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Background: Understanding the status of early childhood development (ECD) and its associated factors could serve as the basis for future policy efforts and interventions. Therefore, this study aimed to determine the status of ECD and its associated factors among children aged 36–59 months in Afghanistan. Methods: We used data from the Afghanistan Multiple Indicator Cluster Survey 2022–2023 (MICS) to assess ECD status. The outcome variable was a binary measure, indicating whether a child was developmentally on track or not. To explore the associations between ECD status and various explanatory variables, we applied binary logistic regression models, presenting both univariate and multivariate analyses. Results: Among the 13,866 children aged 36 to 59 months included in the analysis, 29.95% (95% CI: 29.19-30.72%) were found to be developmentally on track. The likelihood of being developmentally on track was higher in children whose mothers had secondary [adjusted odds ratio (AOR) 1.36 (95%CI 1.04–1.77)] and higher education [1.73 (1.08–2.76)], in children whose fathers had primary [1.32 (1.05–1.67)], secondary [1.40 (1.10–1.79) and higher education [1.60 (1.21–2.11)], and in children belonging to the higher household wealth status [1.46 (1.18–1.82)]. On the other hand, the likelihood of being developmentally on track was lower in children aged 48–59 months [0.35 (0.30–0.40)], in children living in rural areas [0.77 (0.62–0.96)], in children with stunting [0.77 (0.61–0.96)], and in underweight children [0.61 (0.52–0.72)]. Conclusion: Our findings indicate that 29.95% of children aged 36–59 months in Afghanistan are developmentally on track. Positive associations were found between ECD and higher parental education and household wealth status. However, living in rural areas, underweight and stunted growth were negatively associated with ECD. To improve early childhood development programs in Afghanistan, targeted interventions are needed to address the factors identified in this study. [ABSTRACT FROM AUTHOR]

Background: The proliferation of instruments that define instrument-specific metrics impedes progress in comparative assessment across populations. This paper explores a method to extract a common metric from related but different instruments and transform the original measurements into scores with a standard unit of measurement. Methods: Existing data from four assessment instruments of child development, collected from three different samples of children, were used to create "equate clusters" of items that measure the same behaviour in (slightly) different ways. A probability model was formulated to identify best items and groups to serve as anchors linking the instruments, assuming that items in an anchoring or "active" equate cluster are psychometrically equivalent. Quantification and inspection of item characteristic curves were used to resolve which equate clusters should be active. We simulated the impact of various analytic choices. Results: Simulation confirmed the feasibility of creating a common metric from data collected with different instruments from respondent samples with different abilities. The method performed as expected in an application in early childhood development. Conclusions: The use of equate clusters is an intuitive and flexible way to establish a common metric across instruments and facilitates the transformation of measurements obtained to a standardized scale. Standardizing instrument scores to a common metric allows for population-level comparisons on a global scale. [ABSTRACT FROM AUTHOR]

Background: This study aims to examine the association for paternal care and father-child screen use with early childhood development and children's temper tantrums. Method: Study file included questions about paternal characteristics, child care, father-child screen habits, and utilized the UNICEF Early Childhood Development Index (ECDI). Factors influencing ECDI-on-track status and children's responses when screen use was restricted were investigated with Chi-square test and multiple logistic regression. Results: The study included 464 fathers having children aged 3–4 years. The findings showed that 89.7% of the children were on track in three out of the four ECDI subgroups. When screen use was restricted, 55.6% of the children engaged in another activity, while 44.4% reacted by crying. Multiple logistic regression analysis revealed that the father's education level, the child's age and gender, the starting age for screen usage, the child's reaction to screen restriction, and having three or more books were associated with ECDI. Furthermore, the child's reaction to screen restriction was related to the child's and father's screen time, the presence of three or more books, the adequacy of care, and being on track in the literacy-numeracy ECDI subgroup. Conclusion: Screen usage habits significantly impact early childhood development and children's reactions to screen restrictions. These findings underscore the importance of educating fathers about the effects of their own and their child's media habits, the quality of fatherly caregiving, and the presence of books in fostering positive child development. [ABSTRACT FROM AUTHOR]

Aim: Social determinants of health (SDH) have a critical role in child development. Yet these determinants are often overshadowed. This study examines the effect of composites of five SDH on early childhood development (ECD) of children of age 36–59 months. Methods: We used two 2013 and 2019 rounds of Multiple Indicator Cluster Survey Bangladesh data. The analytical sample included ECD data for 25 721 children. ECD was computed following United Nations International Children's Emergency Fund's psychometric approach. Three composite indices of SDH were developed to examine their gradient effects on ECD. Poisson regression with robust variance was used to examine the relationship between SDH indices and ECD. The concentration index was computed, and a concentration curve was developed to measure inequalities in being on track of ECD among children with various levels of SDH. Results: Almost 69% of children were on track in their ECD, a higher percentage in 2019 (74.85%) than in 2017 (65.37%). The prevalence of children on track in their ECD significantly rises per unit in the score of three SDH composites (adjusted prevalence ratios are 1.04 (95% confidence interval (CI): 1.03–1.04) for summative and standardised indexes and 1.49 (95% CI: 1.41–1.58) for weighted index). There is almost a linear positive relationship between the SDH composite and ECD. Significant concentration indexes suggest SDH‐related inequalities in ECD. Conclusion: Children's early development can be hampered due to unfavourable SDH. Although ECD plays a vital role in creating and maintaining socio‐economic and health inequalities through to adulthood, favourable SDH needs to be ensured during childhood. [ABSTRACT FROM AUTHOR]

Children from disadvantaged families are at greater risk of developing regulation difficulties. Research suggests that family-level resources such as parental education or income are related to self-regulation development. However, most studies looking at the role of family resources have used single estimators of socioeconomic status or applied a composite score, neglecting that an interplay of resources may affect self-regulation outcomes. In N = 248 at-risk children (Mage: 65.7 months, 51% female), we examined the effect of economic, cultural, and social family resources on behavioral self-regulation in kindergarten. Results showed that family income, maternal education, and available help in child-rearing predicted the Head-Toes-Knees-Shoulders task performance. The results indicate that behavioral self-regulation is associated with different family resources beyond socioeconomic status. [ABSTRACT FROM AUTHOR]

• Executive functioning at preschool entry is positively related to school readiness skill gains. • Children's negative classroom engagement is negatively associated with school readiness gains. • Observed positive task engagement positively predicts teacher-reported learning approaches. • Negative classroom engagement may underlie executive functioning—school readiness linkage. This study investigated links of executive functioning to gains in school readiness skills and explored the mediating role of children's behavioral engagement in the PreK classroom. We collected direct assessments of executive functioning (EF) and observations of behavioral engagement for 767 children (mean age 52.63 months) from racially/ethnically diverse, low-income backgrounds three times over the PreK year. We also measured school readiness in the domains of language, literacy, and math using direct assessments and collected teacher-report measures of socialemotional-behavioral skills and approaches to learning. Our analyses addressed the following three research questions: 1) To what extent does children's EF predict school readiness skill gains during PreK? 2) To what extent does children's behavioral engagement in PreK classrooms predict school readiness skill gains? 3) To what extent does behavioral engagement mediate the relation of EF with school readiness skill gains? We observed that EF was positively related to gains in language, math, and approaches to learning. Regarding behavioral engagement, Negative Classroom Engagement was negatively related to gains in literacy, math, social-emotionalbehavioral skills, and approaches to learning while Positive Task Engagement was positively related to gains in approaches to learning. Negative Classroom Engagement significantly mediated the effects of EF on gains in the domains of literacy, socialemotional-behavioral skills, and approaches to learning. We describe implications of these findings for promoting children's ability to learn and thrive in PreK contexts with a focus on their engagement with teachers, peers, and learning activities. [ABSTRACT FROM AUTHOR]

To analyze trends in breastfeeding and complementary feeding indicators for infants and young children receiving primary health care (PHC) services in Brazil, considering the contextual aspects of local nurturing care (NC) environments. Ecological time-series study. Ten feeding indicators were extracted from 1,055,907 food intake records of children aged <2 years reported by PHC facilities from 2015 to 2019. Local NC environments were assessed with the Brazilian Early Childhood Friendly Municipal Index, calculating overall and stratified scores for the NC domains of adequate nutrition, good health, opportunities for early learning, and security and safety. Prais–Winsten regression was used to calculate annual percent changes (APC) by sex and the contrast in APC between the lower and upper quintiles of NC scores. Positive or negative APC with P -values <0.05 represented increasing or decreasing trends. No significant trends of exclusive and continued breastfeeding, food introduction, or minimum dietary diversity were observed, with 2019 prevalences of 54.5%, 45.2%, 92.5%, and 78.2%, respectively. Increasing trends were observed for mixed milk feeding (2019: 19.2%; APC, +2.42%) and minimum meal frequency (2019: 61.1%; APC, +2.56%), while decreasing trends were observed for sweet beverage consumption (2019: 31.9%; APC, −5.92%) and unhealthy foods (2019: 16.1%; APC, −4.69%). Indicator improvements were significantly stronger in environments more favorable for NC. Although the indicators did not meet global targets for infant feeding practices, the results suggest that the local NC environment encompasses facilitators that may be strategic in the design of early childhood programs and policies to improve nutrition. [ABSTRACT FROM AUTHOR]

Background: Evidence is needed to understand factors that influence child development and caregiving experiences, especially in marginalized contexts, to inform the development and implementation of early childhood development (ECD) interventions. This study explores caregiving practices for young children in an urban informal settlement with Kenyans and embedded refugees, and identifies factors shaping these caregiving experiences, to inform the design and development of potentially appropriate ECD interventions. Methods: A qualitative formative study, which included 14 focus group discussions (n = 125 participants), and 13 key informant interviews was conducted between August and October 2018. Purposive sampling approaches were used to select a diverse range of respondents including caregivers of children below three years of age and stakeholders of Kenyan nationality and refugees. Data were analysed using a thematic approach and the Nurturing Care Framework was used as an interpretative lens. Results: There was a fusion of traditional, religious and modern practices in the care for young children, influenced by the caregivers' culture, and financial disposition. There were mixed views/practices on nutrition for young children. For example, while there was recognition of the value for breastfeeding, working mothers, especially in the informal economy, found it a difficult practice. Stimulation through play was common, especially for older children, but gaps were identified in aspects such as reading, and storytelling in the home environment. Some barriers identified included the limited availability of a caregiver, insecurity, and confined space in the informal settlement, all of which made it difficult for children to engage in play activities. Physical and psychological forms of discipline were commonly mentioned, although few caregivers practiced and recognized the need for using non-violent approaches. Some overarching challenges for caregivers were unemployment or unstable sources of income, and, particularly for refugee caregivers, their legal status. Conclusion: These findings point to the interplay of various factors affecting optimal caregiving for young children in an urban informal settlement with Kenyans and refugees. Integrated ECD interventions are needed for such a mixed population, especially those that strive to anchor along caregivers' social support system, co-designed together with community stakeholders, that ideally focus on parent skills training promoting nurturing care and economic empowerment. [ABSTRACT FROM AUTHOR]

Background: An estimated 43% of children under age 5 in low- and middle-income countries (LMICs) experience compromised development due to poverty, poor nutrition, and inadequate psychosocial stimulation. Numerous early childhood development (ECD) parenting interventions have been shown to be effective at improving ECD outcomes, at least in the short-term, but they are (a) still too expensive to implement at scale in low-resource and rural settings, and (b) their early impacts tend to fade over time. New approaches to deliver effective ECD parenting interventions that are low-cost, scalable, and sustainable are sorely needed. Methods: Our study will experimentally test a traditional in-person group-based delivery model for an evidence-based ECD parenting intervention against a hybrid-delivery model that increasingly substitutes in-person meetings with remote (mHealth) delivery via smartphones, featuring audiovisual content and WhatsApp social interactions and learning. We will assess the relative effectiveness and cost of this hybrid-delivery model compared to in-person delivery and will extend the interventions over two years to increase their ability to sustain changes in parenting behaviors and ECD outcomes longer-term. Our evaluation design is a cluster Randomized Controlled Trial (cRCT) across 90 villages and approximately 1200 households. Midline and endline surveys collected 12 and 24 months after the start of the interventions, respectively, will examine short- and sustained two-year intention-to-treat impacts on primary outcomes. We will also examine the mediating pathways using mediation analysis. We hypothesize that a hybrid-delivery ECD intervention will be lower in cost, but remote interactions among participants may be an inferior substitute for in-person visits, leaving open the question of the most cost-effective program. Discussion: Our goal is to determine the best model to maximize the intervention's reach and sustained impacts to improve child outcomes. By integrating delivery into the ongoing operations of local Community Health Promoters (CHPs) within Kenya's rural health care system, and utilizing new low-cost technology, our project has the potential to make important contributions towards discovering potentially scalable, sustainable solutions for resource-limited settings. Trial Registration: NCT06140017 (02/08/2024) AEARCTR0012704. [ABSTRACT FROM AUTHOR]

Introduction: The recognition of culture and context as pivotal influences on the developmental trajectory of young children has been underscored by numerous developmental theories. Localized knowledge is essential for comprehending cultural universality with specificity for early childhood development (ECD). Methods: Thirteen focus group discussions were conducted with professionals, caregivers, and teachers from four regions in China. Thematic content analysis was employed to identify patterns and themes, followed by coding to identify more conceptual units of meaning. Results: The findings reveal distinct culture-based skills across four domains of ECD in China. These highlight a local culture that embraces a comprehensive, dynamic, and staged perspective on the development of young children. This study elucidates the multidimensional impact of the environment on young children's development, with a focus on children's behavioral characteristics and temperament traits, ECEC practices, and ECEC beliefs that transcend identity, culture, and the economy. Discussion: This study contributes to the assessment of ECD for future cultural comparisons and enhances the scientific understanding of the interplay between developmental skills in young children and diverse cultural expectations and backgrounds. [ABSTRACT FROM AUTHOR]

The climate crisis encompasses a constellation of risks that threaten human livelihoods, well‐being, and survival globally. In this article, we present a new framework based on bioecological and dynamic systems perspectives, and on evidence for conceptualizing how the distinctive dual time frame of both acute (e.g., extreme weather events) and chronic (e.g., ecological degradation) climate change‐related risks experienced prenatally and early in life across multiple ecological contexts can threaten human development. We conclude with a call to developmental researchers, practitioners, and policymakers to invest more efforts in understanding and addressing the climate crisis and its developmental consequences to ensure a sustainable future for all. [ABSTRACT FROM AUTHOR]

Evidence firmly establishes the link between early childhood interventions and the mitigation of the effects of adverse childhood experiences (ACEs). Given the long-term effects of conflict and displacement on children's healthy development, educational mass media can offer critical learning opportunities to mitigate both the impact of learning disruption and the effects of ACEs. This paper will highlight three different ways media, and its diverse distribution platforms, can support young children's understanding and use of coping strategies in the face of significant adversity. Using examples of diverse distribution to reach refugee and migrant children in the United States and across Latin America and the Middle East, this paper will highlight the ways media can support children and families affected by displacement and conflict to develop critical coping strategies. Lessons learned in developing and adapting coping strategies for diverse contexts and platforms include learnings for content curation and implementation, engagement of local and regional advisors, and importance of a network of on-the-ground implementing partners. These findings offer guidance for those developing content and programs for children in conflict and crisis, in particular creators of children's media and outreach programs. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the impact of structured recreational games on the psychomotor skill development of children at Institution No. 329 in Huancavelica. Given the importance of early childhood development, this research seeks to identify effective strategies to enhance psychomotor abilities through play. Methods: A quasi-experimental design was employed, involving a sample of 60 children aged 5, divided into an experimental group and a control group. The experimental group participated in a series of structured recreational games designed to improve coordination, balance, and fine motor skills over eight weeks. Pre- and post-intervention assessments were conducted using standardized psychomotor skill evaluation tools. Data were analyzed using descriptive and inferential statistics to determine the significance of the findings. Results: The findings indicated a significant improvement in the psychomotor skills of the experimental group compared to the control group, with statistical analysis revealing a mean increase of 25% in overall psychomotor performance scores. Notable enhancements were observed in coordination, which improved by 30%, and balance, which increased by 28%, demonstrating the effectiveness of the structured recreational games in refining hand-eye coordination and stability. Additionally, fine motor skills exhibited an average increase of 22% in tasks requiring dexterity, such as grasping and manipulation. Qualitative observations revealed increased engagement and enthusiasm among children in the experimental group, with many displaying greater confidence in their physical abilities. Educators noted improved social interactions and teamwork as children collaborated during activities. Overall, these results demonstrate that structured recreational games effectively foster the development of critical psychomotor skills in early childhood, supporting the notion that play-based learning is a vital component of early educational strategies. Conclusion: The significant improvements observed suggest that incorporating these games into early childhood education can lead to enhanced motor skills, which are essential for children's overall development. Educators and policymakers are encouraged to implement structured recreational activities in early childhood curricula to facilitate holistic development and prepare children for future learning experiences. Further research is recommended to explore long-term effects and variations in implementation across different educational contexts. [ABSTRACT FROM AUTHOR]

This paper analyses Pakistan Federal Foundational Learning Policy (FFLP) 2024 in light of holistic education. While enhancing the literacy abilities of children is a notable objective of this policy, this study examines policy in terms of its potential for the student’s education as a whole. In this paper, critical discourse analysis was employed by Mullet, focusing on language, the text structure, and the suggested measures of implementation of policy. This study shows that though FFLP 2024 ensures that gaps in foundational learning are filled, it might downplay other elements necessary for early childhood, namely socio-emotional development, creativity, and cultural competence. This policy gap may impose limitations on school’s curriculum and teaching strategies as it centers on quantifiable results & standardized tests. The findings drawn from the analysis of the policy have questioned its suitability for different regions and its effect on the teachers’ professionals’ autonomy. The study proposed that a balanced approach that incorporates basic skills and general goals is needed for inclusive student development. The study provides valuable suggestions for a broader strategy towards the foundational learning. [ABSTRACT FROM AUTHOR]

Abstract Background The prevalence of household violence in low- and middle-income countries (LMICs) is high, and exposure to violence has significant adverse effects on both mental health and child development across generations. Evidence-based services to improve parenting practices and reduce household violence in LMICs are scarce, particularly across rural regions of West Africa. This study explored the feasibility, acceptability, and potential benefits of an evidence-based home-visiting intervention to promote early childhood development and reduce household violence—the Family Strengthening Intervention for Early Childhood Development and Violence-Prevention (FSI-ECD + VP)—among vulnerable families in rural regions of Sierra Leone. Methods Eighty dual-caregiver households in the Makeni region of Sierra Leone were included in the study (N = 160 caregivers; 73% female). Eligibility criteria included having at least one child aged 6–36 months and elevated scores (> 62.5) on the Difficulties in Emotion Regulation Scale (DERS). Community Health Workers (CHWs) employed in the Makeni region completed a 3-week FSI-ECD + VP training. Families were randomized to receive either the FSI-ECD + VP or treatment as usual (TAU). Research assistants blinded to treatment assignment assessed caregiver mental health, caregiver-child interactions, and household violence at baseline, post-intervention, and 3-month follow-up time points. Results Triangulation of quantitative and qualitative data showed that caregivers, CHWs, and supervisors generally perceived the intervention as beneficial, feasible, and acceptable. Mixed effects models showed that caregivers who received the FSI-ECD + VP had significantly improved caregiver-child relationship outcomes compared to TAU as assessed by the Home Observation for Measurement of the Environment and the Observation of Caregiver-Child Interactions at post-intervention. Preliminary data also suggests that caregivers receiving the FSI-ECD + VP were less likely to have experienced intimate partner physical violence during the post-intervention period, and had lower symptoms of anxiety and depression at 3-month follow-up. Conclusions FSI-ECD + VP delivery by CHWs in Sierra Leone may be feasible and acceptable; it may also help improve caregiver-child interactions and reduce the likelihood of household violence among vulnerable families with young children. Task-sharing approaches may help increase acceptability and access to evidence-based behavioral interventions that promote early childhood development and violence prevention among families in rural regions of Sierra Leone and other similar settings. Trial registration The study is registered in clinicaltrials.gov (NCT 03045640; 07/22/2020). This study follows the Consort 2010 guidelines for reporting of clinical trials.

Abstract Background Understanding the status of early childhood development (ECD) and its associated factors could serve as the basis for future policy efforts and interventions. Therefore, this study aimed to determine the status of ECD and its associated factors among children aged 36–59 months in Afghanistan. Methods We used data from the Afghanistan Multiple Indicator Cluster Survey 2022–2023 (MICS) to assess ECD status. The outcome variable was a binary measure, indicating whether a child was developmentally on track or not. To explore the associations between ECD status and various explanatory variables, we applied binary logistic regression models, presenting both univariate and multivariate analyses. Results Among the 13,866 children aged 36 to 59 months included in the analysis, 29.95% (95% CI: 29.19-30.72%) were found to be developmentally on track. The likelihood of being developmentally on track was higher in children whose mothers had secondary [adjusted odds ratio (AOR) 1.36 (95%CI 1.04–1.77)] and higher education [1.73 (1.08–2.76)], in children whose fathers had primary [1.32 (1.05–1.67)], secondary [1.40 (1.10–1.79) and higher education [1.60 (1.21–2.11)], and in children belonging to the higher household wealth status [1.46 (1.18–1.82)]. On the other hand, the likelihood of being developmentally on track was lower in children aged 48–59 months [0.35 (0.30–0.40)], in children living in rural areas [0.77 (0.62–0.96)], in children with stunting [0.77 (0.61–0.96)], and in underweight children [0.61 (0.52–0.72)]. Conclusion Our findings indicate that 29.95% of children aged 36–59 months in Afghanistan are developmentally on track. Positive associations were found between ECD and higher parental education and household wealth status. However, living in rural areas, underweight and stunted growth were negatively associated with ECD. To improve early childhood development programs in Afghanistan, targeted interventions are needed to address the factors identified in this study.

Abstract Background The proliferation of instruments that define instrument-specific metrics impedes progress in comparative assessment across populations. This paper explores a method to extract a common metric from related but different instruments and transform the original measurements into scores with a standard unit of measurement. Methods Existing data from four assessment instruments of child development, collected from three different samples of children, were used to create “equate clusters” of items that measure the same behaviour in (slightly) different ways. A probability model was formulated to identify best items and groups to serve as anchors linking the instruments, assuming that items in an anchoring or “active” equate cluster are psychometrically equivalent. Quantification and inspection of item characteristic curves were used to resolve which equate clusters should be active. We simulated the impact of various analytic choices. Results Simulation confirmed the feasibility of creating a common metric from data collected with different instruments from respondent samples with different abilities. The method performed as expected in an application in early childhood development. Conclusions The use of equate clusters is an intuitive and flexible way to establish a common metric across instruments and facilitates the transformation of measurements obtained to a standardized scale. Standardizing instrument scores to a common metric allows for population-level comparisons on a global scale.

Abstract Background This study aims to examine the association for paternal care and father-child screen use with early childhood development and children’s temper tantrums. Method Study file included questions about paternal characteristics, child care, father-child screen habits, and utilized the UNICEF Early Childhood Development Index (ECDI). Factors influencing ECDI-on-track status and children’s responses when screen use was restricted were investigated with Chi-square test and multiple logistic regression. Results The study included 464 fathers having children aged 3–4 years. The findings showed that 89.7% of the children were on track in three out of the four ECDI subgroups. When screen use was restricted, 55.6% of the children engaged in another activity, while 44.4% reacted by crying. Multiple logistic regression analysis revealed that the father’s education level, the child’s age and gender, the starting age for screen usage, the child’s reaction to screen restriction, and having three or more books were associated with ECDI. Furthermore, the child’s reaction to screen restriction was related to the child’s and father’s screen time, the presence of three or more books, the adequacy of care, and being on track in the literacy-numeracy ECDI subgroup. Conclusion Screen usage habits significantly impact early childhood development and children’s reactions to screen restrictions. These findings underscore the importance of educating fathers about the effects of their own and their child’s media habits, the quality of fatherly caregiving, and the presence of books in fostering positive child development.

Abstract Background Evidence is needed to understand factors that influence child development and caregiving experiences, especially in marginalized contexts, to inform the development and implementation of early childhood development (ECD) interventions. This study explores caregiving practices for young children in an urban informal settlement with Kenyans and embedded refugees, and identifies factors shaping these caregiving experiences, to inform the design and development of potentially appropriate ECD interventions. Methods A qualitative formative study, which included 14 focus group discussions (n = 125 participants), and 13 key informant interviews was conducted between August and October 2018. Purposive sampling approaches were used to select a diverse range of respondents including caregivers of children below three years of age and stakeholders of Kenyan nationality and refugees. Data were analysed using a thematic approach and the Nurturing Care Framework was used as an interpretative lens. Results There was a fusion of traditional, religious and modern practices in the care for young children, influenced by the caregivers’ culture, and financial disposition. There were mixed views/practices on nutrition for young children. For example, while there was recognition of the value for breastfeeding, working mothers, especially in the informal economy, found it a difficult practice. Stimulation through play was common, especially for older children, but gaps were identified in aspects such as reading, and storytelling in the home environment. Some barriers identified included the limited availability of a caregiver, insecurity, and confined space in the informal settlement, all of which made it difficult for children to engage in play activities. Physical and psychological forms of discipline were commonly mentioned, although few caregivers practiced and recognized the need for using non-violent approaches. Some overarching challenges for caregivers were unemployment or unstable sources of income, and, particularly for refugee caregivers, their legal status. Conclusion These findings point to the interplay of various factors affecting optimal caregiving for young children in an urban informal settlement with Kenyans and refugees. Integrated ECD interventions are needed for such a mixed population, especially those that strive to anchor along caregivers’ social support system, co-designed together with community stakeholders, that ideally focus on parent skills training promoting nurturing care and economic empowerment.

Abstract Background An estimated 43% of children under age 5 in low- and middle-income countries (LMICs) experience compromised development due to poverty, poor nutrition, and inadequate psychosocial stimulation. Numerous early childhood development (ECD) parenting interventions have been shown to be effective at improving ECD outcomes, at least in the short-term, but they are (a) still too expensive to implement at scale in low-resource and rural settings, and (b) their early impacts tend to fade over time. New approaches to deliver effective ECD parenting interventions that are low-cost, scalable, and sustainable are sorely needed. Methods Our study will experimentally test a traditional in-person group-based delivery model for an evidence-based ECD parenting intervention against a hybrid-delivery model that increasingly substitutes in-person meetings with remote (mHealth) delivery via smartphones, featuring audiovisual content and WhatsApp social interactions and learning. We will assess the relative effectiveness and cost of this hybrid-delivery model compared to in-person delivery and will extend the interventions over two years to increase their ability to sustain changes in parenting behaviors and ECD outcomes longer-term. Our evaluation design is a cluster Randomized Controlled Trial (cRCT) across 90 villages and approximately 1200 households. Midline and endline surveys collected 12 and 24 months after the start of the interventions, respectively, will examine short- and sustained two-year intention-to-treat impacts on primary outcomes. We will also examine the mediating pathways using mediation analysis. We hypothesize that a hybrid-delivery ECD intervention will be lower in cost, but remote interactions among participants may be an inferior substitute for in-person visits, leaving open the question of the most cost-effective program. Discussion Our goal is to determine the best model to maximize the intervention’s reach and sustained impacts to improve child outcomes. By integrating delivery into the ongoing operations of local Community Health Promoters (CHPs) within Kenya’s rural health care system, and utilizing new low-cost technology, our project has the potential to make important contributions towards discovering potentially scalable, sustainable solutions for resource-limited settings. Trial Registration NCT06140017 (02/08/2024) AEARCTR0012704.

Group well-child care (GWCC) may promote interactive caregiving and prevent developmental delay.MethodThis cross-sectional study explored the association between GWCC attendance and odds for suspected developmental delay among low-income Asian immigrants as measured by the Ages and Stages Questionnaire (ASQ)-III at age 18 months.ResultsOdds for suspected developmental delay (OR=0.81, 95 % CI 0.40-1.62) were not significantly lower for GWCC infants. However, odds for developmental risk were significantly lower for GWCC infants in the ASQ's problem-solving domain (OR= 0.40, 95 % CI 0.17-0.92).ConclusionAmong low-income Asian immigrants, GWCC participation may be associated with lower odds for cognitive developmental delay.

Little is known about differences in physical activity among children from urban and rural areas in low-to middle-income countries and some previous investigations revealed disparities in physical activity levels among children and adolescents residing in urban and rural environments. We aimed to: (i) assess the proportion of preschool-aged children (3.0–4.9 years) meeting the global movement guidelines, (ii) evaluate the feasibility of the methods for the SUNRISE study, (iii) examine gender- and urban-rural differences in health and behavior outcomes. Urban and rural location was based on national classifications. Physical activity (waist-worn ActiGraph); sleep duration, screen time and movement behaviors; Gross and fine motor skills (Lower body strength and mobility, Supine-Timed up and go [S-TUG], One-leg standing balance test, hand grip dynamometer, 9-hole peg-board test); and executive functions (visual-spatial working memory and inhibition) were assessed in 112 preschoolers (n ​= ​50 boys, 33 urban), (n ​= ​62 girls, 41 urban). The results showed that only 18% of children met all movement guidelines, with 53% and 41% meeting the recommendations for sedentary screen time and total physical activity, respectively. A large proportion of children (81%) met the recommended sleep duration of 10–13 ​hours (h) per day. There is a clear need to promote healthy movement behaviours among preschool-aged children through targeted interventions that address their unique challenges related to gender and urban/rural residence.

Background The incidence of delay language development in early childhood is high, and the early recognition rate is low, which has a significant negative impact on the early childhood development of other dimensions. The family cognitive environment is a key factor affecting early childhood language development. Objective This study aimed to explore the influence of family cognitive environment on early childhood language development, and provide theoretical basis for promoting early childhood language development from the perspective of community intervention on family cognitive environment. Methods A retrospective case-control study was conducted on 4 307 children who were admitted to a community child healthcare department in Shanghai from 2018 to 2020. The Shanghai Pediatric Development Screening Scale Ⅱ (DenverⅡ) was used for developmental screening, which was conducted at the child's age of 1, 2, and 3 years old. A total of 172 children with delay language development were selected as the case group, and 516 children with normal language development were included in the control group, which was determined by the matching factor of age, with a ratio of the number of children in the case and control groups being 1∶3. The following information of children in both groups were collected, including children's basic birth characteristics, parental demographic characteristics, maternal pregnancy and childbirth characteristics, and family cognitive environment characteristics. The Logistic regression analysis was used to explore the influencing factors of delay early childhood language development. Results A total of 172 children with delayed early language development had an incidence rate of 3.99%, among them ,1-year-old, 2-year-old, and 3-year old children accounted for 33.14% (57 cases), 53.49% (92 cases), and 13.37% (23 cases), respectively. The proportions of male children, children with premature birth, and children with maternal education of high school and below were higher in the case group than those in the control group (P

Abstract Background Universal parenting campaigns are efficient, cost-effective and can eliminate barriers to accessing conventional, face-to-face parenting interventions. The aims of the CHAMPP4KIDS study were to assess Canadian early childhood providers’ perceptions of the acceptability and feasibility of implementing a universal parenting resource, the Parenting for Lifelong Health tip sheets. Methods Using a convergent mixed method design, an online survey of providers working with families with young children in Ontario, Canada was followed by focus group discussions with a subset of providers to explore their perceptions of using the tip sheets in their professional practice. Results Providers generally perceived the tip sheets to be acceptable but had reservations with respect to the feasibility of distributing the sheets to their clients as standalone, universal parenting resources. Providers agreed the tip sheets covered topics pertinent to caregivers’ concerns, offered useful strategies and, therefore, had the potential to be valuable, engaging resources for families. However, many providers said the sheets would only be effective as complementary resources to facilitated in-person sessions, especially for high-needs families. Conclusion Providers suggested that future iterations of these resources take into consideration more accessible design and formatting, literacy levels, word choice and further cultural adaptation. Insight into the nuances and potential divergence between provider perceptions of universal materials’ acceptability and feasibility can help adapt materials to pre-emptively respond to potential implementation barriers, facilitate intervention fidelity and, ultimately, increase the likelihood of intervention acceptability and feasibility of both providers and caregivers.

Abstract This study examined whether maternal depression is related to Early Childhood Developmental (ECD) delay among children by quantifying the mediating contribution of responsive caregiving. We used data from 1235 children (Children’s mean age = 50.4 months; 582 girls, 653 boys, 93.9% were Han), selected through convenience sampling, in 2021. 4.7% of children had ECD delay, 34.3% of mothers had depression. Children with depressed mothers were less likely to receive responsive caregiving (OR 4.35, 95% CI 2.60–7.27), and those who did not receive responsive caregiving were more likely to experience ECD delay (OR 3.89, 95% CI 1.89–8.02). Responsive caregiving partly mediated the relationship between maternal depression and ECD. Early intervention for children with depressed mothers is worthy of further investigation.

ObjectiveTo analyze the relationship between the utilization of basic public health services for child health management and the early development of infants and young children in rural areas. MethodsFrom May to June 2023, we conducted an on-site, face-to-face survey of 2 559 caregivers of rural children aged 6 – 24 months recruited through multistage sampling in 4 national and 4 provincial poverty alleviation counties in Henan province. Relevant child data were collected using a self-developed questionnaire and the Ages and Stages Questionnaires – Third Edition (ASQ-3). Multivariate logistic regression was used to analyze the association between basic public health services for child health management and children's early development. ResultsOf the 2 230 children with valid information, 15.19% were considered to be at high risk of early developmental delay, and the proportions at high risk were 19.82%, 17.56%, 22.40%, and 27.17% for children aged 7 – 8, 9 – 10, 21 – 22, and 23 – 24 months, respectively. Overall, 66.87% of children were reported to have used basic public health services for child health management. The proportion of children at high risk of early developmental delay was lower among those who used basic public health services for child health management than among those who did not (13.22% vs. 19.17%). The results of multivariate logistic regression analysis showed that, after controlling for potential confounders, the use of basic public health services for child health management was significantly negatively associated with high risk of early developmental delay in infants and young children (odds ratio = 0.76, 95% confidence interval: 0.58 – 0.99). ConclusionIn China, more attention should be paid to the lagging early development of infants and young children in poverty-alleviated rural areas, and improving and perfecting basic public health services in rural areas can help promote the provision of children's services and improve the level of early childhood development of rural children.

Background: Stunting or chronic malnutrition has been one of the major challenges to mankind for ages. The trends from the National Family Health surveys are more or less stagnant with a huge failure of the public health systems to tackle the problem of malnutrition. Innovative approaches are needed to tackle malnutrition. Objective: This pragmatic cluster randomized controlled trial (CTRI registration no. Trial REF/2023/08/071521) is planned to assess the effectiveness of a multifaceted antenatal and postnatal health educational intervention package implemented from the first trimester of pregnancy up to one year of infant age in reducing the rates of Low Birth Weight and improving the maternal-infant growth and developmental indicators in a cohort of rural pregnant women as compared to existing standards of care. Implication - The study emphasizes the importance of an ongoing continuum of care during the first 1000 days for effective birth weight, preventing malnutrition, and fostering infant growth and development as its programmatic pathway to impact. Results: We anticipate that the intervention will complement the existing health programs and will be implemented through the grassroot-level workers along with a community peer named “Safalta Tai” enabling community ownership of the intervention. Discussion: It also has a robust inbuilt monitoring and evaluation system through participatory action research for making it scalable and sustainable beyond the implementation period. Conclusion: The program leverages on the existing goverment programs like the poshan abhiyaan and the digital health mission. It has the potential to be incorporated in the exsiting health infrastructure without any additional resources and scaled up if found effective in reduction of low birth weight which is an important determinant of stunting in under five children.

The indispensable requisite for sustainable, and equitable early childhood education is innovative educators with developmentally appropriate strategies to communicate essential skills to young children. Holistic development of young infants, especially those under five years old lays the foundation of lifelong learning. Research revealed that songs and rhymes aid the development of fundamental abilities in children. However, most of the South African Early Childhood Development (ECD) educators are ill-equipped with expertise hence their constraints in using music-based pedagogy to aid in the Early Childhood Care and Education (ECCE) children’s acquisition of conversational skills. Therefore, this case study explored the constraints and proposed solutions for rural ECD educators in employing music-based pedagogies to impart conversational skills to learners. Six ECCE educators were purposively sampled from centres in Kimberley, Northern Cape province, South Africa to participate in a semi-structured interview and reflective writing. The generated data was analyzed thematically. All the participants concurred that the teaching method centered on music was the best for the ECCE classroom, however, they were restricted by factors such as inadequate expertise in music education, a dearth of musical materials, and a lack of government funding to acquire musical resources and inadequate infrastructural facilities and human resources. They believed that a short musical intervention program would boost their effectiveness and their self-confidence in employing music-based pedagogy to impact children’s language development. The study recommends that a resilient support system be implemented to support ECD educators with basic musical abilities. The results of this study will help curriculum creators and ECD/ECCE policymakers improve the developmental facilities available for teaching and learning.

Abstract Background In Rwanda, the prevalence of childhood stunting has slightly decreased over the past five years, from 38% in 2015 to about 33% in 2020. It is evident whether Rwanda's multi-sectorial approach to reducing child stunting is consistent with the available scientific knowledge. The study was to examine the benefits of national nutrition programs on stunting reduction under two years in Rwanda using machine learning classifiers. Methods Data from the Rwanda DHS 2015–2020, MEIS and LODA household survey were used. By evaluating the best method for predicting the stunting reduction status of children under two years old, the five machine learning algorithms were modelled: Support Vector Machine, Logistic Regression, K-Near Neighbor, Random Forest, and Decision Tree. The study estimated the hazard ratio for the Cox Proportional Hazard Model and drew the Kaplan–Meier curve to compare the survivor risk of being stunted between program beneficiaries and non-beneficiaries. Logistic regression was used to identify the nutrition programs related to stunting reduction. Precision, recall, F1 score, accuracy, and Area under the Curve (AUC) are the metrics that were used to evaluate each classifier's performance to find the best one. Results Based on the provided data, the study revealed that the early childhood development (ECD) program (p-value = 0.041), nutrition sensitive direct support (NSDS) program (p-value = 0.03), ubudehe category (p-value = 0.000), toilet facility (p-value = 0.000), antenatal care (ANC) 4 visits (p-value = 0.002), fortified blended food (FBF) program (p-value = 0.038) and vaccination (p-value = 0.04) were found to be significant predictors of stunting reduction among under two children in Rwanda. Additionally, beneficiaries of early childhood development (p

Background: Integrated child development services (ICDS) include supplementary nutrition, nutrition and health education, health check-ups, immunization, preschool education, and referral services targeted at beneficiaries including pregnant and lactating mothers, children below six years, and women of reproductive age. Specific interventions are implemented to support children for a higher developmental outcome. Objectives: The aims of this study are (1) to compare the development of ICDS beneficiaries in the age group of 4–6 years with the dropouts, (2) to assess caregiver practices among mothers of beneficiaries and the dropouts, and (3) to understand the perceptions of Anganwadi workers (AWWs) on early child development (ECD) and ICDS services. Methods: A cross-sectional study was conducted for two months in select Anganwadi centers (AWCs) of Hyderabad. AWCs were selected through multi-stage sampling. Respondents included 114 mothers and five AWWs. Quantitative data was collected by a questionnaire and qualitative data through an interview guide. Proportions were estimated for description. STATA 14.0 was used to find out correlates of development in children through unpaired t-test, Chi-square test, and logistic regression. Thematic analysis was done for qualitative data. Results: About 68.42% and 33.33% of children from the beneficiary group were found to show normal cognitive and emotional development when compared to the dropout group (59.65% and 21.05%, respectively). KAP assessment revealed no significant difference between the mothers of dropouts and beneficiaries. Lack of infrastructure and poor attention to preschool activities were identified as reasons for dropout. Conclusion: Improving infrastructure, capacity building of AWWs, and reducing their workload will help in focusing on ECD-related activities at ICDS centers.

Abstract Objective Socioeconomic status (SES) has been previously associated with children’s early development, health, and nutrition; however, evidence about the potential role of caregiver-child interaction in such associations was limited. This study aimed to explore the effect of caregiver-child interaction on the associations of SES with child developmental outcomes, including early neurodevelopment and social-emotional behavior. Methods A cross-sectional survey was conducted among 2078 children aged 0–6 in a rural county that just lifted out of poverty in 2020 in Central China. The Ages & Stages Questionnaires-Chinese version (ASQ-C) and the Social-Emotional (ASQ: SE) questionnaire were used to assess children's early neurodevelopment and social-emotional behavior, respectively. Caregiver-child interaction was evaluated with the Brigance Parent–Child Interactions Scale. Regression-based statistical mediation and moderation effect were conducted with the PROCESS macro of SPSS. Results Children with low SES had an increased risk of suspected neurodevelopmental delay [OR = 1.92, 95% CI: 1.50, 2.44] and social-emotional developmental delay [OR = 1.31, 95% CI: 1.04, 1.66]. The caregiver-child interaction partially mediated the associations of SES with child developmental outcomes; the proportion of the indirect effect was 14.9% for ASQ-C total score and 32.1% for ASQ: SE score. Moreover, the caregiver-child interaction had a significant moderation effect on the association of SES with ASQ-C total score (P

Abstract Background Research in the neurosciences has highlighted the importance of intersubjective relationships in promoting neuromental development of the child. Children’s learning in early childhood occurs mainly in a dyadic context of an interaction with their parents: from this perspective, good dialogic parent–child communication is required to be promoted also through good educational practices. Dialogic Book-Sharing (DBS), a dialogic form of parent–child communication through the use of wordless picture books, provides a privileged ‘intersubjective’ space and is highly effective in promoting communication, language, attention, behavioural development and the parent–child relationship. DBS programme, successfully previously trialled in South Africa and the UK, will be applied for the first time in Italy for research purposes in Italian health, educational and maternal-child centres. Methods A multicentre randomised controlled trial is being conducted to evaluate DBS parenting intervention for children aged between 14 and 20 months. Parent–child dyads are randomly allocated to a book-sharing intervention group or to a wait-list control group. In the intervention, parents are trained in supportive book-sharing with their children by local staff of the centres. DBS intervention is carried out in small groups over a period of 4 weeks. Data are collected at baseline, post-intervention and at 6 months post-intervention with a questionnaire and video recording of parent–child interaction. Discussion DBS programme in early childhood could enhance the educational resources offered by Italian health, educational and maternal-child centres, in support of child’s development and parenting. DBS represents a strategic opportunity for bringing about positive effects, also in terms of prevention of socio-emotional and cognitive difficulties. As such it represents a promising response to the new social, health and educational needs of the post-COVID-19 pandemic era caused by the social isolation measures. Furthermore, the application of the DBS methodology is a way to promote the use of books, and thereby counteract the excessive use of technological devices already present in early childhood. Trial registration The trial is registered on the International Standard Randomised Controlled Trial Number database, registration number ISRCTN11755019 Registered on 2 November 2023. This is version 1 of the protocol for the trial.

Background: Universal parenting campaigns are efficient, cost-effective and can eliminate barriers to accessing conventional, face-to-face parenting interventions. The aims of the CHAMPP4KIDS study were to assess Canadian early childhood providers' perceptions of the acceptability and feasibility of implementing a universal parenting resource, the Parenting for Lifelong Health tip sheets. Methods: Using a convergent mixed method design, an online survey of providers working with families with young children in Ontario, Canada was followed by focus group discussions with a subset of providers to explore their perceptions of using the tip sheets in their professional practice. Results: Providers generally perceived the tip sheets to be acceptable but had reservations with respect to the feasibility of distributing the sheets to their clients as standalone, universal parenting resources. Providers agreed the tip sheets covered topics pertinent to caregivers' concerns, offered useful strategies and, therefore, had the potential to be valuable, engaging resources for families. However, many providers said the sheets would only be effective as complementary resources to facilitated in-person sessions, especially for high-needs families. Conclusion: Providers suggested that future iterations of these resources take into consideration more accessible design and formatting, literacy levels, word choice and further cultural adaptation. Insight into the nuances and potential divergence between provider perceptions of universal materials' acceptability and feasibility can help adapt materials to pre-emptively respond to potential implementation barriers, facilitate intervention fidelity and, ultimately, increase the likelihood of intervention acceptability and feasibility of both providers and caregivers. [ABSTRACT FROM AUTHOR]

This study examined whether maternal depression is related to Early Childhood Developmental (ECD) delay among children by quantifying the mediating contribution of responsive caregiving. We used data from 1235 children (Children's mean age = 50.4 months; 582 girls, 653 boys, 93.9% were Han), selected through convenience sampling, in 2021. 4.7% of children had ECD delay, 34.3% of mothers had depression. Children with depressed mothers were less likely to receive responsive caregiving (OR 4.35, 95% CI 2.60–7.27), and those who did not receive responsive caregiving were more likely to experience ECD delay (OR 3.89, 95% CI 1.89–8.02). Responsive caregiving partly mediated the relationship between maternal depression and ECD. Early intervention for children with depressed mothers is worthy of further investigation. [ABSTRACT FROM AUTHOR]

Recognizing the inequities in developmental screening and services for children in immigrant families, a pediatric primary care clinic in partnership with a community-based early childhood program co-created a bicultural, bilingual early childhood developmental (ECD) family navigator program in Seattle, Washington. The primary aim of this study is to explore caregivers' perspectives about this program. Twenty-seven caregivers of young children participated in semi-structured interviews that were thematically analyzed. Three key themes were identified: 1) sharing language and culture, 2) facilitating accessibility, and 3) promoting development. Caregivers valued linguistic and cultural concordance between the navigator and the family, the navigator's approach to screening to improve accessibility and reduce barriers, and the focus on supporting early childhood development. Understanding caregivers' experience with the ECD family navigator development program and the aspects they value, informs clinic-based approaches to ensure families of diverse language and cultural backgrounds have accessible development screening and connection to services. [ABSTRACT FROM AUTHOR]

Introduction: This study reports on the process evaluation of an oral health promotion intervention for educators (principals and teachers) at early childhood development (ECD) centres within a low‐socioeconomic community in South Africa. This approach was based on the premise that oral health literacy plays a significant role in shaping personal health and serves as an impetus to influence change in others. Methods: Using a cross‐sectional, descriptive study design, 91 educators participated in the oral health intervention as part of their 1‐year ECD training programme. The pre‐test questionnaire measured perceived dental status, oral health‐related knowledge, attitudes and practices and impact of oral health problems on oral health‐related quality of life (OHRQoL). The post‐test questionnaire evaluated the usefulness of the oral health workshop to participants, intentions for personal change as well as for the inclusion of oral health in their ECD centre programme. Results: Participants reported: having their natural teeth (80%), being happy with their mouth (56.2%), having oral problems (34%), inadequate oral hygiene practices (43%), dental visits when symptomatic (74%), a compromised OHRQoL and inadequate knowledge of oral problems experienced. Oral health promotion activities at ECD centres were limited, with only 34% reporting on toothbrushing programmes. Following the intervention, participants reported positively on aspects such as, the value of the workshop for themselves and their ECD centres, intentions for personal change to hygiene practices (56%), dietary practices (76%) and dental visits (63%). The incorporation of oral health education in their ECD centres was mentioned by most educators. Daily toothbrushing was noted by up to 40% while some highlighted their engagement with parents. Conclusion: Building oral health literacy among educators has the potential for personal change and serves as an impetus to introduce oral health promotion programmes at ECD centres. The findings may be used to advocate for oral health partnerships with established community‐based structures to increase access to oral care in ECD centres in underserved communities. [ABSTRACT FROM AUTHOR]

We investigate the socioeconomic determinants of early childhood development (ECD) in Türkiye, focusing on maternal education and household wealth, using representative microdata from the 2018 Türkiye Demographic and Health Survey (TDHS), which collected data on the developmental status of young children aged 36–59 months for the first time. Using this data, we construct an ECD index based on four developmental domains (i.e., literacy-numeracy, physical development, learning readiness and socio-emotional). Our results suggest that 74 percent of children (70.3 percent of boys and 78 percent of girls) are developmentally on track. We find that while over 96 percent of children are developmentally on track in physical and learning readiness domains, only 14.5 percent and 73.6 percent are in the literacy-numeracy and socio-emotional development domains, respectively. The multivariate regression results suggest both maternal education and household wealth improve children's ECD outcomes but the latter has a stronger effect. In fact, we find that mother's schooling is only positively and statistically associated with ECD once mothers have at least a high school education. Kindergarten attendance, which stands at a meagre 11.3 percent, is only likely for children from well-to-do and educated households. As a result, we find large gaps in ECD and its components between children with low and high socioeconomic backgrounds. We conclude that leveling the playing field is only possible via a nationwide multisectoral initiative that can support and educate caregivers and children simultaneously. [ABSTRACT FROM AUTHOR]

Background: The pandemic has put at risk the social and emotional development of children on account of the paucity of arenas for social interaction. This study from Kerala, India was conducted to assess the resilience factors, behavioural concerns, psychological distress symptoms among the children aged 3 to 5 years. We also tried to look into the lost opportunities that could have aided the social and emotional development of children like peer interaction, child care hours. Methods: The cross-sectional study was conducted among the children aged 3 to 5 years. A total of 535 children attending the immunisation clinics were enrolled by consecutive sampling. Devereux Early Childhood Assessment P2 (DECA P2) questionnaire was used to assess the levels of resilient factors and behavioural concerns in the study population. Results: We observed a high proportion of children in the area of need category of protective factors under DECA P2. The proportion of children falling under area of concern was 64.5%, 49%, 68.4% for attachment/relationship, self-regulation, and initiative respectively. 24.9% study subjects have a behavioural concern score that puts them in the area of need category. The logistic regression model we created identified 'Male Gender,' 'Mothers could spend only less time for child care' and 'electronic devices used as pacifier' as significant predictors for belonging to Area of need Behavioural Concerns T score category. Conclusion: A large proportion of children aged between 3 to 5 years with reported behavioural concerns and lack of protective factors for socioemotional development. This can be attributed partly to the ongoing pandemic and its associated restrictions. The increased child care hours invested by parents or grandparents could have sized down the full impact that the pandemic would have had on the socio emotional development of the child. Increased time spent using electronic devices coupled with dwindled opportunities for interaction with peers have been notable challenges. [ABSTRACT FROM AUTHOR]

Early childhood development (ECD) is crucial for better health and well‐being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem‐solving and personal–social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community‐based cross‐sectional survey design, 627 mother–child (12–36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ‐3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem‐solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non‐stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition. Key messages: Studies examining early childhood development (ECD) and child nutrition are scarce in Ethiopia, mainly due to lack of reliable and disaggregated ECD data.We estimated the prevalence of ECD delays and examined how different ECD domains were associated with child nutrition in urban Ethiopia using a direct ECD measure.Our study revealed that stunted and underweight children had a higher likelihood of ECD delays. To address these issues, we recommend coordinated efforts across key sectors, such as health, education, women's affairs and social protection, to promote and implement ECD interventions, such as nurturing care. [ABSTRACT FROM AUTHOR]

Despite increasing demands, the uptake of parenting education programs in developing countries is limited. This study evaluated the effectiveness of a Learning Through Play (LTP) informed, illustration-based parent educational training program designed for low-literacy populations in Bangladesh to promote early childhood development. A quasi-experimental design was employed, involving parents of typically developing children and children with special needs aged 0–6 years. Results showed significant enhancements in parenting knowledge, skills, and attitudes in both groups, with larger effects on knowledge and attitudes among parents of special needs children. The findings underscore the potential of LTP Calendar-based educational training programs as cost-effective, culturally sensitive, and accessible strategies for enhancing positive parenting practices and child development outcomes in economically disadvantaged settings. Future research should focus on cultural sensitivity evaluation, sample size expansion, and long-term impact assessment to further validate and extend these findings. [ABSTRACT FROM AUTHOR]

• Using data from three waves of Multiple Indicators Cluster Surveys (2010-2020), we identified three patterns of child development in low- and middle-income countries: Learning Challenged but On Track for Physical and Social-emotional Development; Academically Challenged, but Approaches-to-Learning Competent, On Track for Physical and Social-emotional Development; and Competent across All Domains. • Three predictors at the microlevel showed sizable associations with the class membership of child development: preschool attendance, number of books at home, and maternal education. • Early childhood policy in low- and middle-income countries needs to go beyond a one-size-fits-one approach and tailor resources to meet varying needs and promote child development. Investing in early childhood development (ECD) is critical for individual and societal development. Variable-centered research on ECD has shown that family wealth, maternal education, and parenting practices predict childhood outcomes overall. However, little is known about differences in the ECD patterns and their predictors. This study examined the latent classes of ECD using data from three waves of the Multiple Indicators Cluster Surveys (MICS) conducted in 29 low- and middle-income countries (LMICs) between 2010 and 2020 (MICS 4, 5, and 6) and identified their predictors at different ecological levels. The total sample size for analyses was 226,374 (n MICS4 = 70,082, n MICS5 = 91,652, n MICS6 = 64,640; M age = 47.23(months), SD age = 6.87). Three classes, Learning Challenged but On Track for Physical and Social-emotional Development, Academically Challenged but Approaches-to-Learning Competent, On Track for Physical and Social-emotional Development , and Competent across All Domains , were consistently identified across MICS 4–6 using latent class analysis. Three variables, all at the microsystem level, predicted class membership with acceptable effect sizes in one or more waves of the MICS data: preschool attendance, number of books at home, and maternal education. The study has implications for future research and the development of policies aimed at monitoring and supporting ECD in LMICs. [ABSTRACT FROM AUTHOR]

• Children experience unequal environments and development prior to primary school • Pre-primary quality, home stimulation, and early childhood development are studied • Outcomes by socioeconomic status are examined for pre-primary students in Egypt • There is substantial socioeconomic inequality in stimulation at home • There is less inequality in pre-primary quality and inputs, varying by dimension By the time children start primary school, large socioeconomic disparities are evident in their learning and development. Both pre-primary and home environments can play important roles in influencing school readiness and can contribute to disparities in early childhood development, but there is limited evidence on their relative roles in the Middle East and North Africa. This paper examines how pre-primary quality, stimulation at home, and early childhood development vary by socioeconomic status for pre-primary students in Egypt. The results demonstrate substantial socioeconomic inequality in stimulation at home, more so than in pre-primary quality and inputs, although there is variation in the degree of inequality across different dimensions of pre-primary quality. "Double inequality" is observed, where students with less stimulating home environments experience slightly lower quality pre-primary inputs. There are particularly large pre-primary inequities in structural quality (physical environment) and less inequity in process quality (pedagogy). These results suggest that targeted investments in pre-primary education in Egypt are necessary to reduce inequality in school readiness but are likely insufficient to close the socioeconomic status gap in children's development. Investing in interventions to improve vulnerable children's home learning environments, as well as investing in quality pre-primary, is critical to address disparities in children's development. [ABSTRACT FROM AUTHOR]

Aim: To address: What are the experiences of 2SLGBTQQIA+ parents using parenting supports and services to meet their children's early childhood development needs (<5 years of age)? Design: Whittemore and Knafl's (2005) integrative review methodology. Methods: Electronic databases were searched from 2000 to October 14, 2022 for empirical studies or reviews addressing the research question. The title and abstract of 12,158 articles were screened for inclusion in the review by two independent researchers; 175 of these articles underwent full‐text review. Studies selected were critically appraised using a Joanna Briggs Institute Critical Appraisal tool. Relevant key findings were extracted from each study and entered into N‐VIVO‐12. Thematic content analysis was employed and PRISMA guidelines were adhered to. Results: A total of 18 articles (15 qualitative and three multi‐method studies) met the inclusion criteria and were selected for the review. Seven themes were revealed from analysis of the studies: (1) 2SLGBTQQIA+ Status kept a secret; (2) Forced to come out; (3) Heteronormative messaging; (4) Feeling excluded; (5) Stigmatised; (6) Parents act as educators; and (7) Positive experiences. Conclusion: This integrative review provides nurses with insight into the experiences of 2SLGBTQQIA+ parents using health care services for their young child. Implications for the Profession: This article highlights what changes nurses need to make to their practice to ensure appropriate, inclusive care for clients of diverse sexual and gender identities and their families. Impact: Health care providers, especially nurses, have an opportunity to improve the experiences of these families and positively impact their health and well‐being. Additionally, there is a need for research with the 2SLGBTQQIA+ parent community and the use of rigorous methodological techniques, including clearly linking participants' gender and sexual identities with study findings, to improve our understanding of 2SLGBTQQIA+ parent experiences. Patient or Public Contribution: Although there was no direct patient contribution to the work since it was an integrative review of the literature, indirectly patient contributions are incorporated from the original research results of studies incorporated into this review. [ABSTRACT FROM AUTHOR]

Global guidelines emphasize the critical role of responsive caregiving in terms of reducing violence against children and promoting early childhood development. However, there is an absence of global evidence synthesis on the effects of early childhood parenting programs for children with developmental disabilities. This systematic review and meta-analysis aims to investigate the effectiveness of parenting interventions delivered for preschool-age children with developmental disabilities in reducing violence against children, altering violence-related factors, and promoting child development. We searched for randomized controlled trials with inactive control. Estimates were pooled using robust variance estimations. Meta-regressions were conducted to explore sources of heterogeneity. In all, 33 studies met the inclusion criteria. The results showed that parenting programs improved child behavior, parental mental health, parenting practices, parental self-efficacy, parent–child interaction, child language skills, and child social skills post-intervention. No studies provided data on the actual occurrence of violence against children. Effects might vary by diagnosis, delivery modality, and world region. The findings supported the delivery of parenting programs to alter factors associated with violence against children and promote child language and social skills for families of young children with developmental disabilities, especially attention deficit hyperactivity disorder, autism, intellectual disability, and language disorders. More research using rigorous methods, long-term follow-ups, and transparent reporting is needed, particularly within more low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background: Integrated child development services (ICDS) include supplementary nutrition, nutrition and health education, health check-ups, immunization, preschool education, and referral services targeted at beneficiaries including pregnant and lactating mothers, children below six years, and women of reproductive age. Specific interventions are implemented to support children for a higher developmental outcome. Objectives: The aims of this study are (1) to compare the development of ICDS beneficiaries in the age group of 4-6 years with the dropouts, (2) to assess caregiver practices among mothers of beneficiaries and the dropouts, and (3) to understand the perceptions of Anganwadi workers (AWWs) on early child development (ECD) and ICDS services. Methods: A cross-sectional study was conducted for two months in select Anganwadi centers (AWCs) of Hyderabad. AWCs were selected through multi-stage sampling. Respondents included 114 mothers and five AWWs. Quantitative data was collected by a questionnaire and qualitative data through an interview guide. Proportions were estimated for description. STATA 14.0 was used to find out correlates of development in children through unpaired t-test, Chi-square test, and logistic regression. Thematic analysis was done for qualitative data. Results: About 68.42% and 33.33% of children from the beneficiary group were found to show normal cognitive and emotional development when compared to the dropout group (59.65% and 21.05%, respectively). KAP assessment revealed no significant difference between the mothers of dropouts and beneficiaries. Lack of infrastructure and poor attention to preschool activities were identified as reasons for dropout. Conclusion: Improving infrastructure, capacity building of AWWs, and reducing their workload will help in focusing on ECD-related activities at ICDS centers. [ABSTRACT FROM AUTHOR]

Concerns about language development are among the most common complaints that parents seek medical advice regarding their children's development. Developmental language disorder refers to a delay in children's receptive or expressive language development without an underlying medical condition. Risk factors such as prematurity, low socioeconomic status, screen exposure, maternal depression and family history can affect language development in children. In a child presenting with a complaint of delay in language development, a detailed anamnesis should be taken, including developmental history, home environment, family history and psychosocial risk factors. The evaluation of a child should include not only language development but also all areas of development (language, cognitive, motor, relationship, social-emotional) using a standatdized developmental assessment tool. A detailed physical examination should be performed to check for accompanying genetic, neurological and other medical conditions (e.g. cleft palate). Regardless of the result of newborn hearing screening, all children should undergo hearing tests, and if necessary, hemogram and iron parameters should be evaluated. If there is a history of regression, delay in the relationship area, or signs of accompanying neurudevelopmental problems, further evaluation should be performed. It should not be fogotten that a delay in language development may be the initial sign of problems such as cognitive delay, autism spectrum disoeder, hearing loss, and speech pronounciation disorder. Early intervention shoul be planned for children with delayed language development and should not be waited for. Monitoring and supporting each child's development with family-centered methods is the most effective method for the prevention, early diagnosis, and early intervention of all developmental difficulties, including delay in language development. [ABSTRACT FROM AUTHOR]

Home environments suffered a range of stressors during COVID-19 pandemic. This study examines the impact of these stressors on children's well-being by households' conditions. Participants included main caregivers (N = 615) with a child under the age of 3 in a developing Latin-American country. We use multivariate analysis to explore associations between these shocks, the childrearing environment, and children's well-being. We find that households with lower education and recipients of government assistance were more exposed to negative shocks linked to COVID-19. However, the most educated households were more likely to face an increased burden of childcare. Exposure to negative shocks was associated with a deterioration in the emotional well-being of adults, a higher prevalence of intra-family violence, and behavioral changes in children. Households that reported more time spent caring for children, as well as difficulties in combining care and work, showed higher levels of parental depression and worse indicators of parenting quality. We observe a drop in the frequency of parental involvement in didactic and socializing activities with their children, and a poorer mental health status for the main caregiver (mostly mothers). [ABSTRACT FROM AUTHOR]

Background: Research in the neurosciences has highlighted the importance of intersubjective relationships in promoting neuromental development of the child. Children's learning in early childhood occurs mainly in a dyadic context of an interaction with their parents: from this perspective, good dialogic parent–child communication is required to be promoted also through good educational practices. Dialogic Book-Sharing (DBS), a dialogic form of parent–child communication through the use of wordless picture books, provides a privileged 'intersubjective' space and is highly effective in promoting communication, language, attention, behavioural development and the parent–child relationship. DBS programme, successfully previously trialled in South Africa and the UK, will be applied for the first time in Italy for research purposes in Italian health, educational and maternal-child centres. Methods: A multicentre randomised controlled trial is being conducted to evaluate DBS parenting intervention for children aged between 14 and 20 months. Parent–child dyads are randomly allocated to a book-sharing intervention group or to a wait-list control group. In the intervention, parents are trained in supportive book-sharing with their children by local staff of the centres. DBS intervention is carried out in small groups over a period of 4 weeks. Data are collected at baseline, post-intervention and at 6 months post-intervention with a questionnaire and video recording of parent–child interaction. Discussion: DBS programme in early childhood could enhance the educational resources offered by Italian health, educational and maternal-child centres, in support of child's development and parenting. DBS represents a strategic opportunity for bringing about positive effects, also in terms of prevention of socio-emotional and cognitive difficulties. As such it represents a promising response to the new social, health and educational needs of the post-COVID-19 pandemic era caused by the social isolation measures. Furthermore, the application of the DBS methodology is a way to promote the use of books, and thereby counteract the excessive use of technological devices already present in early childhood. Trial registration: The trial is registered on the International Standard Randomised Controlled Trial Number database, registration number ISRCTN11755019 Registered on 2 November 2023. This is version 1 of the protocol for the trial. [ABSTRACT FROM AUTHOR]

As the U.S Hispanic population has increasingly grown throughout the years, the growing population has indicated that there will be change in the makeup of the cultural fabric of the country. The Hispanic population growth has led to the increase in numbers of English Learner (EL) students in both private and public schools in the U.S. which has subsequently led to the need to adapt and improve the U.S. education system for EL students. As the transformation in our counties cultural fabric continues to change the same change needs to be reflected on the student's education. This narrative will explain and rationalize the pedagogical practices that are in place to improve and embrace multilingualism and multiculturalism in education from early childhood development to higher education. The narrative found that a key indicator that influences the success of Hispanic students is early childhood development and education, this includes having access to necessary resources, being in culturally stimulating environment and training in English proficiency. The narrative also found that early education should not be limited to just schools but also needs the cooperation from the student's family and cultural centers. If early childhood development is not established the student will not be on the same level as other students and will be attempting to catch up to the education level other students are at. As the student gets older practices such as the ones being practiced in early childhood development should expand throughout the student's education. [ABSTRACT FROM AUTHOR]

The state of early learning provision remains elusive in Namibia. This study aimed at determining the provision of early learning to children aged between 0–8 years; caregivers' capabilities; and the resources availability in the country. The study used a mixed methods approach in collecting data from a sample of 32 ECD centres and caregivers. The convergent parallel mixed methods used a questionnaire, observation check list, photography and interviews with caregivers. Thematic analysis was applied to augment the qualitative data. The results showed that achieving inclusive, equitable and quality education for all children in Namibia was a pipe dream in the prevailing education, economic and social situation in the country. Factors contributing to the non-attainment of quality and equitable ECD for all children included; overcrowded ECD centres; inadequate learning environments and poor physical facilities. This study recommends a comprehensive training programme, a better learning environment, and the use of locally available materials for teaching at ECD centres. [ABSTRACT FROM AUTHOR]