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1 | Number | Year | Title | Authors | Journal | Peer-reviewed? | Organization | Type of paper | Countries | Language used | Age groups | Sample size | Form used | Modes of delivery | Abstract | CREDI Use | CREDI evidence | CREDI Psychometric Evidence | Link | ||||||||||
2 | 1 | 2017 | Development and validation of an early childhood development scale for use in low-resourced settings | Dana Charles McCoy, Christopher R. Sudfeld, David C. Bellinger, Alfa Muhihi, Geofrey Ashery, Taylor E. Weary, Wafaie Fawzi & Günther Fink | Population Health Metrics | Yes | Harvard University | validation | Tanzania (Morogoro region) | Swahili | 18-36 months | 2481 | long form | household interviews, clinic visits | Low-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 purpose | 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. 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 | |||||||||||
3 | 2 | 2017 | Effect 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 trial | Sudfeld, C.R., Manji, K.P., Duggan, C.P. et al. | BMC | No | Harvard T.H. Chan School of Public Health | RCT protocol | Tanzania | 0-12 months | 2300 | long form | home visits | The 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 | |||||||||||||
4 | 3 | 2018 | Measuring early childhood development at a global scale: Evidence from the Caregiver-Reported Early Development Instruments | Dana Charles McCoya, Marcus Waldmana, CREDI Field Team1, Günther Fink | Early Childhood Research Quarterly | Yes | Harvard University | validation | 17 countries | local languages | 0-35 months | 8022 | short form | in-person interviews, online survey | Despite 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 purpose | Average CREDI scores varied substantially across country sites | The 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 | ||||||||||
5 | 4 | 2018 | The impact of integrated nutrition-sensitive interventions on nutrition and health of children and women in rural Tanzania: study protocol for a cluster-randomized controlled trial | Mosha, D., Canavan, C.R., Bellows, A.L. et al. The | BMC Nutrition | No | Africa Academy for Public Health, Dar es Salaam, Tanzania | RCT study protocol | Rufiji district, Tanzania | 6–36 months | 1006 households | household visits | This 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 children | https://doi.org/10.1186/s40795-018-0238-7 | ||||||||||||||
6 | 5 | 2018 | Protocol 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 Open | No | Nuffield Institute for International Health and Development, Leeds University | study protocol | Dhaka, Bangladesh | N/A | under 3 years old | expecting 193 households | N/A | considering | Children 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 | ||||||||||||
7 | 6 | 2018 | Improving early childhood development in rural Ghana through scalable low-cost community-run play schemes: Baseline report | Amadu, Salifu et al. | Institute for Fiscal Studies | No | The Institute for Fiscal Studies, Innovations for Poverty Action, Ghana | RCT report | Ghana | under 3 years old | 6,446 target children | short form | household visits | This 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<0.01 | http://hdl.handle.net/10419/201784 | ||||||||||||
8 | 7 | 2018 | Maternal education and socioeconomic status of family as predictors of early childhood development in Armenia | Hakob Karapetyan | disseration | No | Gerald & Patricia Turpanjian School of Public Health, American University of Armenia | descriptive | Amernia (Yerevan) | Armenian | 10-36 months | 225 | long form | in-person household interviews | Early 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 | |||||||||||
9 | 8 | 2018 | Prenatal nutrition, stimulation, and exposure to punishment are associated with early child motor, cognitive, language, and socioemotional development in Dar es Salaam, Tanzania | Pitchik, H. O., Fawzi, W. W., McCoy, D. C., Darling, A. M., Abioye, A. I., Tesha, F., ... & Sudfeld, C. R. | Child: care, heath and development | Yes | School 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 Sciences | evaluation | Tanzania | Swahili | 18–36 months | 608 children | long form | in-person interview using Android tablet | Despite 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 supplementation | Children 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 | |||||||||||
10 | 9 | 2018 | Positive parenting as a critical element in child development: The Philippine experience | Maria Perlita E. de Leon, Catherine A. Manzano, Whimcy Luck C. Sagpang | conference | No | Save the Children | Philipines | N/A | 0 to 4 years | N/A | N/A | N/A | Save 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 CREDI | https://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 | ||||||||||||
11 | 10 | 2019 | A 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 countries | Marlow, Servili & Tomlinson | Autism Research | Yes | Stellenbosch University, South Africa | systematic review | N/A | N/A | N/A | N/A | N/A | N/A | Without 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 | |||||||||||||
12 | 11 | 2019 | Trial of thiamine supplementation in Cambodia | Whitfield, K. et al. | No | Department of Applied Human Nutrition Mount Saint Vincent University | RCT protocol | Kampong Thom province, Cambodia | 0-13 months | 192 women | long form | interviews | Objectives: 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 doses | https://classic.clinicaltrials.gov/ProvidedDocs/88/NCT03616288/Prot_SAP_001.pdf | ||||||||||||||
13 | 12 | 2019 | Contextual variation in young children’s acquisition of social-emotional skills | Dana C. McCoy, Jorge Cuartas, Marcus Waldman, Günther Fink | PLOS One | Yes | Harvard University | descriptive | 11 sites across 10 countries | country-dependent | 0 to 35 months | 5,447 infants’ and toddlers’ | long form | This 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 comparision | The 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 | |||||||||||
14 | 13 | 2020 | Measuring 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) | Yes | IVEPESP | validation | Brazil | Portuguese | 0-35 months | 1,265 | short form | in-person interviews, online survey | The 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 characteristics | https://doi.org/10.1016/j.jpedp.2018.11.001 | ||||||||||||
15 | 14 | 2020 | Assessing the performance of the Caregiver Reported Early Development Instruments (CREDI) in rural India | Harold Alderman, Jed Friedman, Paula Ganga, Mohini Kak, Marta Rubio-Codina | Annals of the New York Academy of Sciences | Yes | International Food Policy Research Institute, World Bank, Columbia University | validation | India (Madhya Pradesh) | Hindi | 22–35 months | 994 | long form | household interviews | Although 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 | ||||||||||||
16 | 15 | 2020 | Reliability and validity of the Caregiver Reported Early Development Instruments (CREDI) in impoverished regions of China | Ying Li, Lei Tang, Yu Bai, Shuhang Zhao & Yaojiang Shi | BMC Pediatrics | Yes | Minzu University of China, China Institute for Vitalizing Border Areas and Enriching the People | validation | China | Chinese | 5–36 months | 946 | long form | verbal interviews | There 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 | ||||||||||||
17 | 16 | 2020 | Relationship between docohexaenoid acid in breastmilk and development scores at infant 18–23 months of age | Karmila Sarih, Saifuddin Sirajuddin, Tahir Abdullah et al. | Enfermería Clínica | Yes | Hasanuddin University, Indonesia | descriptive | Tanzania | NA | 18 and 23 months | 64 | long form | N/A | This 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 | ||||||||||||
18 | 17 | 2020 | Evaluating the Effects of a Child-focused Water, Sanitation, and Hygiene (WASH) Intervention in Laos | Wright, Dorianne B | N/A | No | Department of Psychology, Graduate School of the University of Oregon | dissertation, RCT | Laos | Khmu, Hmong, or Lao | 0-60 months | 145 children | long form | electronic 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 hygiene | http://search.proquest.com.ezp-prod1.hul.harvard.edu/dissertations-theses/evaluating-effects-child-focused-water-sanitation/docview/2436411993/se-2 | ||||||||||||
19 | 18 | 2021 | Measuring early childhood development: considerations and evidence regarding the Caregiver Reported Early Development Instruments | Dana Charles McCoy, Jonathan Seiden, Marcus Waldman, Günther Fink | Harvard University | commentary | Reflecting 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 | |||||||||||||||||||||
20 | 19 | 2021 | Validation of motor, cognitive, language, and socio-emotional subscales using the Caregiver Reported Early Development Instruments: An application of multidimensional item factor analysis | Waldman, M., McCoy, D. C., Seiden, J., Cuartas, J., & Fink, G. | International Journal of Behavioral Development | Yes | Harvard University | validation | 17 high- and LMICs | multiple | 0-36 months | 14,113 caregiver reports | long form | N/A | The 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 | |||||||||||||
21 | 20 | 2021 | Psychometric properties of the Child Development Assessment Questionnaire (QAD-PIPAS) for use in population studies involving Brazilian children aged 0-59 months | Venancio, S. et al. | Jornal de Pediatria | Yes | São Paulo State Department of Health | validation for another instrument | Brazil | Portuguese | 0-36 months | 2005 children | short form | Interviews through clinic visits | This 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 | 21 | 2021 | Effects of a Government-Led Parenting Programme on Early Child Development Outcomes in Rural China: A Cluster-Randomised Controlled Trial | Bai, Yu et al. | International Association of Agricultural Economists Conference | No | Center of Experimental Economics in Education (CEEE), Shaanxi Normal University | evaluation | rural China | Chinese | 6-27 months | 621 | long form | phone interviews | Over 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 counties | Parenting 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 | ||||||||||
23 | 22 | 2021 | A home visit-based early childhood stimulation programme in Brazil—a randomized controlled trial | Brentani, A. et al. | Health Policy and Planning | Yes | Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP) | evaluation | Brazil | N/A | 9–15 months | 900 children | long form | Household interviews | Home 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 | |||||||||||
24 | 23 | 2021 | Effects of Two Early Childhood Interventions on the Developmental Outcomes of Children in Post-Earthquake Nepal | Seiden, J. et al. | Journal on Education in Emergencies | Yes | Save the Children | evaluation | Nepal | Nepali | 0-24 months | 363 children | long form | Household interviews | Natural 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 | |||||||||||
25 | 24 | 2021 | Breastfeeding, Physical Growth, and Cognitive Development | Wallenborn, J. et al. | Pediatrics | Yes | Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel | descriptive | São Paulo, Brazil | NA | NA | 2288 | NA | NA | Breastfeeding 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 | |||||||||||
26 | 25 | 2021 | A multi-center longitudinal study on responsive breastfeeding in China from the perspective of health equity: research protocol | Shu, W. et al. | International Journal for Equity in Health | Yes | Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China | RCT protocol | China | Chinese | 700 mothers (estimating) | short form | online questionnaire | The 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 months | https://doi.org/10.1186/s12939-021-01430-5 | |||||||||||||
27 | 26 | 2021 | Neurodevelopmental outcomes of being born during the COVID-19 pandemic and the role of early tactile experiences | Antunes, Joana Carolina Simões | dissertation | No | University of Minho | descriptive | Portugal | Portugese | 0-12 months | 524 mothers | long form | online questionnaire | Recent 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 | ||||||||||||
28 | 27 | 2022 | Caregiver parenting practices, dietary diversity knowledge, and association with early childhood development outcomes among children aged 18-29 months in Zanzibar, Tanzania: a cross-sectional survey | Russell, A.L., Hentschel, E., Fulcher, I. et al. | BMC Public Health | Yes | D-tree International, Zanzibar, Tanzania | descriptive | Zanzibar, Tanzania | Kiswahili | 18-29 months | 499 children | long form | Household interviews | Many 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 | 28 | 2022 | Parental locus of control and early childhood development: Evidence on parent and grandparent caregivers in rural China | Yu Bai, Dorien Emmers, Ying Li & Lei Tang | China Economic Review | Yes | School of Economics, Minzu University of China, | descriptive | rural Shaanxi Province, China | Mandarin | 6 to 36 months | 995 children | long form | Household interviews | This 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 orientation | No 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 | |||||||||||
30 | 29 | 2022 | Association of Exposure to Intimate Partner Violence With Maternal Depressive Symptoms and Early Childhood Socioemotional Development Among Mothers and Children in Rural Tanzania | Oliveira, C. et al. | JAMA network | Yes? | School of Nursing, University of Nevada, Las Vegas, Harvard T. H. Chan School of Public Health, Ifakara Health Institute, Dar es Salaam, Tanzania | descriptive | Tanzania | N/A | 18-24 months | 388 children | socioemotional scale in the long form (20 items) | Household interviews | To 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 development | internal 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 | |||||||||||
31 | 30 | 2022 | Risk and protective factors to early childhood development during the COVID-19 pandemic | Costa, P. et al. | Journal of School of Nursing, São Paulo | No | Universidade Federal de São Paulo, Brazil | descriptive | São Paulo, Brazil | N/A | 0 to 35 month | 108 guardians | short form | electronic form | Objective: 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 | ||||||||||||
32 | 31 | 2022 | Supporting Reading Aloud Beginning Prenatally and in Early Infancy: A Randomized Trial in Brazil | Piccolo, Luciane R. et al. | Journal of Developmental & Behavioral Pediatrics | Yes | Instituto de Medicina Integral Professor Fernando Figueira | evaluation | Brazil | Portugese | 0 to 24 months | 400 families | long form | household 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 interventio | Cronbach's α in this sample was 0.80 | https://doi.org/10.1097/DBP.0000000000001118 | |||||||||||
33 | 32 | 2022 | Cohort 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 Open | No | Harvard University T H Chan School of Public Health | descriptive | Brazil | Portugese | N/A | 351 mothers | long form | phone interviews | Maternal 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 | 33 | 2022 | Effects of HIV Exposure, TB and HIV Treatment, and Isoniazid Preventive Therapy on Prognosis and Growth Trajectories of Children | Cherkos, Ashenafi Shumey | dissertation | No | University of Washington | evaluation | Western Kenya | N/A | 24-35 months | 400 mothers | short form | study vitis | The 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 | 34 | 2023 | Impact of a nutrition-sensitive agroecology program in Andhra Pradesh, India, on dietary diversity, nutritional status, and child development | Durga, L. et al. | medRxiv | No | Harvard T.H. Chan School of Public Health | RCT outcome evaluation | Andhra Pradesh, India | N/A | 0-36 months | 3,511 households | short form | NA | 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. 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 intervention | 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). 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 | 35 | 2023 | Unmasking the Effect of Teachers’ Socio-Demographic Attributes on Promoting Early Childhood Development: Children’s Cognitive and Emotional Empathy into School | Ul Hassan, M., Kouser, T., Hussain Chaudhary, A. et al. | International Journal of Early Childhood | Yes | Department of Education, The University of Lahore | descriptive | Punjab, India | NA | from 2 years old | 3082 teachers | short form | classroom interview with teachers during class time | Lifespan 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/10.1007/s13158-023-00360-3 | |||||||||||
37 | 36 | 2023 | Intimate Partner Violence Against Brazilian Mothers is Associated With Their Children’s Lower Quality-of-Life Scores: A Cross-Sectional Study During the COVID-19 Pandemic | Mélo, T. et al. | Health Services Insights | Yes | Federal University of Paraná, Brazil | descriptive | Brazil | Portuguese | 0-36 months | 701 children | short form | Google Forms, internet-based | The 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 violence | https://doi-org.ezp-prod1.hul.harvard.edu/10.1177/11786329231157550 | ||||||||||||
38 | 37 | 2023 | Associations Between Social Support and Symptoms of Antenatal Depression with Infant Growth and Development Among Mothers Living with HIV in Tanzania | Saleh, A. et al. | AIDS and Behavior | Yes | Harvard TH Chan School of Public Health, | descriptive | Tanzania | N/A | 12 months | 1,312 infants | long form | one-on-one interview with trained study nurses | Children 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 scores | https://doi-org.ezp-prod1.hul.harvard.edu/10.1007/s10461-023-04073-5 | ||||||||||||
39 | 38 | 2023 | Family-level factors of early childhood development: Evidence from rural China | Ma, Y. et al. | Infant Behavior and Development | Yes | Stanford Center on China’s Economy and Institutions | descriptive | Southwestern China | 18–24 months | 77 households | long form | household interview or hospital interview | Family-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 development | Stimulating parenting is significantly correlated with overall, cognitive, and language development | https://doi.org/10.1016/j.infbeh.2022.101787 | ||||||||||||
40 | 39 | 2023 | Co-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 One | No | University of Edinburgh | RCT protocol | India | Telugu | < 38 months | N/A | offline mobile app administered by data collectors | The 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 households | At 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 | ||||||||||||
41 | 40 | 2023 | Fostering early childhood development in low-resource communities: Evidence from a group-based parenting intervention in Tanzania | Leighton, M. et al. | World Development | Yes | University of St Andrews Castlecliffe | evaluation | Tanzania | N/A | 4-36 months | 2,289 children | long form | household interviews | Group-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 domain | https://doi.org/10.1016/j.worlddev.2023.106335 | |||||||||||
42 | 41 | 2023 | Risks to Child Development and School Readiness Among Children Under Six in Pakistan: Findings from a Nationally Representative Phone Survey | Hentschel, E. et al. | International Journal of Early Childhood | Yes | Harvard T.H. Chan School of Public Health | descriptive | Pakistan | 0-3 years | 3,021 caregivers | short form | phone interviews | This 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 factors | Consistent 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 0.91 | https://rdcu.be/dv7O5 | |||||||||||
43 | 42 | 2023 | The home language environment and early childhood development: a LENA study from rural and peri-urban China | Zhang, X. et al. | Applied Developmental Science | Yes | Stanford Center on China’s Economy and Institutions | descriptive | rural and urban Western China | Mandarin | 18–24 months | 158 children | long form | household/hospital interviews | The 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 environment | The 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 CREDI | https://doi.org/10.1080/10888691.2023.2267440 | ||||||||||
44 | 43 | 2023 | How does the family environment affect toddlerhood language and cognitive development? Evidence from peri-urban China | Yue M. et al. | Applied Developmental Science | Yes | Freeman Spogli Institute for International Studies, Stanford University, School of Public Administration, Northwest University, Xi’an, China | descriptive | Southwestern China | Mandarin | 18-24 months | 81 households | long form | household interviews | Research 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 0.713 | doi.org/10.1080/10888691.2023.2165077 | ||||||||||
45 | 44 | 2023 | Assessing environmental enteric dysfunction via multiplex assay and its relation to growth and development among HIV-exposed uninfected Tanzanian infants | Lauer J.M. et al. | PLOS Neglected Tropical Diseases | Yes | Department of Health Sciences, College of Health & Rehabilitation Sciences: Sargent College, Boston University | descriptive | Tanzania | 12 months | 467 infants of mothers living with HIV | long form | clinic interviews | Environmental 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 | ||||||||||||
46 | 46 | 2024 | Beyond Poverty Reduction: Evidence from a Multifaceted Program on Poverty, Nutrition, and Child Development | Bouguen & Dillon | Journal of Development Economics | Yes | Northwestern University - Kellogg School of Management | evaluation | Burkina Faso | 0- 36 months | 3500 households | long form | NA | We 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 intervention | Using 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 | ||||||||||||
47 | 47 | 2024 | Willingness-to-pay for early childhood development: A field experiment in Western China | Wang et al. | China Economic Review | Yes | Business School, Shaanxi Normal University, Shaanxi, China | descriptive | China | Chinese | 6–35 months | 79 | long form | NA | Given 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 communities | Although 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 | ||||||||||
48 | 48 | 2024 | Evidence of potential impacts of a nutrition-sensitive agroecology program in Andhra Pradesh, India, on dietary diversity, nutritional status, and child development | Durga, L. et al. | Plos One | Yes | Global Academy of Agriculture and Food Systems, The University of Edinburgh, Midlothian, United Kingdom/ International Food Policy Research Institute, Washington, DC, United States of America | evaluation | India | 0- 36 months | 3,511 households (1,121 intervention and 2,390 control) | short form | NA | While 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 | ||||||||||||
49 | 49 | 2024 | The 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 Childhood | Yes | Harvard, University of Pennsylvannia | descriptive | multiple | multiple | 0- 36 months | 9,099 children | long form | NA | Caregiver 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/10.1007/s13158-024-00398-x | |||||||||||
50 | 50 | 2024 | The gender gap in early language development among children from peri-urban China | Ma et al. | Early Childhood Research Quarterly | Yes | School of Public Administration, Northwest University, Xi'an, China | descriptive | China | Chinese | 18-24 months | 81 children | long form | NA | In 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 differences | Girls 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 | ||||||||||
51 | 51 | 2024 | Effectiveness of lipid-based nutrient supplementation during the first 1000 days of life for early childhood development: A community-based trial from Pakistan | Imtiaz, A. et al. | Maternal & Child Nutrition | Yes | Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar | evaluation | Pakistan | Pashto | 6-24 months | 1204 mothers | long form | interviews | 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 interventio | At 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 = 0.009 | https://doi-org.ezp-prod1.hul.harvard.edu/10.1111/mcn.13727 | |||||||||||
52 | 53 | 2024 | Effect of sleep duration on child development in Fortaleza, Northeastern Brazil | Castro, S. et al. | Jornal de Pediatria | Yes | Universidade Federal do Ceará (UFC), Departamento de Fisioterapia, Fortaleza, CE, Brazil | descriptive | Brazil | 278 mother-child dyads | 278 mother-child dyads | long form | NA | The 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 outcome | Among 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 | ||||||||||||
53 | 54 | 2024 | Experimental Evidence on Rural Childcare Provision | Donald A., Lowes S.& Vaillant J. | World Bank report | No | World Bank | evaluation | Democratic Republic of the Congo | 6-48 months | 627 mother-child dyads | short form | in-person interviews | Women 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 RCT | we 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 MELQO | https://documents1.worldbank.org/curated/en/099030725162010336/pdf/P143272-6d48017d-980e-4a63-9ef3-76e5157b9523.pdf | ||||||||||||
54 | 55 | 2025 | Perceived Stress Of Mothers, Harsh Discipline, and Early 143 Childhood Mental Health: Insights From a Cross-Sectional Study in Marginalized Roma Communities | Chovan, Shoshana | dissertation | Yes | University of Groningen | descriptive | Slovakia | Slovak | 18 and 24 months | 173 mother-child dyads | long form | Mothers 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 models | Harsh 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 | ||||||||||
55 | 56 | 2025 | Breastfeeding and Complementary Feeding are Associated With Cognition and Vision in Rural Ghanaian Infants | Amoako, M. et al. | Reproductive, Female and Child Health | Yes | Kwame Nkrumah University of Science and Technology, Kumasi,Ghana | descriptive | Bosomtwe district, Ghana | 6‐23 months | 279 children | long form | NA | Importance: 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 study | 2.96% 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 | ||||||||||||
56 | 57 | 2025 | Validation of the Global Scales of Early Development (GSED) tool in rural Western Kenya | Jeong, J. et al. | BMC Public Health | Yes | Rollins School of Public Health, Emory University | validation | Kenya | preferred language (i.e., Kiswahili, Luo, Luhya, or English) | 0-24 months | 647 children | long form | in-person interviews | Background 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 | |||||||||||
57 | 58 | 2025 | The Challenges of Scaling up Effective Child-Rearing Practices Using Technology in Developing Settings: Experimental Evidence From India | Arteaga, Barros & Ganimian | Journal of Research on Educational Effectiveness | Yes | University of Missouri | evaluation | India | Hindi | 6-30 months | 2,433 caregivers | short form | phone interviews | Home-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 interventions | Null 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 | |||||||||||
58 | 59 | 2026 | Digital support systems to improve child development in Peru: A cluster-randomized controlled open-label trial | Fink et al. | Science Advances | Yes | Basel Research Centre for Child Health | evaluation | Peru | 25-41 months | 2461 households | short form | in-person interviews | Digital technologies have the potential to transform early childhood development (ECD) interventions by delivering personalized support at scale. We conducted a cluster-randomized controlled trial in rural Peru to evaluate the effectiveness and cost-effectiveness of an artificial intelligence–supported digital parenting chatbot as well as traditional home visits as interventions to improve child development. Among 2461 caregiver-child dyads, both the digital and home-visiting interventions improved child development outcomes at 2.5 years of age, with standardized effect sizes of 0.11 and 0.17, respectively. At 1/15 of the cost of in-person support, the digital intervention yielded superior cost-effectiveness. These findings suggest that digital platforms can be a viable, scalable alternative to support children’s development in resource-constrained settings. | as an outcome for a digital parenting intervention | Effects of similar magnitudes were found for caregiver-reported child development, with HVs increasing child development by 0.10 SD ([−0.02, 0.22]) and DI increasing child development by 0.12 SD ([0.01, 0.23]) in the fully adjusted models | https://www.science.org/doi/full/10.1126/sciadv.aeb9403 | ||||||||||||
59 | 60 | 2026 | Development and Validation of the Nurturing Parenting Beliefs and Behaviors Scale (NPBBS): Measuring Parenting in High Andean Peru | Hickley, K. et al. | Developmental Psychology | Yes | Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland | validation | Peru | 24–48 months | 2274 dyads | short form | in-person interviews with tablets | Despite growing interest in supporting caregivers’ use of nurturing care globally, few parenting measures have been validated for use outside of Minority World contexts. This study aims to develop, describe, and provide validity evidence for an efficient, culturally relevant instrument to measure local nurturing parenting beliefs and behaviors regarding responsive caregiving and early learning within a sample of caregivers of 2- to 5-year-olds in Cajamarca, Peru. We used a multiple methods phased study design to develop the self-reported parenting instrument, Nurturing Parenting Beliefs and Behaviors Scale, including qualitative interviews, focus groups, cognitive testing, and quantitative pilot testing. The final validation sample included 2,274 mothers of children (Mage = 29.41 months, 49.56% female) from Cajamarca, Peru. We used exploratory and confirmatory factor analysis to examine the factor structure of the instrument and correlations and regressions to validate it against parenting and child development outcomes. Results indicate a two-factor structure reflecting nurturing parenting beliefs (α = .84) and behaviors (α = .82). Analyses of concurrent validity showed that the parenting beliefs and behaviors subscales correlated positively with parental stimulation and learning materials. Both parenting beliefs and behaviors positively predicted early childhood development (parent report and direct assessment). This instrument can be used as a starting point for measuring parenting in other Majority World contexts with similar caregiver characteristics. | as an outcome to establish predictive validity for a parenting belief/behavior scale | We saw that both parenting beliefs and behaviors positively and significantly predicted directly assessed (GSED) and parent-reported ECD (CREDI). beta=0.31 (0.06) for parenting belief and 0.55 (0.04) for parenting behaviors | https://doi.org/10.1037/dev0002037 | ||||||||||||
60 | 61 | 2025 | The barriers to female employment: Experimental evidence from Egypt | Caria, S. et al. | LIC Working Paper | No | IZA Institute of Labor Economics | evaluation | Egypt | Arabic | 0-35 months | 919 | short form | Can making jobs easier to find and keep raise female employment in societies where gender norms discourage women from working? We report the results of an experiment in Egypt — a country where social norms limiting female employment are widely held, but many women nevertheless look for work and identify lack of childcare as the key barrier to employment — designed to help women with young children obtain employment. The study cross-randomized job matching (making jobs easier to find) and child care subsidies (making jobs easier to keep). Take-up of the child care subsidies was low, and while nearly half of the women who were offered the opportunity signed up for the job-matching services, only some applied to jobs and very few obtained jobs through the services. Neither intervention led to appreciable changes in women’s employment or the use of child care. We present evidence that a mismatch between desired non-pecuniary job attributes and the attributes of available jobs limited the impacts of the interventions. While this may be partly due to gender norms, we also document a mismatch between desired and existing job attributes for couples who do not report restrictive norms. Overall, our results demonstrate the limits of female employment interventions that do not address — by either tackling norms or strengthening job amenities — the mismatch between desired and available non-pecuniary job attributes. | as an outcome for an intervention supporting females finding jobs | In terms of children’s development (Table D24), there is some suggestive evidence for the 100 percent discount, if anything, worsening development outcomes for younger children, based on the CREDI score (by 0.6 points relative to a control mean of 44). | https://g2lm-lic.iza.org/wp-content/uploads/2025/03/glmlic-wp092.pdf | ||||||||||||
61 | 62 | 2026 | Measuring parenting interactions in resource-constrained settings: Evidence from an observational tool implemented in Andean Peru. | McCoy, D. et al. | Psychological Assessment | Yes | validation | Peru | 24-48 months | 2,260 | short form | in-person interviews | Measuring parenting interactions in resource-constrained settings: Evidence from an observational tool implemented in Andean Peru. | as an outcome to establish criterion validity for a parenting interaction scale (Observation of Mother–Child Interactions assessment) | Mother-reported child development scores (using the CREDI) were also positively and significantly associated with maternal emotional support (b = 0.09, SE = 0.03, p < .01, ß = 0.05) and cognitive support (b = 0.11, SE = 0.02, p < .01, ß = 0.09). When controlling for mother-reported parenting measures, observed maternal emotional support predicted children’s CREDI scores only marginally ( p < .10)...When examining child development and behavior, emotional support no longer significantly predicted child development (GSED and CREDI) when using factor scores, whereas correlations for cognitive support were statistically significant and positive for all child development and behavior measures | https://doi.org/10.1037/pas0001462 | |||||||||||||
62 | 63 | 2026 | Climate predictors of child undernutrition: Insights from a machine learning model | Essiam, F. et al. | Plos One | Yes | University of Science and Technology, Kumasi, Ghana | descriptive | Ghana | 6–23 months | 270 children | long form | in-person interviews | In a mixed-method approach, a cross-sectional study assessed nutrition and child health outcomes in May 2024, while retrospective climate data was assessed spanning January 2022 to December 2023. The cross-sectional study recruited two hundred and seventy (270) children aged 6–23 months from rural areas in the Bosomtwe district. Anthropometry, hemoglobin concentrations, and food frequency were assessed using standard procedures. The collected data was standardized and subjected to principal component analyses to identify dietary patterns. Household food security was assessed using the USDA Household Food Security questionnaire, while the climate data was obtained from ERA5 reanalysis. Random forest algorithms were employed to evaluate the relative importance of various climatic factors in predicting undernutrition and morbidity. Decision trees were then derived from the models to examine interactions and thresholds. Results Rainfall emerged as the most critical climate predictors of stunting, while severe acute malnutrition was more sensitive to shortwave radiations. Temperature was the top predictor of fever, anaemia and diarrhoea. Low rainfall and high temperature substantially increased the possibility of undernutrition and morbidity. Threshold effects showed that rainfall below 4.78 mm and temperature under 23.40°C, increased stunting risk, especially when SW radiation drops below 6.01 W/m2. For severe acute malnutrition, rainfall below 5.53 mm and temperatures above 27.67°C significantly increased the risk. Conclusion This study finds significant influences of climate variables on child undernutrition, highlighting the importance of integrated climate health strategies that account for compound climate effects. These findings can inform the development of early warning systems and targeted interventions to mitigate climate-related health risks in vulnerable populations. | as an outcome to test the climate predictors of child undernutrition | The malnutrition and cognitive development indicators showed distinct hierarchical interactions between climate variables as shown by the decision tree splits in Fig 4. The root node split for stunting occurred at a rainfall threshold of 4.78 mm. Regions with rainfall ≤ 4.78 mm split into two child nodes; those with moderately cool temperatures (≤ 23.395 °C) exhibited improved stunting z-scores suggesting that moderate cooling synergizes with reduced rainfall to mitigate stunting severity. Regarding wasting, temperature emerged as the root node. Areas with moderate temperature specifically between 23.455 < T ≤ 24.985 °C together with LW < 417.21 W/m2 had lower wasting scores while those with lower temperature (≤ 23.395 °C) had better wasting scores. Rainfall emerged at the root node for underweight. Reduced rainfall (≤ 4.78 mm) together with low temperatures reduced the outcome of underweight. In areas with individuals exposed to higher rainfall and LW < 409.855 W/m2, underweight was higher. Low temperature (≤26.235 °C) together with rainfall below 5.545 mm contributed to better cognitive development. On the other hand, increasing temperature (> 26.235 °C) together with decreasing LW radiation (≤ 411.42 W/m2) contributed to worse cognitive development...Cognitive development in infants and young children showed a unique sensitivity to relative humidity, SW radiation and rainfall. This suggests an indirect but powerful influence of climatic stressors on neurodevelopment. High humidity and SW radiation reflects indirect heat-humidity synergies, which impair neurodevelopment through maternal stress and inflammation during pregnancy [31]. | https://doi.org/10.1371/journal.pone.0342448 | ||||||||||||
63 | 64 | 2026 | Prevalence and correlates of mental health difficulties in young Ghanaian children | Ahun, M. et al. | BMJ Global Health | Yes | McGill University | descriptive | Ghana | 6-36 months | 748 children | long form | KoBoToolbox form | Background Although 90% of youth live in low- and middle-income countries, only 10% of child mental health research is conducted in these settings. We sought to shed light on the mental health of Ghanaian children by estimating the prevalence of socioemotional difficulties and examining associations with psychosocial risk and protective factors. Methods Data come from the cross-sectional Mental Health in Ghana study. Mothers and fathers reported their depressive symptoms, positive mental health, parenting practices and sociodemographic and household characteristics. Mothers reported child (ages 6–60 months) characteristics, including mental health according to the Ages and Stages Questionnaire Social-Emotional (ASQ:SE-2) (administered for all children), Caregiver Reported Early Development Instruments (CREDI) (6–36 months old) and the Strength and Difficulties Questionnaire (SDQ) (37–60 months old). Receiver operating characteristic analysis was used to determine CREDI and SDQ cut-offs, with the ASQ;SE-2 as the gold standard. Multivariate linear regression analyses were used to examine associations with correlates. Findings Out of 750 households, 748 with data on child mental health were included in analyses. According to the CREDI and ASQ:SE-2, 35.9% (95% CI 31.4% to 40.4%) of 6–36 months old were at risk of experiencing socioemotional difficulties. Prevalence rates in 37–60 months old were slightly lower at 26.3% (95% CI 21.2% to 31.4%). The prevalence of socioemotional difficulties in the whole sample was 47.1% (95% CI 43.5% to 50.6%), with higher rates in male (51.6% (95% CI 46.5% to 56.7%)) compared with female (42.5% (95% CI 37.5% to 47.6%)) children. Maternal and paternal positive mental health and maternal use of positive disciplinary strategies were significantly associated with fewer socioemotional difficulties in female children. Only maternal positive mental health was a significant protective factor for male children’s mental health. Conclusion A high burden of socioemotional difficulties exists among young Ghanaian children. Parental positive mental health is a key protective factor, highlighting the importance of considering the full spectrum of parental mental health and its associations with child mental health. | to establish cut-off and determin proportion of children with mental health difficulties | The prevalence of socioemotional difficulties in the whole sample (n=748) was 47.1% (95% CI 43.5% to 50.6%). In 6–36 months old (n=444), prevalence rates significantly varied ( Inline Formula =36.69, p<0.001) across mental health measures, with the PCA-generated CREDI score indicating that 52.7% (95% CI 48.0% to 57.4%) children were at risk of experiencing socioemotional difficulties and the ASQ:SE-2 score indicating a prevalence of 54.4% (95% CI 49.8% to 59.1%). Overall, 35.9% (95% CI 31.4% to 40.4%) of 6–36 months old children were at risk of experiencing socioemotional difficulties according to both the CREDI and ASQ:SE-2 | PCA for the CREDI revealed that the component consisting of items 1, 3 and 5 (see table 2) demonstrated the strongest predictive relationship (p<0.001) with ASQ:SE-2 scores. The performance metrics and comparative analysis of the PCA-generated CREDI, SDQ and CREDI sum scores are shown in tables 3 and 4. The PCA-generated CREDI score demonstrates superior predictive capabilities compared with the CREDI sum score for mental health screening assessments. The former has a better model fit (BIC: 4271 vs 4388) and exhibits stronger diagnostic performance with a sensitivity of 0.63 and specificity of 0.66 at an optimal cut-off of 0.104, where higher values indicate more socioemotional difficulties. The PCA-generated CREDI score shows impressive predictive power with an OR of 3.28, meaning that when scores are above the cut-off, there is more than three times higher likelihood of identifying children with mental health concerns. The score’s effectiveness is further validated by its higher odds ratio (1.83) compared with the CREDI sum score (1.34) in logistic regression analysis. These robust statistical indicators, combined with its practical cut-off range of −2.27 to 2.67, suggest that the PCA-generated CREDI score is a reliable and efficient screening instrument for mental health assessment.... | https://doi.org/10.1136/bmjgh-2024-018658 | |||||||||||
64 | 65 | 2026 | Effects of a liquefied petroleum gas stove and fuel intervention and air pollution exposure on early childhood development: Findings from the household air pollution intervention network trial | Thompson, L. et al. | Environment International | Yes | School of Nursing, University of California, San Francisco | validation | rural Guatemala, Peru, India, and Rwanda. | Spanish (Guatemala and Peru); Kinyarwanda and Tamil languages | 12 months | 3195 pregnant women | long form | in-person interviews; REDCap forms | Early Child Development (ECD) encompasses physical, cognitive, social, and emotional changes during childhood. Air pollution exposure has been associated with ECD delays. The Household Air Pollution Intervention Network (HAPIN) randomized controlled trial evaluated the health effects of a liquefied petroleum gas cookstove and fuel intervention during pregnancy and infancy. Here we present the intervention effect and exposure–response relationship between fine particulate matter (PM2.5) and ECD. Methods The HAPIN trial enrolled 3195 pregnant women in rural Guatemala, Peru, India, and Rwanda. ECD was assessed at 12 months of infant age using the Caregiver Reported Early Development Instruments (CREDI). Personal 24-hr PM2.5 exposure was measured from baseline through 12 months. Linear regression analyses were conducted to evaluate intervention effects on overall and domain-specific CREDI scores and exposure–response relationships between prenatal and postnatal PM2.5 and infant development. Results Of 3061 live births, 2446 (79.9%) had valid CREDI assessments at 12 months. Despite substantial reductions in personal PM2.5 exposures, the intervention did not have a significant effect on the overall age-standardized ECD score (adjusted mean difference 0.033, 95% CI: −0.023 to 0.088) or on sub-domain age-standardized scores. Subgroup analyses revealed that the intervention improved CREDI scores among infants whose mothers received the intervention before 18 weeks of gestation, and among female infants. No clear associations were observed between PM2.5 exposure and CREDI scores at 12 months. | as an outcome for an intervention (HAPIN LPG intervention) and an outcome for a descriptive analysis | Subgroup analyses suggest that the intervention had a protective effect on early child development at 12 months among infants born to trial participants who received the LPG stove before 18 weeks of gestation. This was observed for the age-standardized overall (adjusted mean difference 0.1; 95% CI: 0.032 to 0.169) and domain-specific CREDI scores (adjusted mean differences: cognitive 0.086; 95% CI: 0.012 to 0.16; motor, 0.068; 95% CI: 0.004 to 0.131; language, 0.147; 95% CI: 0.065 to 0.228; and social-emotional, 0.09; 95% CI: 0.008 to 0.173) (Fig. 2). We also observed a protective effect of the intervention for female infants, on the overall, motor, and language domains age-standardized CREDI scores (adjusted mean differences: overall, 0.091; 95% CI: 0.012 to 0.17; motor, 0.075; 95% CI: 0.002 to 0.149; and language, 0.12; 95% CI: 0.025 to 0.214). Considerable variation was observed for the effect of the intervention between participants from the four study countries, with participants from India having a higher age-standardized language score in the intervention group (adjusted mean difference 0.139; 95% CI: 0.019 to 0.258). The effect did not vary considerably for participants given SES at baseline...Linear models with untransformed or log-transformed exposures did not show consistent associations between gestational or postnatal exposures to PM2.5 and the overall or domain-specific CREDI scores (Table 5; Supplementary Tables and Figures, Tables S4 and S5). Compared to the lowest quartile, infants in the higher PM2.5 quartile showed very small and inconsistent differences in overall ECD score; however, none of these reached statistical significance or were clinically meaningful (Table 6). Likewise, cubic spline models did not show a trend in age-standardized overall CREDI score at higher exposures compared to the first quartile for both the gestational and postnatal periods | Infants in this study tended to have lower ECD scores than the global CREDI norm-referenced population (Table 3). Notably, infants from India tended to have higher overall and motor scores, and slightly higher cognitive and social-emotional scores for their age than infants from the other countries in our study. Infants from Guatemala and Peru had lower norm-referenced standardized scores than infants from Rwanda and India, across all domains. | https://doi.org/10.1016/j.envint.2026.110350 | ||||||||||
65 | 66 | 2026 | Do early childhood education, stimulation, and caregiver distress associate with child development outcomes differentially by gender? A household survey in Pakistan | Franchett, E. et al. | Early Childhood Research Quarterly | Yes | NYU Steinhardt School of Culture, Education, and Human Development | descriptive | Pakistan: Punjab (n = 1,301), Sindh (n = 425), Khyber Pakhtunkhwa (n = 903), and Balochistan (n = 223). | 0-35 months | 1366 parents | short form | phone interviews | This study examined distributions and associations of psychosocial stimulation, caregiver distress, and early childhood education (ECE) enrollment with child development outcomes for two age cohorts (0-35 months (n = 1,366) and 36-72 months (n = 1,486)) of boys and girls in Pakistan. We conducted secondary analysis of data from a nationally representative phone survey of caregivers. For children aged 0-35 months, early child development was measured using the Caregiver-Reported Early Development Instrument (CREDI). For children aged 36-72 months, school readiness was measured using an adapted version of the Measuring Early Learning Quality and Outcomes (MELQO)-Measure of Development and Early Learning (MODEL) caregiver report. We observed no statistically significant gender differences in distributions of developmental outcomes or the three risk/protective factors. For children aged 0-35 months, lower caregiver distress (β = -0.09, p < 0.001) and higher stimulation (β = 0.54, p < 0.001) were associated with better early child development overall. However, on average, girls appeared more sensitive to psychosocial stimulation (girls: β = 0.56, p < 0.001; boys: β = 0.49, p < 0.001) and caregiver distress (girls: β = -0.16, p < 0.001; boys: β = -0.04, p = 0.138) than boys. Among 36-72 month-olds, psychosocial stimulation (β = 0.31, p < 0.001) and ECE enrollment (β = 0.38, p < 0.001) were positively associated with school readiness regardless of gender. Results highlight the importance of early learning and caregiving supports in the first six years, suggesting that girls aged 0-35 months in this sample may be particularly sensitive to caregiving environments marked by low stimulation and high caregiver distress. | as an outcome to test associations with risk and protective factors | There is a negative direct association of caregiver distress with ECD (CREDI z-scores) (β = − 0.12, p < 0.001). To further probe this interaction among younger children in our sample, Fig. 1 shows the marginal effects of caregiver distress on ECD (CREDI z-scores) for boys and girls based on the estimates in Table 2 Model 2. Among children aged 0-35 months, caregiver distress had a negative association with ECD for girls (β = − 0.16, p < 0.001). On average, a one standard deviation increase in caregiver distress corresponded to a 0.16 standard deviation decrease in the CREDI z-score for girls, after adjusting for risk/protective factors and socio-demographic characteristics. In contrast, for boys, though still negative, this association was smaller in magnitude and not statistically significant (β = − 0.04, p = 0.138). As Fig. 1 demonstrates, among the younger cohort, the difference in average ECD outcomes between boys and girls widened as caregiver distress scores increased. Specifically, at high levels of caregiver distress, on average girls aged 0-35 months in the sample had lower CREDI z-scores compared to boys. We found no relationship between caregiver distress and school readiness scores among older children (36-72 months), nor did this association vary by child gender....For younger children (0-35 months), Appendix Table A Model 1 reveals a strong positive direct association between psychosocial stimulation and ECD (CREDI z-scores) (β = 0.54, p < 0.001). Appendix Table A Model 2 further shows that this positive association was stronger for girls than for boys, as indicated by a significant interaction between psychosocial stimulation and female child gender (β = 0.10, p = 0.043). The interaction term remained significant after adjusting for multiple hypothesis testing across models. These patterns persisted after adjusting for other risk and protective factors: Table 2 Model 1 confirms the positive association between stimulation and ECD for both genders (β = 0.54, p < 0.001), and Model 2 indicates an even stronger positive association for girls (β = 0.09, p = 0.049). for the younger cohort (0-35 months), psychosocial stimulation was strongly positively associated with ECD for both genders, but this association was statistically significantly stronger for girls. Girls were more sensitive to changes in psychosocial stimulation compared to boys: a one standard deviation increase in psychosocial stimulation corresponded to an average 0.56 standard deviation increase in the CREDI z-score for girls (β = 0.56, p < 0.001), compared to a 0.49 standard deviation increase for boys (β = 0.49, p < 0.001), after adjusting for risk/protective factors and socio- demographic characteristics. | https://doi.org/10.1016/j.ecresq.2026.06.001 | ||||||||||||
66 | 67 | 2025 | Toxocariasis, risk and protective factors, and mental health difficulties in early childhood: a comparison of marginalised Roma communities and the majority population | Bobáková, D.F. et al. | Parasitology Research | Yes | Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia | descriptive | Roma communities: 49 children from the Slovak Majority population and 39 children from MRCs. | 14–21 months | 88 children | long form (Mental Health subscale) | self-reported survey | Toxocariasis is a parasitic infection that poses significant health risks to children, particularly in marginalised populations with limited access to sanitation and healthcare. This study aimed to compare the occurrence of toxocariasis in early childhood between a group of children from the Slovak majority population and from marginalised Roma communities (MRCs), explore potential risk and protective factors and the association with mental health difficulties in early childhood. Cross-sectional data were obtained from mothers, and blood samples of their children aged 14–21 months were collected during the first wave of the longitudinal RomaREACH study. A total of 88 blood samples from children were analysed: 49 children from the Slovak Majority population and 39 from MRCs. Anti-Toxocara canis IgG antibodies were detected in serum samples using an enzyme-linked immunosorbent assay (ELISA). Though it was not statistically significant, seropositivity for Toxocara canis was more often observed in children from MRCs (35.9%) than in the majority population (20.4%). The absence of running water in households significantly increases the risk of Toxocara infection in children, whereas a longer duration of breastfeeding decreases it. Children seropositive for Toxocara canis showed higher levels of early mental health difficulties even when controlled for MRC residence. These results indicate the need for integrated public health interventions targeting parasitic infections in susceptible populations. Improving access to sanitation, promoting breastfeeding, and strengthening the preventive and educational role of early childhood health services are critical strategies to reduce the risk of exposure to Toxocara spp. eggs and mitigate its potential impact on child health and development. | as a predictor of seropositivity for T. canis infection | hildren tested seropositive for T. canis showed significantly higher levels of early mental health difficulties manifesting as more frequent emotional and behavioural symptoms (B = 1.40; 95% CI: 0.43–2.37), even when controlled for MRC residence (B = 0.99; 95% CI: 0.05–1.94) or current breastfeeding (B = 1.24; 95% CI: 0.24–2.24). Additionally, MRC residence was independently associated with more early mental health difficulties (B = 1.37; 95% CI: 0.50–2.24). | Lastly, the internal consistency of the Mental Health subscale of the CREDI was modest (Cronbach’s α = 0.64), which may reflect the challenge of reliably capturing a broad range of early emotional and behavioural symptoms in very young children through caregiver reports. | https://doi.org/10.1007/s00436-025-08557-2 | |||||||||||
67 | 68 | 2026 | Early predictors of infant executive functioning: Contributions of maternal sensitivity and mind-mindedness across distress and non-distress contexts | Ramos, C. et al. | Infant Behavior and Development | Yes | Instituto Universitário de Lisboa (Iscte-IUL), CIS-Iscte, Lisbon, Portugal | descriptive | USA | Portuguese | 9-13 months | 66 infants-mothers | short form | in-person interviews | Executive functioning (EF) in early childhood plays a critical role in shaping later cognitive, socioemotional, and academic outcomes. Although the influence of caregiving on EF is well documented in preschool and older children, relatively little is known about how early relational factors contribute to the emergence of rudimentary EF abilities during the first year of life. The present study examined the contributions of maternal sensitivity and mind-mindedness to the emergence of EF in infancy. Fifty-one typically developing infants aged 9–13 months were invited to participate. Infants completed the A-not-B task to assess their EF abilities. Maternal sensitivity and appropriate mind-minded comments were assessed during a structured interaction task, which included both non-distress (free-play) and distress-eliciting episodes. Results showed that both maternal sensitivity and appropriate mind-minded comments were related to infant EF, yet only mind-mindedness in non-distress contexts emerged as a significant predictor of early EF abilities. These findings emphasize the importance of caregivers’ attunement to their infants’ mental states in fostering the emergence of EF. | as a screening for study eligibility | https://doi.org/10.1016/j.infbeh.2026.102219 | ||||||||||||
68 | 69 | 2025 | A Short Parent-Reported Attachment Relationship Questionnaire: Development and Cultural Validation for a Majority World Context | Jäggi, L. et al. | International Journal of Behavioral Development | Yes | Swiss Tropical and Public Health Institute: Basel, CH | validation | Andean Peru | Spanish | 24-36 months | 1,000 mother–child dyads | short form | in-person interviews | Secure attachment relationships provide the foundation for lifelong emotional resilience and social flourishing. However, measuring attachment with observational methods is challenging at scale in low-resource settings. Caregiver-report questionnaires offer a feasible alternative but remain underutilized and insufficiently validated for Majority World contexts. This study aimed to address this gap by culturally adapting and validating the Attachment Relationship Inventory-Caregiver Perception 2–5 years Short Form Peru (ARI-SF-Peru) questionnaire for use in an Andean setting. Using a stepwise mixed-methods design, we employed qualitative methods to refine the questionnaire, followed by confirmatory factor analyses (CFA) to test its psychometric properties in a validation sample of N = 1,000 mothers. A simplified two-factor model (secure vs. insecure attachment) demonstrated strong reliability and predictive validity for child outcomes, though a four-factor model with all attachment styles can be used to provide additional theoretical insights. The final 21-item questionnaire provides a practical, culturally adapted, and valid tool for assessing mothers’ perceptions of their attachment relationships with their young children in an understudied population. The study also provides a framework for adapting self-report assessments in similar contexts, recommending simplified language, positive phrasing, and reduced response options to enhance clarity. | as an outcome to establish predictive validity for a parental attachement measure | Regression analyses (Table 3) highlighted the predictive utility of the Secure and Insecure subscales for child outcomes. Secure attachment behaviors positively predicted directly assessed child development (GSED-LF: β = 0.08, p < .01) parent reports of developmental milestones (CREDI-SF: β = 0.18, p < .001), and less externalizing behaviors (SDQ: β = −0.15, p < .001), though effect sizes were small. Insecure attachment behaviors were not significantly related to overall child development outcomes, but were strongly associated with behavior problems (SDQ: β = 0.31, p < .001). | https://doi.org/10.1177/01650254251368797 | |||||||||||
69 | 70 | 2025 | Validation of the Kidsights Measurement Tool: A parent-reported instrument to track children’s development at the population level | Waldman, M. et al. | Plos One | Yes | Munroe-Meyer Institute, Education and Child Development, University of Nebraska Medical Center, Omaha, Nebraska, USA | validation | USA | English | 0-36 months | 5,001 parents | long form | Qualtrics | Disparities in child development between groups of children arise early and reflect social inequities in early environments, geography, and other factors. To track and address these disparities, valid and reliable tools are needed that can be implemented at-scale and across populations. However, no population-level measures of child development appropriate for children from birth to age five years have been developed and validated in the United States to date. The Kidsights Measurement Tool (KMT) is a parent-report, population-level tool for children birth to age five years intended to track group-level differences in the developmental status across normative aspects of children’s motor, cognitive, language, and social/emotional development. This study reports on validation of KMT as a feasible tool that can be implemented in large-scale surveys to track disparities in early childhood development. Using a sample of N = 5,001 initial parent reports residing in Nebraska and across the United States, we find strong evidence that the KMT can detect disparities in child development birth to age five, as indicated by expected criterion associations with parent education and mental health, as well as child’s race and ethnicity. In addition, we found that the KMT is strongly associated with gold-standard direct observation instruments (i.e., the Bayley Scale of Infant Development and the Woodcock-Johnson) that measure similar developmental constructs both concurrently and one-year 12–24 months later. Finally, the KMT exhibits strong reliability even after controlling for age, and we find no evidence that measurement noninvariance threatens valid inferences about group difference. Taken together, our findings indicate that a parent-report measure can generate valid and useful estimates for tracking disparities in early child development at the population level. | Use to triangulate with the newly developed measure to establish convergent validity evidence. | Kidsights scores were highly correlated with D-scores (0.93) and CREDI-LF Overall scores (rho=0.89). Correlation coefficients were also greater than the ideal threshold value for all CREDI subscores (0.82-0.96), ECDI2030 scores, and NOM early learning factor scores. | https://doi.org/10.1371/journal.pone.0324082 | |||||||||||
70 | 71 | 2025 | Active vs. passive urbanization: Does urbanization type affect early childhood cognitive and language development? Evidence from peri-urban China | Ju, Q. et al. | Applied Developmental Science | Yes | descriptive | China | Mandarin | 18-24 months | 77 households | long form | in-person interviews | China’s urbanization has created growing peri-urban communities, where children face challenges to early childhood development (ECD) despite proximity to developed urban areas. Little is known about how the environmental factors of ECD differ between rural migrants and new urban residents. To address this, we sampled 77 peri-urban households with 18–24-month-old Han Chinese children to examine the associations between early cognitive and language development, parental self-efficacy, stimulating parenting practices, and the home language environment measured with Language Environment Analysis (LENA). We find that rural migrants and new urban residents exhibited no significant difference in any child or household characteristic except parental residency. There was no significant difference in the family environment factors or early cognitive or language development, either. However, parental self-efficacy and stimulating parenting practices both predicted better cognitive and language development in rural migrant households, whereas only conversation turn counts predicted better language development in new urban resident households | as a ECD construct to test differences across urban/rural settings and an outcome predicted by home environment | Concerning early cognitive development, the average scores of the CREDI cognitive scales showed no significant differences. Similarly, regarding early language development, the average scores on the CREDI language and CDI scales for both the rural migrant and new urban resident samples did not exhibit significant differences, whether for the entire sample or when divided into top and bottom halves...In the rural migrant sample, after controlling for child and household variables, Table 5 shows that both PSE and FCI were significantly and positively associated with CREDI cognitive and language development (p < 0.05). For new urban resident households, Table 6 reveals that only CTC was significantly and positively associated with CDI scores (p < 0.05), but not with CREDI language scores. Lastly, unlike the rural migrant sample, the PSE and FCI of the new urban resident sample did not have significant associations with any ECD outcome | Cronbach alphas for CREDI overall scores in the rural migrant and new urban resident samples were 0.83 and 0.71, respectively, indicating their reliability | https://doi.org/10.1080/10888691.2025.2581627 | |||||||||||
71 | 72 | 2025 | What factors are associated with the development of children under 3 years old during the pandemic? | Melo, T. et al. | Early Years | Yes | University of Paraná, Curitiba, Paraná, Brazil | descriptive | Brazil | 0–35 months | 307 | short form | Google Forms | The study aimed to identify household factors associated with neuropsychomotor development in Brazilian children aged 0–35 months during social distancing measures of the COVID-19 pandemic. Caregivers completed an online personal and environmental questionnaire, and child development was assessed using the short version of the Caregiver Reported Early Development Instruments (CREDI). Logistic regression identified risk relationships. Among 307 responses, most caregivers reported on children who were White (83.4%), in good health (87%), and living in Southern Brazil (66.1%). Media exposure was common, with screen time often exceeding two hours daily, and physical activity was limited. CREDI scores indicated that 20.5% of children showed lower neuropsychomotor development. Protective factors included having married parents and not using media. These findings highlight the impact of family and environmental factors on early development and suggest implications for policies in health and education. | as an outcome in a correlation study | In the adjusted model, married parents (high and intermediate: p = 0.01) and children not using media (high: p < 0.01; intermediate: p = 0.04) were the significant variables that best explained neuropsychomotor development (high and intermediate CREDI scores) and were considered protective factors in children 0–35 months old...The age groups were also analyzed separately, following the CREDI subdivisions. The results were as follows: protective factors for high neuropsychomotor development, from 6 to 11 months: having attended a day care center before the pandemic (p < 0.01); from 30 to 35 months: living with other children (p < 0.01) and screen time ≤2 hours (p < 0.01). The risk factors for low neuropsychomotor development (negative coefficient) were as follows: from 6 to 11 and 12 to 17 months: screen time ≤2 hours (p < 0.01). From 0 to 5, 18 to 23 and 24 to 29 months, no variable was significant to explain high, intermediate or low neuropsychomotor development scores. CREDI Classification (0–35 months) Low <7.04 63 (20.5), Intermediatea >7.04 < 16.43 187 (60.9), High >16.43 57 (18.6) | https://doi.org/10.1080/09575146.2025.2556267 | ||||||||||||
72 | 73 | 2025 | Infant EEG power predicts early childhood language and motor skills in a rural South African cohort | Brady, S. et al. | Global Pediatrics | Yes | Department of Psychological and Brain Sciences, College of Arts and Sciences, Boston University | validation | https://doi.org/10.1016/j.gpeds.2025.100298 | ||||||||||||||||||||
73 | 74 | 2026 | Can a graduation model reduce child undernutrition? Experimental evidence from Ethiopia | Hirvonen, K. et al. | Working paper | No | International Food Policy Research Institute | evaluation | Ethiopia | 0-36 months | 2212 | short form | in-person interviews | We experimentally evaluate a nutrition-sensitive graduation model embedded in a large-scale safety net in Ethiopia. The program combined savings groups, behavior change communication, livelihoods grants for the poorest, and maternal cash transfers in one arm. Without cash transfers, the model improved caregiver knowledge and savings but not children’s diets or growth, while adding cash transfers improved diet quality and enhanced child development. The largest gains in child growth (a gain in 0.2 standard deviations in height-for-age) occurred among households receiving both livelihoods grants and maternal cash transfers. Coupling livelihoods support with sufficient financial resources appears critical for reducing child undernutrition. | as an outcome for a multifaceted RCT program | Substantial positive effects of 0.2 standard deviations on the CREDI index of early childhood development (Column 8), observed in T3 only. The T2 - grant arm now shows more positive effects: a 0.17 increase in height-for-age that is significant at the ten percent level when using the sharpened q-value, a slightly larger increase in the child stimulation index, and a 0.1 standard deviation increase in CREDI scores (albeit imprecisely estimated). Children in households that would have been grant-eligible do generally show lower height-for-age and lower CREDI scores, and the gap (between eligible and non-eligible control households) seems to be widening over time. | https://www.kallehirvonen.com/SPIR_II.pdf | ||||||||||||
74 | 75 | 2026 | Effect of eggs on Maya child development and growth: the Saqmolo’ Project randomized clinical trial | The Lancet Regional Health Americas | The Lancet Regional Health - Americas | Yes | Center for Indigenous Health Research, Wuqu’ Kawoq/Maya Health Alliance, Tecpán, Guatemala | evaluation | Maya | 6-9 months | 1200 infants | long form | in-person interviews (REDCap) | Background There is worldwide interest in determining whether frequent egg provision during complementary feeding enhances child development and growth in low-resource settings. We evaluated effects of adding one whole egg per day to local standard nutrition care on infant outcomes. Methods The Saqmolo’ Project individually randomized, partially blinded, comparative effectiveness clinical trial was conducted in rural Guatemala from 2021 to 2023. Maya infants aged 6–9 months were randomized to standard nutrition care alone (growth monitoring, complementary and responsive feeding education, deworming medication, multiple micronutrient powders, and referrals for medical care) versus standard care plus one whole egg per day for 6 months. Mixed linear or logistic regression models were used to estimate between-group differences in primary (global development score) and secondary (growth, anemia status, and diet quality) outcomes. Findings This trial included 1200 Maya infants (51.3% male). After adjustment for baseline values and participant characteristics, there was no significant between-group difference in global development score (β −0.08 points [95% CI −0.22 to 0.06]). There were also no significant between-group differences for most secondary outcomes. Intervention participants did have significantly higher odds of stunting (odds ratio [OR] 1.42 [95% CI 1.10–1.82]; p = 0.007) and of meeting minimum dietary diversity (OR 1.41 [95% CI 1.20–1.65]; p < 0.001) and minimum adequate diet (OR 1.44 [95% CI 1.26–1.64]; p < 0.001) benchmarks than standard care participants. Interpretation Provision of one whole egg per day in addition to standard care improved diet quality but did not benefit development, growth, or anemia status among Maya infants. | an an outcome for a nutrition RCT | The primary outcome of global raw scaled CREDI score increased for both groups (as expected with developmental progression) and was nearly identical between groups at endline (median 47.7 [IQR 46.8, 48.4] for the intervention group versus median 47.7 [IQR 46.9, 48.5] for the standard nutrition care group). For both groups, median CREDI Z-scores were negative and declined from ages 6–8 months to 12–14 months, indicating that children in the study dropped further below the same-age average of the reference population...In the adjusted endline model, global CREDI score was not significantly different between groups (β [SE] −0.08 [0.07] points [95% CI −0.22 to 0.06]; p = 0.26) (Table 4) or in the change in global CREDI score model conducted as a sensitivity analysis (Table S5 in Appendix 1). No significant interactions were observed for prespecified effect modifiers. In addition, there were no significant differences between groups in a sensitivity analyses examining impact on CREDI cognitive, language, motor, and social-emotional domain scores | https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(25)00350-3/fulltext | ||||||||||||
75 | 76 | 2026 | Effects of an early childhood father engagement program in Rohingya camps and host community in Cox's Bazar, Bangladesh: a cluster randomized controlled trial | Iqbal, Y. et al. | BMC Global and Public Health | Yes | Division of Social Sciences, Duke Kunshan University, Kunshan, China | evaluation | Bangladesh | Bengali | 0-36 months | 2002 fathers | long form | in-person interview | This study evaluates a 6-month early childhood father engagement intervention delivered in-person to fathers in the Rohingya camps and surrounding host communities in Cox’s Bazar, Bangladesh. The intervention is an added component to an existing intervention that works with mothers of 0–3-year-old children to improve positive outcomes of child development and targets fathers with children below 3 years, with objectives to promote fathers’ wellbeing by improving their emotional literacy, encouraging fathers to strengthen relationships with their spouses and children, and encouraging responsive and stimulating caregiving practices among fathers. We used a cluster-randomized controlled trial design (total N = 2002 fathers, 786 in the Rohingya camps and 1216 in the host communities) to assess the impact of the program on fathers’ parenting and engagement with family (reported by both fathers and mothers), fathers’ mental health, and child development. Results We find that the program has a positive impact on the fathers’ parenting (father reported) and engagement with family (father and mother reported), as well as on father-reported child social-emotional development, compared to the mother-only program. While the program did not have a main effect on directly assessed child development outcomes, we do find that baseline mother-reported stimulation with child and mother health moderate the impact on father-reported child social-emotional development in the camp community (larger positive impacts for fathers from households with lower baseline mother-reported stimulating behaviors and health). We also find that child gender and mother-reported stimulating behaviors moderate impacts on multiple mother-reported child developmental outcomes in both host and camp communities (treatment effects on these outcomes were negative for boys and positive but weak for girls, and larger positive impacts on mother-reported motor development were found among mothers from households who reported lower stimulation at baseline). Additionally, child age moderates the impact on fathers’ collaboration with the mother (reported by the mother), such that the treatment effect is larger for mothers of older children. | an an outcome for a parenting RCT | We found no statistically significant impacts on cognitive or language domains of direct assessment (Bayley-4) or mother-reported child development (CREDI). However, we did find a positive impact on father-reported social-emotional development (sub-scale of CREDI; β = 0.14, p = 0.01, ES = 0.12, 95% CI = 0.03–0.21)....While we find no evidence of any moderation of direct child assessment impacts (Bayley), mother-reported stimulating behaviors and mother health moderate the impact on father-reported child SEL (CREDI) in the camp community, while child gender and mother-reported stimulating behaviors moderate impacts on mother-reported CREDI outcomes in the host and camp community, respectively. Child gender (1 = female) is a significant moderator of all mother-reported CREDI outcomes in the host community (βs = 0.25—0.29, ps = 0.03), whereby the treatment effects on these items were negative for boys (βs = − 0.17–0.23, ESs = − 0.11–− 0.15), and positive but weak for girls (βs = 0.06–0.08, ESs = 0.04–0.07). Baseline values of mother stimulating behaviors in the household moderate the impact on the motor domain of the CREDI (mother-reported) in the camp community, whereby larger positive impacts were found among mothers from households who reported lower baseline levels of stimulation. Mother-reported stimulating behaviors and mother health also moderate the impacts on the father-reported SEL CREDI domain, whereby larger positive impacts were found among fathers from households who reported lower baseline levels of mother stimulation and health. | The internal consistency of all CREDI domains/subscales—cognitive, motor, language, and social-emotional—show high Cronbach’s alphas, ranging from 0.96 to 0.98. We also found a strong correlation between the CREDI subscales of cognitive, language, motor, and social-emotional, with correlation coefficients ranging from 0.88 to 0.96, all significant at p < 0.001. | https://doi.org/10.1186/s44263-026-00266-x | ||||||||||
76 | 77 | 2025 | Beyond poverty reduction: Evidence from a multifaceted program on poverty, nutrition and child development | Bouguen, A. & Dillon, A. | Journal of Development Economics | Yes | Santa Clara University | evaluation | Burkina Faso | 0-36 months | 509 children | long form | household surveys | We study the impacts of a multifaceted program implemented in Burkina Faso that targets ultra-poor households with young children or pregnant women. The design includes a cash transfer program (T1), T1 plus animal transfer (T2) and T2 plus a nutrition bundle which includes fortified flour, a gardening kit and nutrition education (T3). We find that the program reduces extreme poverty in all treatment branches, but only T3 positively impacts child nutrition. T3 also impacts motor and cognitive development of new born children. Our results suggest that while standard multi-faced programs are effective at reducing poverty, nutritionally focused programs are likely necessary to better address children’s long-run earning potential via improved cognitive skills. | as an outcome for a cash transfer + nutrition RCT program | Using the 3-year CREDI test, we observe moderate-to-small impacts across all dimensions except for mental health. The aggregated CREDI score and the language sub-index show significant impacts, particularly in group T3, which experienced substantial and lasting anthropometric effects due to nutrition interventions. These findings align with our original theory of change that connects nutrition and cognition. | https://doi.org/10.1016/j.jdeveco.2025.103596 | ||||||||||||
77 | 78 | 2025 | Parent psychological distress and beliefs about nurturing care: Associations with parent investments and early child development in Ethiopia. | Suntheimer, N. et al. | Developmental Psychology | Yes | University of Pennsylvania | descriptive | Ethiopia | Amharic | 0-35 months | 3000 | long form | in-person interviews | Parental engagement in stimulating activities and support in both formal and informal learning environments are important for early childhood development. However, little is known about how parental mental health and beliefs about early childhood development shape such investments. We draw on a sample of young children and their primary caregiver from Addis Ababa, Ethiopia (N= 3,000; Mage = 34.1 months; 48.5% girls) and examine how parental distress and beliefs predict investments in learning at home and how these, in turn, predict children’s development across multiple domains. We examine these associations separately for infants/toddlers (0–35 months) and preschool-aged children (36–72 months), for whom enrollment in preprimary school is also included as an additional form of parent investment. Results showed different patterns of associations between the two age groups. Speci cally, for infants and toddlers, parental distress and beliefs did not predict parent investments or child outcomes, but both access to learning materials and cognitive stimulation at home positively predicted child development in every domain. For preschool-aged children, parental beliefs positively predicted hours in preschool, and parental distress negatively predicted the availability of learning materials and cognitive stimulation at home; these three forms of parent investments each positively predicted children’s outcomes across all developmental domains. Collectively, these ndings deepen our understanding of parent factors that shape children’s formal and informal learning experiences and point to several important areas for future research to more fully understand early childhood development in low-resource contexts. | the availability of more learning materials at home was positively associated with children’s motor skills, β= .19, SE= .03, p < .001; cognitive skills, β= .20, SE= .03, p < .001; language skills, β= .12, SE= .03, p < .001; and social–emotional skills, β= .19, SE= .03, p < .001. Likewise, statistically signicant relations were found between cognitive stimulation at home and all four child outcomes, such that greater amounts of cognitive stimulation were associated with higher levels of motor skills, β= .17, SE= .03, p < .001; cognitive skills, β= .17, SE= .03, p < .001; language skills, β= .18, SE= .03, p < .001; and social–emotional skills, β= .17, SE= .03, p < .001. | https://doi.org/10.1037/dev0001820 | ||||||||||||
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