisms of early development, though less is known about how these family-level factors impact child development in low- or middle-income settings. Even less is known about these family-level factors and early childhood development in rural China, where rates of cognitive and language delay in children aged 0–3 years are as high as 45% and 46%, respectively. Using data collected from 77 rural households with children aged 18–24 months in Southwestern China, this study examines the associations between stimulating parenting, the home language environment, and parental self-efficacy, and early cognitive and language development. The results indicate that stimulating parenting was significantly associated with cognitive, language, and overall development; the home language environment was only significantly associated with language development; and parental self-efficacy was not significantly associated with any developmental outcomes. The implications of such findings reveal mechanisms for supporting healthy child development in rural China.as an outcome in assessing the associations between stimulating parenting, the home language environment,and parental self-efficacy, and early cognitive and language developmentStimulating parenting is significantly correlated with
overall, cognitive, and language development
https://doi.org/10.1016/j.infbeh.2022.101787
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392023Co-Benefits of Largescale Organic farming On
huMan health (BLOOM): Protocol for a
cluster-randomised controlled evaluation of
the Andhra Pradesh Community-managed
Natural Farming programme in India
Jaacks, L. et al.Plos OneNoUniversity of EdinburghRCT protocolIndiaTelugu< 38 monthsN/Aoffline mobile app administered by data collectorsThe BLOOM study (co-Benefits of Largescale Organic farming On huMan health) aims to determine if a government-implemented agroecology programme reduces pesticide exposure and improves dietary diversity in agricultural households. To achieve this aim, a community-based, cluster-randomised controlled evaluation of the Andhra Pradesh Community-managed Natural Farming (APCNF) programme will be conducted in 80 clusters (40 intervention and 40 control) across four districts of Andhra Pradesh state in south India. Approximately 34 households per cluster will be randomly selected for screening and enrolment into the evaluation at baseline. The two primary outcomes, measured 12 months post-baseline assessment, are urinary pesticide metabolites in a 15% random subsample of participants and dietary diversity in all participants. Both primary outcomes will be measured in (1) adult men ≥18 years old, (2) adult women ≥18 years old, and (3) children <38 months old at enrolment. Secondary outcomes measured in the same households include crop yields, household income, adult anthropometry, anaemia, glycaemia, kidney function, musculoskeletal pain, clinical symptoms, depressive symptoms, women’s empowerment, and child growth and development. Analysis will be on an intention-to-treat basis with an a priori secondary analysis to estimate the per-protocol effect of APCNF on the outcomes. The BLOOM study will provide robust evidence of the impact of a large-scale, transformational government-implemented agroecology programme on pesticide exposure and dietary diversity in agricultural households. It will also provide the first evidence of the nutritional, developmental, and health co-benefits of adopting agroecology, inclusive of malnourishment as well as common chronic diseases.as an outcome to evaluate impact of a government-implemented agroecology programme to reduce pesticide exposure and improves dietary diversity in agricultural householdsAt baseline, the Caregiver-Reported Early Development Instruments
(CREDI), will be used to assess child development in children <38 months of age
https://doi.org/10.1371/journal.pone.0281677
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402023Fostering early childhood development in low-resource communities: Evidence from a group-based parenting intervention in TanzaniaLeighton, M. et al.World DevelopmentYesUniversity of St Andrews CastlecliffeevaluationTanzaniaN/A4-36 months2,289 childrenlong formhousehold interviewsGroup-based parent training programmes present an affordable means to influence the early experiences of children at scale. This paper reports evidence on the effectiveness of a practice-led intervention piloted in rural Tanzania evaluated through a matched control study design. The core of the programme is an 8–10 week caregiver training course led by local facilitators, built around early stimulation and nurturing care. After two years of implementation, the intervention led to improvements in the development of 3-year olds of 0.29 standard deviations. Detailed data on caregivers indicates that these improvements are due to changes in the type and frequency of caregiver-child interactions for both mothers and fathers, as well as the quality of play materials in the home.as an outcome to evaluate the effectiveness of a practice-led group-based parenting intervention evaluated through a matched control study design In the first wave, when the panel children were 4–12 months old, both the treatment and control groups scored on average very close to the reference population (treat: +0.066 SD, control: +0.024 SD.). By the second wave, when the children were aged 2–3, differences emerged: the control group had now fallen slightly behind the reference population, scoring 0.089 standard deviations below the reference. The treatment group, on the other hand, had pulled ahead by 0.203 standard deviations. Children in the treatment group had 28.7% of a standard deviation higher child development scores, compared with similar children in the control group. Large effect of 0.28 on social-emotional domainhttps://doi.org/10.1016/j.worlddev.2023.106335
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412023Risks to Child Development and School Readiness Among Children Under Six in Pakistan: Findings from a Nationally Representative Phone SurveyHentschel, E. et al.International Journal of Early ChildhoodYesHarvard T.H. Chan School of Public HealthdescriptivePakistan0-3 years3,021 caregiversshort formphone interviewsThis paper analyzes the risks to child development and school readiness among children under age 6 in Pakistan. Drawing on a nationally representative telephone survey conducted in the midst of a global pandemic, between December 2021 and February 2022, we present the first nationally representative estimates of child development for children under 3 years of age and school readiness for children 3–6 years of age, using internationally validated instruments. The paper examines how risk factors that were exacerbated due to the COVID-19 pandemic, such as parental distress, lack of psychosocial stimulation, food insecurity, low maternal education, no enrollment in early childhood education, and living in a rural area, are associated with children’s outcomes. The data indicate that more than half (57 percent) of parents with children under age 3 were distressed and that 61 percent of households reported cutting down on the size of or skipping meals since the start of the pandemic. The data reveal that over half of parents fail to engage in adequate psychosocial stimulation with their child and enrollment in early childhood education is very low (39 percent). The paper finds that child development outcomes decline rapidly as the number of risks increase. Specifically, for children under 3 years, lack of psychosocial stimulation at home and higher levels of parental distress were most significantly associated with lower child development levels. For a child aged 3–6 years, early childhood education enrollment and the amount of psychosocial stimulation the child received at home had the strongest association with school readiness scores.as an outcome of a descriptive study on ECD risk factorsConsistent with evidence from other LMICs, the average Z-score in our sample was 0.03 (95%, CI = −0.02, 0.09). A child who experienced any two risk factors on average scored 0.29 SDs above the mean. This is in sharp contrast to a child who experienced three risk factors (0.01 SD below the mean), four risk factors (0.50 SDs below the mean) or all five risk factors (1.49 SDs below the mean)internal consistency reliability for each age group ranged between 0.70 to 0.91https://rdcu.be/dv7O5
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422023The home language environment and early childhood development: a LENA study from rural and peri-urban ChinaZhang, X. et al.Applied Developmental ScienceYesStanford Center on China’s Economy and Institutionsdescriptiverural and urban Western ChinaMandarin18–24 months 158 children long formhousehold/hospital interviewsThe home language environment is a significant correlate of early childhood development outcomes; however, less is known about this mechanism in rural and peri-urban China where rates of developmental delay are as high as 52%. This study examines associations between the home language environment and child development in a sample of 158 children (58% boys) aged 18–24 months (Mage = 21.5) from rural and peri-urban households in Western China. Results show a significant association between adult-child conversation count and language development, suggesting the home language environment may be a mechanism for child development in rural and peri-urban China. 22.5% of the sample were at risk of language delay. Mother’s employment and child’s age were significant factors in the home language environment.as a predictor of a descriptive study on Chinese children's home language environmentThe average z-score for the motor domain was 0.35 (SD = 0.98), and 8.9% of children were at risk of motor developmental delay. For the CREDI cognitive domain, the average z-score was 0.06 (SD = 0.94), and 12% of children were at risk of cognitive developmental delay. The average z-scores for the language and social-emotional domains were 0.46 (SD = 1.20) and 0.28 (SD = 0.90), respectively. Moreover, the proportions of children at risk of social-emotional or language developmental delays were 8.2 and 14.6%, respectively. Finally, the average z-score for CREDI Overall was 0.31 (SD = 0.92), and only 5% of children were at risk of overall developmental delay.22.15% of children were below the Mandarin CDI cutoff scores for typical language development across age ranges vs. 14.6% at risk of language developmental delays using the CREDIhttps://doi.org/10.1080/10888691.2023.2267440
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432023How does the family environment affect toddlerhood language and cognitive development? Evidence from peri-urban ChinaYue M. et al. Applied Developmental ScienceYesFreeman Spogli Institute for International Studies, Stanford University, School of Public Administration, Northwest University, Xi’an, ChinadescriptiveSouthwestern ChinaMandarin18-24 months81 householdslong formhousehold interviewsResearch suggests that elements of the family environment may have significant associations with cognitive and language development outcomes. Less is known, however, about the family environment in peri-urban China, where rates of cognitive and language delay in children aged 0-3 years are as high as 51% and 54%, respectively. Using data collected from 81 peri-urban households with toddlers aged 18-24 months in Southwestern China, this study examines the associations between stimulating parenting practices, the home language environment, and parental self-efficacy, with cognitive and language development. The results indicate that stimulating parenting practices was significantly associated with cognitive development, the home language environment was significantly associated with language development, and parental self-efficacy was significantly associated with cognitive development. The implications of such findings reveal several mechanisms for supporting healthy cognitive and language development among toddlers from peri-urban China.as a predictor of a descriptive study on parenting practices and home environment Parent self-efficacy(PSE) was significantly associated with CREDI cognitive scores (p < 0.01), but not with CREDI language scores. Specifically, a higher PSE score by 1 SD was significantly associated with higher CREDI cognitive scores by 0.17 SD.The Cronbach alpha of CREDI for this sample is 0.713doi.org/10.1080/10888691.2023.2165077
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442023Assessing environmental enteric dysfunction via multiplex assay and its relation to growth and development among HIV-exposed uninfected Tanzanian infantsLauer J.M. et al.PLOS Neglected Tropical DiseasesYesDepartment of Health Sciences, College of Health & Rehabilitation Sciences: Sargent College, Boston UniversitydescriptiveTanzania12 months467 infants of mothers living with HIVlong formclinic interviewsEnvironmental enteric dysfunction (EED) may contribute to poor growth and development in young children. While validated EED biomarkers are currently lacking, multiplex assays are able to capture multiple domains of the condition. The purpose of this exploratory study was to examine the relationship between biomarkers of EED and subsequent growth and development among Tanzanian HIV-exposed uninfected (HEU) infants. We enrolled 467 infants of mothers living with HIV who had participated in a trial of vitamin D3 supplementation during pregnancy. Infant serum samples collected at 6 weeks (n = 365) and 6 months (n = 266) were analyzed for anti-flagellin and anti-lipopolysaccharide (LPS) IgA and IgG via ELISA as well as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), which incorporates two biomarkers of EED [intestinal fatty acid-binding protein (I-FABP) and soluble CD14 (sCD14)]. Outcomes were 12-month growth [length-for-age z-score (LAZ), weight-for-length z-score (WLZ), and weight-for-age z-score (WAZ)] and development [Caregiver Reported Early Development Instruments (CREDI) z-scores] and were assessed using linear regression. In primary analyses, higher quartiles of 6-month anti-LPS IgG concentrations were significantly associated with lower LAZ at 12 months (ptrend = 0.040). In secondary analyses, higher log2-transformed 6-week anti-flagellin IgA and 6-month anti-LPS IgA concentrations were significantly associated with lower LAZ at 12 months. No associations were observed between I-FABP or sCD14 and infant growth. However, higher log2-transformed 6-week sCD14 concentrations were significantly associated with lower overall CREDI z-scores, while higher log2-transformed 6-month I-FABP concentrations were significantly associated with higher overall CREDI z-scores.as an outcome to examine the relationship between biomarkers of EED (Environmental enteric dysfunction) and subsequent growth and development among Tanzanian HIV-exposed uninfected (HEU) infants."only higher quartiles of 6-week AGP concentrations were significantly associated with lower CREDI z-scores at 12 months (ptrend = 0.026). S4 Table shows associations between log2-transformed biomarker concentrations at 6 weeks and 6 months and CREDI scores at 12 months, both overall and individually for the domains of motor development, language development, and cognitive development. In adjusted analyses, higher sCD14 concentrations at 6 weeks were significantly associated with lower overall CREDI z-scores (β: -0.29 z-score, 95% CI: -0.57, -0.01), and higher I-FABP concentrations at 6 months were significantly associated with higher overall CREDI z-scores (β: 0.13 z-score 95% CI: 0.03, 0.22)."https://doi.org/10.1371/journal.pntd.0011181
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462024Beyond Poverty Reduction: Evidence from a Multifaceted Program on Poverty, Nutrition, and Child DevelopmentBouguen & DillonJournal of Development EconomicsYesNorthwestern University - Kellogg School of ManagementevaluationBurkina Faso0- 36 months3500 householdslong formNAWe study the impacts of a multifaceted program implemented in Burkina Faso that targets
ultra-poor households with young children or pregnant women. The experimental design includes a cash transfer program, a cash plus animal transfer program and a cash, animal and
nutrition-focused transfer program. We find that the program significantly reduced extreme
poverty in all treatment branches, but only the third, nutritionally focused program, positively
impacted child nutrition and development. We find large impacts on young children’s anthropometrics measures, motor development and cognitive development of new born children in
the nutritionally focused program branch. Our results suggest that while transfer programs
are effective at reducing household poverty, nutritionally focused programs are critical to
trigger a cognitive response at the child level.
as an outcome for evaluating a cash transfer + nutrition interventionUsing the 3-year CREDI test, we find moderate-to-small impacts across all dimen- sions of the tests, except for mental heath. For the aggregated CREDI score and the sub-index language, the impact is significant at less than 5%https://doi-org.ezp-prod1.hul.harvard.edu/10.1016/j.jdeveco.2025.103596
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472024Willingness-to-pay for early childhood development: A field experiment in Western ChinaWang et al.China Economic ReviewYesBusiness School, Shaanxi Normal University, Shaanxi, ChinadescriptiveChinaChinese6–35 months79long formNAGiven the size of the problem and the scientific evidence that timely intervention can improve long-term outcomes, an important question is how to best scale-up early childhood development (ECD) interventions in low- and middle-income countries (LMICs). A key component of the solution is financing. However, there has been little research on the question of whether cost-sharing models can equitably and sustainably finance ECD programs at scale in LMICs. We built parenting centers in two rural communities of Western China to teach caregivers how to stimulate child development through fun and interactive activities. We used the Becker-Degroot-Marschak (BDM) mechanism to elicit the household willingness-to-pay (WTP) for a one-month pass to the parenting centers. The results of the BDM suggest that a cost-sharing model would not be suitable for China's rural population at least in the short-run. Demand was found to be highly elastic. In addition, we found limited evidence of selection effects. We also found no evidence of sunk-cost effects.as a variable describing differences in CREDI scores between two communitiesAlthough there are no significant differences in the raw scores of the CREDI subscales between the two communities, the means of the resettlement community are significantly lower than that of the migrant community in some cases — 43 percentage points lower in the share of primary caregivers who had completed high school (p < 0.01). The results also show a lower household asset index (p < 0.05), and RMB 28,200 (~USD 4029) less than the average household annual income (p < 0.05).We used the factor analysis of the cognition, language, motor, and social-emotional subscales of CREDI to construct a latent child development index.https://doi.org/10.1016/j.chieco.2024.102146
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482024Evidence of potential impacts of a nutrition-sensitive agroecology program in Andhra Pradesh, India, on dietary diversity, nutritional status, and child developmentDurga, L. et al.Plos OneYesGlobal Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, United Kingdom/ International Food Policy Research Institute, Washington, DC, United States of AmericaevaluationIndia0- 36 months3,511 households (1,121 intervention and 2,390 control)short formNAWhile a number of studies have examined the nutritional impacts of agroecological interventions, few have examined impacts on child development, maternal and child anemia, and men’s dietary diversity. Moreover, there have been few such evaluations at scale. We evaluated the impact of a large-scale, multi-component food-based nutrition intervention involving homestead food production, nutrition counselling, cooking demonstrations, and crop planning exercises.

Methods
A cross-sectional assessment was conducted in 2021–2022 of 50 intervention villages where the nutrition-sensitive agroecology program had been implemented since 2018 and 79 control villages where only the agroecology program had been implemented. Data on self-reported dietary intake, caregiver-reported early child development, anthropometric measurements, and hemoglobin concentrations were collected using standardized procedures by trained Nutrition Farming Fellows, who were also responsible for implementing the program.

Results
A sample of 3,511 households (1,121 intervention and 2,390 control) participated in the survey. Dietary diversity scores (DDS) among women and men were mean (SD) 6.53 (±1.62) and 6.16 (±1.65), respectively, in intervention villages and 5.81 (±1.58) and 5.39 (±1.61), respectively, in control villages (p<0.01). DDS among children 6–24 months of age in intervention and control villages was 2.99 (±1.52) and 2.73 (±1.62), respectively (p<0.01). Children <2 years of age were less likely to be anemic in intervention versus control villages (59% versus 69%, p<0.01). Children 18–35 months age in intervention villages had higher child development scores than children in control villages (all p<0.05).

Conclusion
Nutrition-sensitive agroecological programs may be effective in improving diets, nutrition, and child development in rural India.
as an outcome for evaluating a food-based nutrition intervention We also found large, consistent, and beneficial effects on child development, with larger benefits among older children 24–36 months of age.. Children in intervention villages had better early child development scores as compared to children in control villages with larger benefits among older age groups (Fig 4). We observed a shift from negative Z-score to positive Z- scores with increase in child age. Among children 0–5 months of age, children in control villages had better Z-scores than children in intervention villages: -0.37 versus -0.68, respectively (p<0.01). Among children 6–11 months and 12–17 months old, children in intervention villages had consistently higher Z-scores, albeit not statistically significant (S5 Table). However, among children 18–23 months of age, those in intervention villages had significantly higher mean Z-scores compared to children in control villages (0.46 versus 0.24, respectively, p = 0.02). Among children 24–29 months of age, those in intervention villages had significantly higher Z-scores compared to children in control villages (-0.14 versus -0.53 respectively, p<0.01). Among children 30–35 months of age, those in intervention villages had significantly higher Z-scores relative to children in control villages (-0.38 versus -0.91 respectively, p<0.01)https://doi.org/10.1371/journal.pone.0286356
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492024The Relations Between Caregiver Education, Home Stimulation, and Children’s Developmental Outcomes: Research in Majority World Countries.Do, H., McCoy, D.C.International Journal of Early ChildhoodYesHarvard, University of Pennsylvanniadescriptivemultiplemultiple0- 36 months9,099 childrenlong formNACaregiver education and home stimulation have shown positive associations with children’s developmental outcomes in early childhood in high-income “Minority World” countries, and these processes also predict children’s long-term health and well-being. However, relatively little is known about these processes in low- and middle-income “Majority World” countries, where an estimated 250 million children under the age of five are at risk of not reaching their developmental potential. This paper attempts to address these gaps in knowledge by exploring the relations between caregiver education, household stimulation, and early childhood development in a sample of infants and toddlers aged birth to three using data on 9,099 caregiver-child dyads from eight under-represented Majority World sites: Brazil, Guatemala, India, Jordan, Lebanon, Pakistan, the Philippines, and Zambia. It also explored the differences in these developmental processes between children’s sex and geographical regions. Results showed that home stimulation partially mediated the associations between caregiver education and children’s developmental outcomes across eight sites. These developmental processes differed by geographical regions and by children’s sex. In sum, these findings contribute to the field’s understanding of the universality and specificity of child development across settings and child characteristics. They also suggest the importance of supporting caregiver education and home stimulation activities as means of promoting children’s developmental outcomes, as well as the need to promote gender equity in the Majority World to ensure equal access to learning opportunities, especially opportunities in the home.as an outcome variable to establish the mediating role of home simulation on the assocation between caregiver education and CREDI outcomes the associations were the strongest between home stimulation and children’s motor skills (β = 0.304, SE = 0.007, p < 0.001) and caregiver education and children’s motor skills (β = 0.273, SE = 0.016, p < 0.001). Additionally, higher levels of home stimulation predicted higher social-emotional, language, and cognitive scores (β = 0.263, SE = 0.007, p < 0.001; β = 0.213, SE = 0.005, p < 0.001; β = 0.293, SE = 0.007, p < 0.001, respectively). Similarly, higher levels of caregiver education also predicted higher scores in children’s social-emotional, language, and cognitive skills (β = 0.224, SE = 0.015, p < 0.001; β = 0.209, SE = 0.012, p < 0.001; β = 0.251, SE = 0.015, p < 0.001, respectively).https://doi-org.ezp-prod1.hul.harvard.edu/10.1007/s13158-024-00398-x
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502024The gender gap in early language development among children from peri-urban ChinaMa et al.Early Childhood Research QuarterlyYesSchool of Public Administration, Northwest University, Xi'an, ChinadescriptiveChinaChinese18-24 months81 children long formNAIn rural China, there exists a gender gap in academic achievement where girls outperform boys, suggesting similar differences in early language development. Moreover, recent research has revealed that children in peri-urban communities have worse language outcomes than children in rural communities. This study examines the impact of gender on early language development in low-SES, peri-urban Chinese communities. Data from 81 children (56.79% boys) aged 18-24 months (Mage = 21.16) living in peri-urban China were collected using two caregiver-reported tests for child language development and ability, and language environment analysis technology for measuring the home language environment. Results show that in peri-urban communities, girls were generally exposed to more adult-child conversations and showed higher counts of vocalizations than did boys; girls scored higher on language development measures than did boys. The implications of these findings on the gender gap and child development are discussed.as an variable to understand gender mean differencesGirls significantly outperformed boys on the CREDI by 0.69–1.67 SD across all percentiles (p < 0.01–0.05). In the adjusted regression, the size of the gap at the 10th percentile was nearly four times the size of the gap at the 90th percentile. The gender gap was significantly larger among children with the lowest CREDI scores than children with the highest scores, with girls’ outperforming boys by 0.48–1.77 SD (p < 0.01–0.05). CDI scores of boys and girls were also significantly different at all five percentiles, with girls’ again outperforming boys across all percentiles.The maximum and minimum values of CREDI scores were 53.62 and 48.94, respectively. The mean CREDI score was 50.73 (SD = 0.93) for boys and 51.66 (SD = 0.71) for girls. The maximum and minimum values of CDI scores were 109 and 0, respectively. The differences between boys’ and girls’ language development were statistically significant for both CREDI and CDI. In the unadjusted linear regression, boys’ CREDI and CDI scores were both significantly lower than girls’ scores. Specifically, boys scored 1.14 SD lower than girls on the CREDI (p < 0.001) and 0.97 SD lower than girls on the CDI (p < 0.001). In the adjusted linear regression, boys’ scores remained significantly lower than girls’ scores (p < 0.001), with boys scoring 1.1 SD lower on the CREDI and 0.91 SD lower on the CDI (p < 0.001).https://doi.org/10.1016/j.ecresq.2024.09.008
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512024Effectiveness of lipid-based nutrient supplementation during the first 1000 days of life for early childhood development: A community-based trial from PakistanImtiaz, A. et al.Maternal & Child NutritionYesDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, QatarevaluationPakistanPashto6-24 months1204 motherslong forminterviews A community-based, cluster non-randomized controlled trial was conducted in Kurram district, Pakistan between January 2018 to December 2020. Age-appropriate lipid-based nutrient supplements and health education (sessions conducted in the households) were given to pregnant women and their born children (6–23 months) in the intervention arm (n = 40 clusters) versus health education only in the control arm (n = 40 clusters) to evaluate its effect on child development. The first and second developmental assessments were completed at ~24 months (n = 689) and ~32 months (n = 608), respectively, using the Caregiver-Reported Early Development Instrument Long form. The overall and domain-specific (motor, language, cognitive and socio-emotional) scores were computed with higher scores indicating better child development. Higher development scores, including overall (β = 0.40, 95% confidence interval [CI]: 0.14, 0.65; p = 0.002), cognitive (β = 0.27, 95% CI: 0.10, 0.45; p = 0.002), motor (β = 0.39, 95% CI: 0.22, 0.56; p < 0.001) and language (β = 0.33, 95% CI: 0.14, 0.51; p = 0.001) were reported for children who received the intervention compared to the control arm at first developmental assessment. However, the effect was not sustained after the discontinuation of the intervention. The LNS received by the mothers (during pregnancy and first 6 months after delivery) and by children during 6–23 months of age was beneficial for the children.as an outcome to estimate the treatment effect of an interventioAt the first developmental assessment, after controlling for covariates, the estimated effect of the intervention suggested an increase in child development scores, with strong evidence against the model hypothesis at this sample size (Table 3). The overall development score was positive (β = 0.40, 95% CI: 0.14, 0.65; p = 0.002) in the intervention arm compared to the control arm. Similarly the domain-specific scores were also positive in the intervention arm, including cognitive (β = 0.27, 95% CI: 0.10, 0.45; p = 0.002), motor (β = 0.39, 95% CI: 0.22, 0.56; p ≤ 0.001), and language (β = 0.33, 95% CI: 0.14, 0.51; p = 0.001) all with strong evidence against the model hypothesis at this sample size, except for socio-emotional development (β = 0.12, 95% CI: −0.04, 0.29; p = 0.148). Post-intervention: The estimated effect of the intervention was negative, overall (β = −0.35, 95% CI: −0.54, −0.16; p < 0.001), cognitive (β = −0.24, 95% CI: −0.41, −0.07; p = 0.006), motor (β = −0.25, 95% CI: −0.44, −0.05; p = 0.013), language (β = −0.42, 95% CI: −0.59, −0.24; p < 0.001) and socioemotional (β = −0.23, 95% CI: −0.40, −0.056; p = 0.009https://doi-org.ezp-prod1.hul.harvard.edu/10.1111/mcn.13727
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532024Effect of sleep duration on child development in Fortaleza, Northeastern BrazilCastro, S. et al.Jornal de PediatriaYesUniversidade Federal do Ceará (UFC), Departamento de Fisioterapia, Fortaleza, CE, Brazil
descriptiveBrazil
278 mother-child dyads
278 mother-child dyadslong formNAThe present study's objective is to assess whether sleep duration affects Early Childhood Development (ECD). A prospective cohort study was carried out with 278 mother-child dyads in the city of Fortaleza, northeastern Brazil, with data collection every 6 months.

The data used in this study are from the third (18 months) and fourth (24 months) survey waves. Information on sleep duration was collected using the Brief Infant Sleep Questionnaire (BISQ) and information on ECD using the Caregiver Reported Early Development Instrument (CREDI). Crude and adjusted regression models were run for each CREDI domain as an outcome with 5 % significance.

The authors found that after adjusting for maternal age and schooling, family income, and the presence of other children in the house, night sleep duration was associated with better ECD scores (cognitive: coef. 0.14; 95 % CI 0.04,0.24; language: coef. 0.10; 95 % CI 0.01,0.19; motor: coef. 0.10; 95 % CI 0.03,0.18; socio-emotional: coef. 0.16; 95 % CI 0.06,0.25; overall: coef. 0.14; 95 % CI 0.04,0.24), and the time awake at night associated with worse scores (cognitive: coef. -0.12; 95 % CI -0.23,0.02; motor: coef. -0.09; 95 % CI -0.17,-0.01; socio-emotional: coef. -0.11; 95 % CI -0.21,-0.01; overall: coef. -0.11; 95 % CI -0.21,-0.01).
as an outcome for descriptive evidence establishing association between sleep duration and early childhood outcomeAmong CREDI domains, language had the lowest score (−0.58; SD: 1.13).. The authors found significant correlations between nocturnal sleep duration and all CREDI domains: cognition (0.16); language (0.14); motor (0.15); social-emotional (0.14); and overall (0.15). Similarly, total daily sleep time was correlated with the language (0.16), social-emotional (0.12), and overall (0.15) CREDI domains. Negative and significant correlations were found between time awake at night and all CREDI domains: cognition (−0.23); language (−0.15); motor (−0.21); social-emotional (−0.15); and overall (−0.17)https://doi.org/10.1016/j.jped.2024.09.002
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542024Experimental Evidence on Rural Childcare ProvisionDonald A., Lowes S.& Vaillant J. World Bank report NoWorld BankevaluationDemocratic Republic of the Congo6-48 months627 mother-child dyadsshort formin-person interviewsWomen are often the primary caregivers for children, which may restrict women’s economic activities. Evidence on the benefits of childcare is often from more developed urban settings. We examine how the provision of community-based childcare centers for children aged 2 to 6 in rural areas of the Democratic Republic of the Congo affects outcomes for women, their husbands, and children. Using a randomized controlled trial, we find that 73% of households provided with access to the centers use them. This translates into a reduction in the amount of time women spend on childcare. The centers lead to significant increases in women’s engagement in commercial agriculture, plot productivity and monthly income. We find some evidence that these benefits may arise from a decrease in women’s need to multi-task while farming. Additionally, women report an increase in their concentration and sense of control. We also observe changes in men’s economic activities: they are more likely to be engaged in non-agricultural self-employment and experience an increase in income in this sector. Finally, children benefit from attending childcare centers; we find evidence of improvements in early childcare development
indicators. Our results underscore the broad welfare benefits of increasing childcare access in low-income
rural settings.
as an outcome for an RCTwe find a significant increase of 0.76 in the CREDI score, measured for children aged 6 to 48 months. This amounts to an increase of 7 percent in the index. We do not detect a significant change in our child development measure for older children using MELQOhttps://documents1.worldbank.org/curated/en/099030725162010336/pdf/P143272-6d48017d-980e-4a63-9ef3-76e5157b9523.pdf
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552025Perceived Stress Of Mothers, Harsh Discipline, and Early 143 Childhood Mental Health: Insights From a Cross-Sectional Study in Marginalized Roma CommunitiesChovan, Shoshana dissertation YesUniversity of GroningendescriptiveSlovakiaSlovak
18 and 24 months
173 mother-child dyadslong formMothers filled out paper self-report questionnaires This study aims to compare the early childhood mental health of children from marginalized Roma communities (MRCs) in Slovakia with
that of the majority and explore possible mediating pathways of mothers’
perceived stress and harsh discipline practices.
Methods
We used data from the first wave of the longitudinal RomaREACH study
collected in 2021–2022. Two populations were included in the sample:
94 mother-child dyads from MRCs and 79 from the majority population
(children aged 14–18 months). Data were analysed using linear regression, and mediation was tested using PROCESS Macro in SPSS.
Results
Belonging to MRCs vs. the majority, perceived stress of mothers and
harsh discipline were found to be associated with early mental health
problems in children. Perceived stress of mothers partially mediates the
relationship between belonging to MRCs vs. majority and harsh discipline and harsh discipline partially mediates the relationship between
perceived stress of mothers and the mental health of children.
Conclusion
Mothers from MRCs perceive more stress, which is associated with more
frequent use of harsh discipline practices having a negative impact on the
mental health of young children.
as an outcome in mediation modelsHarsh discipline partially mediates the relationship between belonging to marginalized Roma communities vs. the majority and the mental health of children (b= 0.24, t= 2.19) and the relationship between perceived stress of mothers and the mental health of children (b= 0.06, t= 2.61) Sum-score ranged from 0 to 9 (Cronbach’s α=0.64).https://pure.rug.nl/ws/portalfiles/portal/1180558445/Chapter_06.pdf
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562025Breastfeeding and Complementary Feeding are Associated With Cognition and Vision in Rural Ghanaian InfantsAmoako, M. et al.Reproductive, Female and Child HealthYesKwame Nkrumah University of Science and Technology, Kumasi,GhanadescriptiveBosomtwe district, Ghana6‐23 months279 childrenlong formNAImportance: Dietary patterns during infancy play a key role in shaping developmental outcomes including vision and cog-nition in children.Objective: This study sought to investigate the association between breastfeeding, complementary feeding patterns and childdevelopmental outcomes including cognition, vision, motor skills, language and socio‐emotional development.Methods: This cross‐sectional study recruited two hundred and seventy (270) children aged 6‐23 months from rural areas in theBosomtwe district through convenience sampling. Data on socio‐demographics, breastfeeding practices, complementary feedingpractices and food frequency were collected. Haemoglobin concentration was assessed using standard protocols. Cognition wasassessed with the Caregiver Reported Early Development Instruments while visual acuity was assessed with Teller Acuity Cards.Results: Two major dietary patterns were identified within the population; Vegetable‐enriched Indigenous Diet (VID) patternand Milk‐enriched Cereals & infant Formular (MCF) pattern. The VID pattern significantly improved the odds of a better visualacuity (OR = 4.55, 95 CI: 1.62–12.80, p = 0.004) and language skills (OR = 1.90, 95% CI: 1.02–3.54, p = 0.043) whiles the MCFpattern improved the likelihood of good cognition (AOR = 2.00 95% CI: 1.028–3.90, p = 0.041). Continued breastfeeding wassignificantly associated with good cognition (AOR: 4.30, 95% CI: 2.03–9.14).Interpretation: Breastfeeding and Milk‐enriched cereals and Infant formula patterns were associated with cognition.Vegetable‐enriched indigenous pattern improved the odds of visual acuity and language development. Interventions aimed atpromoting optimal nutrition and supporting breastfeeding practices could significantly enhance developmental outcomesamong children in similar settings.as an outcome for a descriptive study2.96% of the participants had developmental deficits, regarding motor skills, 29.26% of theinfants showed developmental deficits while about 70.74%showed optimal development. Approximately 35.56% and32.22% of infants had deficits in language and socio‐emotional skills development, respectively....After adjusting for age and sex, continuedbreastfeeding remained significantly associated with goodcognition (AOR: 4.30, 95% CI: 2.03 – 9.14) and good motorskills (AOR: 2.72 95% CI: 1.45–5.23), and the association wasextended to good language skills (AOR: 3.69, 95% CI:1.76–7.51) and good socio‐emotional skills (AOR = 3.79, 95%CI: 1.85–7.78).https://onlinelibrary-wiley-com.ezp-prod1.hul.harvard.edu/share/DEI9G5BWHNZAI8U65C4G?target=10.1002/rfc2.70025
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572025Validation of the Global Scales of Early Development (GSED) tool in rural Western KenyaJeong, J. et al.BMC Public HealthYesRollins School of Public Health, Emory UniversityvalidationKenya
preferred language (i.e., Kiswahili, Luo, Luhya, or English)
0-24 months647 childrenlong formin-person interviewsBackground
Early childhood development (ECD) is a key determinant of long-term health, education, and wellbeing. However, one major global challenge is the lack of ECD assessment tools validated for use in low- and middle-income countries. To address this gap, the World Health Organization (WHO) launched in 2023 the Global Scales for Early Development, an open-access tool designed to generate reliable, valid, and internationally-comparable data on ECD for children aged 0–3 years globally. In this study, we examined the concurrent and convergent validity of the Global Scales for Early Development-long form (GSED-LF) for use with children aged 0–24 months in Kenya.

Methods
We analyzed baseline data collected in October-November 2023 as part of a cluster-randomized controlled trial evaluating a parenting program for improving ECD in rural Western Kenya. Primary caregivers (91% mothers) with a child under 24 months were enrolled across 64 villages in Busia and Homabay counties. The GSED-LF was administered to all children (N = 647). In a randomly selected sub-sample of children (N = 116), the Bayley Scales of Infant and Toddler Development (Bayley-III) and the Caregiver Reported Early Development Instruments (CREDI) were also administered to compare their scores with those from the GSED-LF. Concurrent validity of GSED-LF was assessed in terms of its correlations with Bayley-III and CREDI. Convergent validity of GSED-LF was examined with respect to parenting outcomes, including parental stimulation, home caregiving environment, and maternal mental health.

Results
GSED-LF scores had moderate associations with those on the Bayley and CREDI across the domains of cognitive, language, and motor development. GSED-LF had small associations with socioemotional development and relatively weaker concurrent validity for younger children under 12 months. GSED-LF also demonstrated good convergent validity in terms of showing moderate associations with maternal and paternal stimulation and the home caregiving environment.

Conclusions
Overall, this study demonstrated the feasibility and initial validity of the GSED-LF as a direct assessment tool for use in rural Western Kenya. Additional psychometric analyses across diverse settings are needed to strengthen the reliability and validity evidence of the GSED-LF and establish it as a robust, globallyapplicable tool for assessing ECD in resource-limited settings.
as one of the ECI measures (along with GSED LF and Bailey)Holistic D-score on the GSED was consistently associated with cognitive, language, and motor development subscale scores on both the Bayley and CREDI. The associations between the GSED and both the Bayley and CREDI were smaller and mostly not statistically significant for children under one year, whereas they were larger and more robust for children older than one year.
Positive correlations were also observed between the GSED and the cognitive, motor, and socioemotional subscales of the CREDI. Again, the motor subscale of the CREDI has the largest associations with the GSED (r = 0.29). CREDI language and mental health subscale scores were not significantly associated with the GSED.
Upon stratifying by child age, GSED D-scores were more consistently and strongly associated with both the Bayley-III and CREDI scores among older children aged 13–24 months compared to younger children aged 0–12 months (Table 3). For older children, GSED D-scores had moderate-sized associations with most domains of the Bayley-III and the CREDI (r = 0.32–0.49), except for the Bayley-III’s expressive language, fine motor, and socioemotional domains and the CREDI child mental health domain. On the other hand, for younger children, GSED D-scores had smaller associations with Bayley-III and CREDI domain scores, most of which were not statistically significant (r = 0.02–0.31).
magnitude of associations between GSED and CREDI were generally similar between boys and girls, apart from CREDI socioemotional motor development for which the associations were larger among boys than girls.
Table 4: positive and significant correlations between maternal stimulation, paternal stimulation and HOME and all four domains of CREDI (excluding mental health)
https://doi-org.ezp-prod1.hul.harvard.edu/10.1186/s12889-025-21801-9
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582025The Challenges of Scaling up Effective Child-Rearing Practices Using Technology in Developing Settings: Experimental Evidence From IndiaArteaga, Barros & GanimianJournal of Research on Educational Effectiveness YesUniversity of MissourievaluationIndiaHindi6-30 months2,433 caregiversshort formphone interviewsHome-visitation programs have improved child development in low- and middle-income
countries, but they are costly to scale due to their reliance on trained workers. We
evaluated an inexpensive and low-tech alternative with 2,433 caregivers of children aged
6 to 30 months served by 250 public childcare centers in Uttarakhand, India: automated
phone calls offering parenting advice. The intervention was implemented largely as
intended, with more than two-thirds of caregivers completing at least 10 calls. Yet,
counter to expectations, it had negative but statistically insignificant effects on caregivers’
knowledge and interactions with their children, reduced their self-efficacy (by 0.11
standard deviations), and increased their anxiety (by 0.10 standard deviations). Consistent
with this pattern, it had precisely estimated null effects on children’s development and
language. An analysis of program materials suggests four reasons why the program
may not have had the desired effects.
as an outcome for evaluating a phone-based parenting interventionsNull effect on children’s overall development (CREDI z-score difference=0.003 (0.039)https://www-tandfonline-com.ezp-prod1.hul.harvard.edu/doi/full/10.1080/19345747.2025.2450318#d1e1285
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