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Introduction Digital parenting interventions could be potentially cost-effective means for providing early child development services in low-income settings. This 5-month mixed-methods pilot study evaluated the feasibility of using Afinidata, a comprehensive Facebook Messenger-based digital parenting intervention in a remote rural setting in Latin America and explored necessary adaptations to local context. Methods The study was conducted in three provinces in the Cajamarca region, Peru, from February to July 2021. 180 mothers with children aged between 2 and 24 months and regular access to a smartphone were enrolled. Mothers were interviewed three times in-person. Selected mothers also participated in focus groups or in-depth qualitative interviews. Results Despite the rural and remote study site, 88% of local families with children between 0 and 24 months had access to internet and smartphones. Two months after baseline, 84% of mothers reported using the platform at least once, and of those, 87% rated it as useful to very useful. After 5 months, 42% of mothers were still active on the platform, with little variation between urban and rural settings. Modifications to the intervention focused on assisting mothers in navigating the platform independently and included adding a laminated booklet with general information on child development, sample activities and detailed instructions on how to self-enrol in case of lost phones. Conclusions We found high access to smartphones and the intervention was well received and used in very remote areas of Peru, suggesting that digital parenting interventions could be a promising path forward for supporting low-income families in remote parts of Latin America., Archives of Disease in Childhood, 108 (6), ISSN:0003-9888, ISSN:1468-2044

ImportanceApproximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children’s socioemotional development; however, there is limited evidence on these outcomes.ObjectiveTo examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development.Design, Setting, and ParticipantsThis 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.ExposuresLifetime 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.Main Outcomes and MeasuresChild socioemotional development was measured by the Caregiver-Reported Early Childhood Development Instruments.ResultsA total of 981 mother-child dyads were included in the analytic sample; 388 children (39.6%) were between ages 18 and 24 (mean [SD] age, 27.06 [6.08]) months, and 515 (52.5%) were male children. A negative association was observed between maternal report of physical IPV only (mean difference, −0.022; 95% CI, −0.045 to −0.006) and physical and sexual IPV (mean difference, −0.045; 95% CI, −0.077 to −0.013) with child socioemotional scores, but neither was statistically significant after including depressive symptoms in the model, which is consistent with mediation. Furthermore, a negative association was observed between maternal mild to severe depressive symptoms and child socioemotional development, including adjustment for IPV (mean difference, −0.073; 95% CI, −0.103 to −0.043). Harsh disciplinary practices and stimulation were not associated with child socioemotional development after adjusting for IPV, maternal depressive symptoms, and other factors.Conclusions and RelevanceThe findings of this study suggest that maternal depressive symptoms may explain the negative association between IPV and child socioemotional development.

Observational data collected prior to the pandemic (between 2004 and 2019) were used to simulate the potential consequences of early childhood care and education (ECCE) service closures on the estimated 167 million preprimary‐age children in 196 countries who lost ECCE access between March 2020 and February 2021. COVID‐19‐related ECCE disruptions were estimated to result in 19.01 billion person‐days of ECCE instruction lost, 10.75 million additional children falling “off track” in their early development, 14.18 million grades of learning lost by adolescence, and a present discounted value of USD 308.02 billion of earnings lost in adulthood. Further burdens associated with ongoing closures were also forecasted. Projected developmental and learning losses were concentrated in low‐ and lower middle‐income countries, likely exacerbating long‐standing global inequities.

This study estimates the effect of physical punishment on the cognitive development of 1,167 low-income Colombian children (Mage = 17.8 months old) using 3 analytic strategies: lagged-dependent variables, a difference-in-differences-like approach (DD), and a novel strategy combining matching with a DD-like approach. Across approaches, physical punishment at ages 9-26 months predicted reductions in children's cognitive development of 0.08-0.21 SD at ages 27-46 months. These results, plus null results of falsification tests, strengthen the argument that physical punishment leads to slower cognitive growth and illustrate the utility of alternative statistical methods to reduce problems of selection bias in developmental research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

This study explores children's early academic and self-regulatory skills as potential pathways through which a preschool enrichment program-the Chicago School Readiness Project (CSRP)-may contribute to low-income children's long-term outcomes (N = 466; Mage at baseline = 4.10 years). We find that CSRP's impact on high school grades may be partially explained by early gains in vocabulary and math skills. Although impacts on high school executive function (EF) were more equivocal, our results suggest that early improvements in math skills attributable to the intervention may, in turn, predict long-term gains in EF skills. These results complement the existing literature on preschool fade out, while also shedding light on the cross-domain relations between academic and self-regulatory skills. [ABSTRACT FROM AUTHOR]

About 250 million children under age five are at risk of not reaching their developmental potential due to continued exposure to ill health, malnutrition and lack of appropriate learning environments. A large number of initiatives have been launched in recent years to support early childhood development, with home visiting programs increasingly being recognized as a key strategy for improving child wellbeing. However, the most effective ways to reach families in low income settings remain unclear due to the large expense associated with personal family visits. In this project, we assess the effectiveness and equity of a newly developed digital platform designed to deliver evidence-based, individualized parenting support through automated services. The Afinidata platform uses state-of-the art machine learning algorithms to allow caregivers to get answers to questions about child health and development, while also identifying and promoting age- and development-appropriate activities for parents to support their children. We will collaborate with partners in Peru to rigorously assess the reach, impact and cost effectiveness of this digital platform in a poor rural population through a randomized controlled trial. Our work will follow a mixed-methods evaluation approach with repeated feedback into the Afinidata system. A total of 2,400 newborns will be enrolled in a randomized controlled trial in San Marcos, Peru, and followed up for two years. The primary study outcome will be children's healthy development at 24 months of age assessed through the Bayley Scales of Infant and Toddler Development (BSID-III). Secondary outcomes will be systems utilization, program coverage and cost-effectiveness, as well as caregiver satisfaction. If proven effective, this innovative digital platform may increase global access to low-cost parental support -a widely recognized key strategy for improving child well-being.

OBJECTIVES: To test the hypothesis that child diet and maternal responsiveness mediated the effects of an integrated responsive stimulation (RS) and enhanced nutrition (EN) intervention on child growth and development. METHODS: We used data from the Pakistan Early Child Development Scale-up (PEDS) cluster-randomized controlled trial which evaluated the effectiveness of the Lady Health Worker (LHW) Program in rural Pakistan from 2010–2012. LHWs were randomized into one of four intervention arms (20 LHWs each): (1) RS: UNICEF-WHO Care for Child Development package (locally adapted), (2) EN: EN education and multiple micronutrient powders for children 6–24 mo, (3) RS + EN, and (4) Control. LHWs delivered the interventions in routine monthly home visits and group sessions. Mother-child pairs were enrolled form birth to 24 mo (N = 1324). Primary outcomes were child growth (assessed with length-for-age Z-score (LAZ)) and development (assessed with the Bayley Scales of Infant and Toddler Development, Third Edition) at 12 and 24 mo. We examined whether child diet (assessed with the WHO indicator for minimum acceptable diet) and maternal responsiveness (assessed with the Observation of Mother-Child Interaction tool) at 12 mo mediated intervention effects at 24 mo. Structural equation modelling was used to estimate the total, direct and indirect (via child diet and maternal responsiveness) intervention effects on child growth and development at 24 mo. RESULTS: The RS, EN and RS + EN interventions improved cognitive, language and motor development at 24 mo, but had no significant effect on LAZ and socio-emotional development. Child diet and maternal responsiveness mediated intervention effects on cognitive development, whereas maternal responsiveness alone mediated intervention effects on language and motor development. Despite the lack of significant total intervention effects on LAZ and socio-emotional development, there were significant positive indirect effects on LAZ via maternal responsiveness and child diet, and on socio-emotional development via maternal responsiveness. CONCLUSIONS: Child diet and maternal responsiveness are two important mechanisms which mediated the effect of a RS and EN intervention on child growth and development. Leveraging these mechanisms can help enhance the effectiveness of RS and EN interventions. FUNDING SOURCES: None.

The present study examined the relationships between caregivers’ self-reported positive and negative emotional expressiveness, observer assessments of children’s emotion regulation, and teachers’ reports of children’s internalizing and externalizing behaviors in a sample of 97 primarily African American and Hispanic Head Start families. Results indicated that higher caregiver negativity and lower child emotion regulation independently predicted more internalizing behavior problems in children. Additionally, children’s externalizing behavior problems were negatively predicted by caregivers’ self-reports of positive emotional expressiveness. Importantly, results also suggested that caregivers’ emotional expressiveness and children’s behavioral problems may be non-linearly related, and that child gender may play an important moderating role. These results emphasize the importance of family emotional climate and child emotion regulation in the behavioral development of preschool-age children, and highlight the need for improved theoretical and practical understanding of socioemotional development in diverse populations.

Although research has shown fade-out of the cognitive benefits of classroom-based preschool interventions, less is known regarding the durability of social-emotional impacts. This study examines the extent to which the multicomponent Chicago School Readiness Project (CSRP) intervention lowered risk of internalizing, externalizing, attention, and social difficulties from Head Start through elementary school for 602 low-income children. Results suggest that most children in this sample showed few social-emotional difficulties over time. However, one quarter of the sample exhibited profiles of transitory or building difficulties over six years. Random assignment to the CSRP preschool intervention significantly reduced children's odds of transitory attention and social difficulties in middle childhood, with preliminary evidence suggesting stronger impacts for children attending elementary schools characterized by low academic rigor and high neighborhood crime. CSRP was not found to be effective in preventing more robust, increasing forms of difficulty in the externalizing and attention domains. Implications for early childhood intervention and policy are discussed. (PsycINFO Database Record

Background and objectivesGlobally, studies have shown associations between maternal stimulation and early child development. Yet, little is known about the prevalence of paternal and other caregivers' stimulation practices, particularly in low- and- middle-income countries (LMICs).MethodsData from the Multiple Indicators Cluster Survey (MICS) and the Demographic and Health Survey (DHS) were combined across 62 LMICs (2010-2018). The sample included 205,150 mothers of children aged 3 and 4 years. High levels of stimulation were defined as caregiver engagement in at least 4 out of 6 possible activities with the child. The proportion of mothers, fathers, and other caregivers providing high levels of stimulation was calculated by country, region, and for the whole sample. Socioeconomic disparities within and between countries were estimated.ResultsOn average, 39.8% (95% CI 37.4 to 42.2) of mothers, 11.9% (95% CI 10.1 to 13.8) of fathers, and 20.7% (95% CI 18.4 to 23.0) of other adult caregivers provided high levels of stimulation. Stimulation varied by region, country income group, and Human Development Index (HDI), with higher levels of maternal and paternal-but not other caregivers'-stimulation in high-income and high-HDI countries. Within countries, stimulation levels were, on average, lower in the poorest relative to the richest households, and some but not all countries exhibited differences by child sex (i.e., boys vs. girls) or area (i.e., urban vs. rural).ConclusionsResults suggest a need for intervention efforts that focus on increasing caregiver stimulation in LMICs, particularly for fathers and in low-income contexts.

BackgroundInequalities in early childhood development (ECD) tend to persist into adulthood and amplify across the life course. To date, little research on inequalities in early childhood care and development in low/middle-income countries has been available to guide governments, donors and civil society in identifying which young children and families should be targeted by policies and programmes to improve nurturing care that could prevent them from being left behind.MethodsUsing data from 135 Demographic and Health Surveys and Multiple Indicator Cluster Surveys between 2010 and 2018, we assessed levels and trends of inequalities in exposure to risks of stunting or extreme poverty (under age 5; levels in 85 and trends in 40 countries), early attendance of early care and education programmes (36–59 months; 65 and 17 countries), home stimulation (36–59 months; 62 and 14 countries) and child development according to the Early Childhood Development Index (36–59 months; 60 and 13 countries). Inequalities within countries were measured as the absolute gap in three domains—child gender, household wealth and residential area—and compared across regions and country income groups.Results63% of children were not exposed to stunting or extreme poverty; 39% of 3–4-year olds attended early care and education; and 69% received a level of reported home stimulation defined as adequate. Sub-Saharan Africa had the lowest proportion of children not exposed to stunting or extreme poverty (45%), attending early care and education (24%) and receiving adequate home stimulation (47%). Substantial gaps in all indicators were found across country income groups, residential areas and household wealth categories. There were no significant reductions in gaps over time for a subset of countries with available data in two survey rounds.ConclusionsAvailable data indicate large inequalities in early experiences and outcomes. Efforts of reducing these inequalities must focus on the poorest families and those living in rural areas in the poorest countries. Improving and applying population-level measurements on ECD in more countries over time are important for ensuring equal opportunities for young children globally.

ObjectiveTo determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).DesignMeta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.Data sourcesWe searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.Eligibility criteria for selecting studiesStudies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study.AnalysesLinear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses.ResultsWe retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (–0.24 to –0.05) and 0.23 SD (–0.42 to –0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from −0.18 to −0.10 SDs.ConclusionsDifferential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.

Parenting behaviors have been studied largely in isolation with regard to child development in cross-national contexts. We examine and compare the relative strength of association between physical discipline and deprivation with risk of children's socioemotional and cognitive developmental delay in a cross-national sample.The sample was drawn from the UNICEF Multiple Indicator Cluster Survey. Analyses used observations with data on parental physical discipline, parenting behaviors associated with deprivation, and child developmental outcomes. The present analysis included 29,792 children aged 36-59 months across 17 countries. Using the Early Child Development Index, risk for cognitive or socioemotional developmental delay was indicated if a child could not accomplish 2 or more items within that specific subdomain. Overall risk for delay was indicated if a child was at risk in either subdomain. Associations among discipline, deprivation, and delay were assessed using multivariable logistic regression.Five of the 7 exposures were associated with risk of overall developmental delay. Physical discipline (odds ratio [OR] = 1.49 [95% CI = 1.39, 1.59]; p .001) had the largest association with risk for socioemotional delay. Not having books (OR = 1.62 [95% CI = 1.42, 1.84]; p .001) and not counting with the child (OR = 1.47 [95% CI = 1.32, 1.64]; p .001) had the largest associations with risk of cognitive delay.The exposures of physical discipline and deprivation measured here have distinct associations with risk of socioemotional and cognitive delay cross-nationally. Programmatic and clinical interventions should seek to act on adversities that are relevant to the targeted delay.

ObjectiveTo compare early motor and language development of children DesignCross-sectional study.SettingWe analysed differences in motor and language skills across study sites in Cambodia, Chile, Ghana, Guatemala, Lebanon, Pakistan, the Philippines and the USA.Main outcome measureCognitive and language development assessed with the Caregiver Reported Early Development Instruments (CREDI) tool.Results4649 children aged 0–35 months (mean age=18 months) were analysed. On average, children in sites with a low Human Development Index (HDI) had 0.54 SD (95% CI –0.63 to –0.44) lower CREDI motor scores and 0.73 SD (95% CI –0.82 to –0.64) lower language scores than children growing up in high HDI sites. On average, each unit increase in national log income per capita was associated with a 0.77-month (95% CI –0.93 to 0.60) reduction in the age of motor milestone attainment and a reduction in the age of language milestone attainment of 0.55 months (95% CI –0.79 to –0.30). These observed developmental differences were not universal: no developmental differences across sites with highly heterogeneous socioeconomic contexts were found among children growing up in households with highly educated caregivers providing stimulating early environments.ConclusionDevelopmental gaps in settings with low HDI are substantial on average, but appear to be largely attributable to differences in family-level socioeconomic status and caregiving practices. Programmes targeting the most vulnerable subpopulations will be essential to reduce early life disparities and improve long-run outcomes.

Background: The growth of >300 million children

Recent research suggests that Head Start may be differentially effective in improving low-income children’s early language and literacy skills based on a number of individual- and family-level characteristics. Using data from the Head Start Impact Study (n = 3503; 50% male, 63% treatment group), the present study extends this work to consider program impact variation based on centers’ location in urban versus rural communities. Results indicate that Head Start is more effective in increasing children’s receptive vocabulary (as measured by the PPVT) in urban areas and their oral comprehension (as measured by the Woodcock-Johnson Oral Comprehension task) in rural areas. Additional analyses suggest that related characteristics of the center – including concentration of dual language learners and provision of transportation services – may underlie these associations. Implications for research on program evaluation and policy are discussed.

IntroductionThe first 1000 days of life is a period of great potential and vulnerability. In particular, physical growth of children can be affected by the lack of access to basic needs as well as psychosocial factors, such as maternal depression. The objectives of the present study are to: (1) quantify the burden of childhood stunting in low/middle-income countries attributable to psychosocial risk factors; and (2) estimate the related lifetime economic costs.MethodsA comparative risk assessment analysis was performed with data from 137 low/middle-income countries throughout Asia, Latin America and the Caribbean, North Africa and the Middle East, and sub-Saharan Africa. The proportion of stunting prevalence, defined as ResultsApproximately 7.2 million cases of stunting in low/middle-income countries were attributable to psychosocial factors. The leading risk factor was maternal depression with 3.2 million cases attributable. Maternal depression also demonstrated the greatest economic cost at $14.5 billion, followed by low maternal education ($10.0 billion) and IPV ($8.5 billion). The joint cost of these risk factors was $29.3 billion per birth cohort.ConclusionThe cost of neglecting these psychosocial risk factors is significant. Improving access to formal secondary school education for girls may offset the risk of maternal depression, IPV and orphanhood. Focusing on maternal depression may play a key role in reducing the burden of stunting. Overall, addressing psychosocial factors among perinatal women can have a significant impact on child growth and well-being in the developing world.

BackgroundIdentification of children at risk of developmental delay and/or impairment requires valid measurement of early child development (ECD). We systematically assess ECD measurement tools for accuracy and feasibility for use in routine services in low-income and middle-income countries (LMIC).MethodsBuilding on World Bank and peer-reviewed literature reviews, we identified available ECD measurement tools for children aged 0–3 years used in ≥1 LMIC and matrixed these according towhen(child age) andwhat(ECD domains) they measure at population or individual level. Tools measuring Results61 tools were initially identified, 8% (n=5) population-level and 92% (n=56) individual-level screening or ability tests. Of these, 27 tools covering ≥3 domains beginning Conclusions and implicationsAlthough multiple measurement tools exist, few are designed for multidomain ECD measurement in young children, especially in LMIC. No available tools rated strongly acrossallaccuracy and feasibility criteria with accessibility, training requirements, clinical relevance and geographical uptake being poor for most tools. Further research is recommended to explore this gap in fit-for-purpose tools to monitor ECD in routine LMIC health services.

BackgroundRenewed global commitment to the improvement of early child development outcomes, as evidenced by the focus of the United Nations Sustainable Development Goal 4, highlights an increased need for reliable and valid measures to evaluate preventive and interventional efforts designed to affect change. Our objective was to create a new tool, applicable across multicultures, to measure development from 0 to 3 years through metadata synthesis.MethodsFourteen cross-sectional data sets were contributed on 21 083 children from 10 low/middle-income countries (LMIC), assessed using seven different tools (caregiver reported or directly assessed). Item groups, measuring similar developmental skills, were identified by item mapping across tools. Logistic regression curves displayed developmental trajectories for item groups across countries and age. Following expert consensus to identify well-performing items across developmental domains, a second mapping exercise was conducted to fill any gaps across the age range. The first version of the tool was constructed. Item response analysis validated our approach by putting all data sets onto a common scale.Results789 individual items were identified across tools in the first mapping and 129 item groups selected for analysis. 70 item groups were then selected through consensus, based on statistical performance and perceived importance, with a further 50 items identified at second mapping. A tool comprising 120 items (23 fine motor, 23 gross motor, 20 receptive language, 24 expressive language, 30 socioemotional) was created. The linked data sets on a common scale showed a curvilinear trajectory of child development, highlighting the validity of our approach through excellent coverage by age and consistency of measurement across contributed tools, a novel finding in itself.ConclusionsWe have created the first version of a prototype tool for measuring children in the early years, developed using novel easy to apply methodology; now it needs to be feasibility tested and piloted across several LMICs.

Rates of participation in early childhood education (ECE) programs are on the rise globally, including in sub-Saharan Africa. Yet little evidence exists on the quality of these programs and on the role of classroom quality in predicting learning for young children across diverse contexts. This study uses data from the Greater Accra Region of Ghana (N = 3,407; Mage = 5.8 years; 49.5% female) to examine how changes in four culturally validated dimensions of ECE classroom quality predict children's growth in early academic and social-emotional skills from the beginning to the end of one academic year. We find that improvements in domains of classroom instructional quality are related to small, positive gains in children's early academic and social-emotional outcomes over the school year, and that these improvements are generally larger for children and classrooms with higher baseline proficiency and quality levels. Associations between changes in social-emotional aspects of classroom quality and child outcomes were mixed. These results extend the knowledge base on ECE quality to a new and underrepresented context while also providing important information regarding the contexts and children for whom teacher training and other quality-focused improvement efforts may be most needed. (PsycINFO Database Record

BACKGROUND: Evidence on the relationship between maternal depression and exposure to intimate partner violence (IPV) with child physical growth and development is equivocal. Our aim in the current study is to examine these relationships among women and their children in Tanzania. METHODS: The Bayley Scales of Infant Development and anthropometric measures were used to assess children 18 to 36 months of age (n = 1031). Maternal exposure to IPV and depression were assessed using the Tanzania Demographic and Health Survey questionnaire and the Patient Health Questionnaire-9, respectively. We used linear regression models to calculate standardized mean differences (SMDs) for developmental outcomes and generalized linear models to estimate the associations with nutritional status. RESULTS: Mild depressive symptoms in mothers (Patient Health Questionnaire-9 ≥5) and exposure to physical and sexual IPV were associated with lower SMDs for motor skills (−0.14 [P = .023] and −0.23 [P < .01], respectively), expressive communication (−0.13 [P = .187] and −0.23 [P < .01], respectively), receptive communication (−0.19 [P < .009] and −0.16 [P = .03], respectively), and cognitive development (−0.08 [P = .245] and −0.12 [P = .07], respectively). Exposure to physical and sexual IPV was associated with higher risk for stunting (relative risk = 1.6; P < .001). CONCLUSIONS: This study reveals that maternal depressive symptoms and IPV are associated with adverse child nutritional and developmental outcomes. Further research is needed to develop programs to address IPV and depression among women and enhance the growth and development of their children.

Governments in sub-Saharan Africa have made marked efforts to increase school enrollment. Yet attendance and completion rates remain low, particularly for girls. This study examines the reasons that school children do not attend school in a sample of Ghanaian students. Girls were more likely to miss school because a family member was sick, whereas boys were more likely to miss school due to work. Caregivers’ inability to pay school fees and belief that it is better to educate boys than girls were related to lower school attendance for girls but not for boys. Implications of the findings to inform efforts to improve educational access for all children are discussed.

Background Parents are the primary providers of nurturing care for young children’s healthy early development. However, the literature on parenting in early childhood, especially in low- and middle-income countries, has primarily focused on mothers. In this study, we investigate how parents make meaning of fathers’ parenting roles with regards to their young children’s early health and development in rural Pakistan. Methods Data were collected between January and March 2017 through in-depth interviews with fathers (N = 33) and their partners (N = 32); as well as separate focus group discussions with fathers (N = 7) and mothers (N = 7). Data were analyzed using thematic content analysis. Results Parents described a distinct division of roles between fathers and mothers; and also several shared caregiving roles of fathers and mothers. Specifically, parents highlighted aspects of fathers’ coparenting and several common ways by which fathers supported their partners. We found that these gendered divisions in parenting roles were strongly embedded within a complex network of interacting factors across the individual, family, and sociocultural contexts of the study community. Conclusions Our findings suggest a more family-centered conceptualization of fatherhood during early childhood that encompasses both fathers’ direct engagement with their young children and their indirect contributions through coparenting, while recognizing a variety of contextual systems that shape paternal parenting. Future parenting interventions that reflect the lived experiences of both fathers and mothers as parents and partners may further enhance the nurturing care environments that are critical for promoting healthy early child development.

The present cross-sectional study aims to examine the relations between socioeconomic status (SES), parenting practices, and child internalizing and externalizing behavior problems in Brazil. To achieve this aim, we begin by examining the factor structure of a parenting scale (the ACT scale) for use in the Brazilian context. Participants were 204 Brazilian mothers of 3- to 8-year-old children, who answered questionnaires about SES, parenting practices, and child behavior. The results of exploratory and confirmatory factor analysis of the ACT scale revealed three latent parenting practices in the Brazilian context: emotional and behavioral regulation, communication, and positive discipline. Results of the final structural equation model showed that lower socioeconomic status was directly related to higher levels of child internalizing behavior problems and more negative parenting practices in the communication and positive discipline domains. Although mothers' emotional and behavioral regulation was not related to socioeconomic status, it was negatively predictive of children's behavior problems. The findings provide evidence for the utility of the ACT scale for measuring three distinct dimensions of parenting practices in Brazil. Results also suggest nuanced relations between SES, parenting practices, and child behavior in this developing country context.

Past research suggests robust positive associations between household socioeconomic status and children's early cognitive development in Western countries. Relatively little is known about these relations in low-income country settings characterized by economic adversity, high prevalence of malnutrition and infectious disease, and relatively lower school enrollment. The present study develops and empirically evaluates an adapted model of early childhood development using a sample of 2,711 Zambian 6-year-olds. Early learning in and out of the home was found to explain much of the relation between socioeconomic status and children's cognitive skills, including language, nonverbal reasoning, and executive function. Child height-for-age (a proxy for overall nutritional status and health) was also predictive of children's cognitive skills and both early and on-time school enrollment. Implications for global child development, intervention, and future work are discussed.

BACKGROUND: 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. RESULTS: 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

Despite calls to expand early childhood education (ECE) in the United States, questions remain regarding its medium- and long-term impacts on educational outcomes. We use meta-analysis of 22 high-quality experimental and quasi-experimental studies conducted between 1960 and 2016 to find that on average, participation in ECE leads to statistically significant reductions in special education placement (d = 0.33 SD, 8.1 percentage points) and grade retention (d = 0.26 SD, 8.3 percentage points) and increases in high school graduation rates (d = 0.24 SD, 11.4 percentage points). These results support ECE's utility for reducing education-related expenditures and promoting child well-being.

Prior research has found that higher residential mobility is associated with increased risk for children’s academic and behavioral difficulty. In contrast, evaluations of experimental housing mobility interventions have shown moving from high poverty to low poverty neighborhoods to be beneficial for children’s outcomes. This study merges these disparate bodies of work by considering how poverty levels in origin and destination neighborhoods moderate the influence of residential mobility on 5th graders’ self-regulation. Using inverse probability weighting with propensity scores to minimize observable selection bias, this work found that experiencing a move during early or middle childhood was related to negative child outcomes (as indicated by increased behavioral and cognitive dysregulation measured via direct assessment and teacher-report) in 5th grade. However, these relationships were moderated by neighborhood poverty; moves out of low poverty and moves into high poverty neighborhoods were detrimental, while moves out of high poverty and moves into low poverty neighborhoods were beneficial.

The purpose of this study was to examine whether the walking activity of persons with stroke could be increased through participation in a step activity monitoring program and to assess whether this occurred through a change in the structure of walking activity.Sixteen individuals living with chronic stroke (6 months post-stroke) wore a StepWatch Activity Monitor (SAM) and completed a four-week goal centered activity monitoring program. Descriptors of step activity were averaged across baseline and the last week of monitoring, and were used to analyze the changes. Descriptors of step activity included: steps per day, bouts per day, steps per bout, total time walking per day, and the number of short (40 steps), medium (41-500 steps), and long (500 steps) walking bouts.As a group, the number of steps per day significantly increased over the four weeks of activity monitoring (p = 0.005). Subjects also demonstrated a significant improvement in the total time walking (p = 0.023), and the number of medium (p = 0.033) and long (p = 0.050) walking bouts. At the baseline and the final assessment, more than half of the bouts were short bouts of walking (67.6 ± 8% and 68.2 ± 8% respectively).A goal centered step activity monitoring program can improve daily walking activity after stroke through increases in the amount of total time walking, and medium and long walking bouts.

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.

The present longitudinal study tested the roles of early childhood executive control (EC) as well as exposure to poverty-related adversity at family and school levels as key predictors of low-income children’s EC in elementary school (n = 391). Findings suggest that children’s EC difficulties in preschool and lower family income from early to middle childhood are robust predictors of later EC difficulties as rated by teachers in second and third grades. Findings also suggest enrollment in unsafe elementary schools is significantly predictive of higher levels of teacher-rated EC difficulty, but only for those children who showed initially elevated levels of EC difficulty in early childhood. Implications for scientific models of cognitive development and poverty-related adversity are discussed.

Background 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. Methods 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. Results 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

Summary Early childhood development programmes vary in coordination and quality, with inadequate and inequitable access, especially for children younger than 3 years. New estimates, based on proxy measures of stunting and poverty, indicate that 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of not reaching their developmental potential. There is therefore an urgent need to increase multisectoral coverage of quality programming that incorporates health, nutrition, security and safety, responsive caregiving, and early learning. Equitable early childhood policies and programmes are crucial for meeting Sustainable Development Goals, and for children to develop the intellectual skills, creativity, and wellbeing required to become healthy and productive adults. In this paper, the first in a three part Series on early childhood development, we examine recent scientific progress and global commitments to early childhood development. Research, programmes, and policies have advanced substantially since 2000, with new neuroscientific evidence linking early adversity and nurturing care with brain development and function throughout the life course.