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About this paper symposium
| Panel information |
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| Panel 27. Solicited Content: Global South |
| Paper #1 | |
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| Effects of Caregiver Cognitive Stimulation on Early Childhood Development: A Systematic Review and Meta-Analysis | |
| Author information | Role |
| Sarah Hatch, Harvard, United States | Presenting author |
| Noelle M. Suntheimer, University of Minnesota, United States | Non-presenting author |
| Laura Tang, University of British Columbia, USA | Non-presenting author |
| Dana C. McCoy, Harvard University, United States | Non-presenting author |
| Sharon Wold, University of Pennsylvania, United States | Non-presenting author |
| Abstract | |
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Parents’ cognitive stimulation–the provision of mentally engaging activities like reading, singing, or counting–is widely considered a key mechanism that supports young children in achieving their developmental potential across geographically diverse samples. Theory and research on cognitive stimulation has inspired numerous interventions and policies to encourage the provision of cognitively stimulating activities (Bates et al., 2006; Sénéchal & Young, 2008). This line of work also informed the creation of multiple monitoring tools which assess home levels of cognitive stimulation (Bradley & Caldwell, 1979; Melhuish et al., 2008). Results of assessment in representative and international samples indicate that frequency of cognitive stimulation varies across both family and macroeconomic conditions (Coley et al., 2021; Flood et al., 2022; McCoy et al., 2022). Yet, despite this rich body of observational and experimental literature, no systematic review and meta-analysis has assessed the size and variation in relations between the frequency of early childhood cognitive stimulation experiences and children’s developmental outcomes. To address this gap in the literature, the current study conducts a systematic review and meta-analysis to provide an overview of the associations between cognitive stimulation and child outcomes across multiple domains. Using guidelines established by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA; Page et al., 2021), we imported 5,992 articles from four online databases that examined the associations between frequency of cognitive stimulation experiences with a primary caregiver before the age of six and children’s cognitive, psychosocial, physical, and learning outcomes. We excluded 1807 studies while downloading due to duplication, 3689 studies while abstract screening due to irrelevance, and 312 studies while full-text screening due to our exclusion criteria, leaving a final sample of 146 studies in our meta-analysis. We will use random effects meta-analysis to quantify the overall association between stimulation and child outcomes across the final sample of 146 studies. We will also examine subgroup differences based on child age, distance between time of stimulation and outcome, and country income classification (low-, middle-, and high-income countries). This examination is of particular interest as the concept of cognitive stimulation as frequently used in research has been adapted to, but did not originate in, the Majority World, and an estimated 81.0 million children ages 3 and 4 in low- and middle-income countries experience low cognitive and social-emotional development (McCoy et al., 2017). [For SRCD reviewers: to this point, we have completed the search, screening, and extraction stages. We are now preparing our extracted data for analysis. We have coded studies for country income level based on World Bank classifications from the year study data was collected; child age and gender; caregiver marital status, age, gender; type of stimulation and outcome, and effect sizes with relevant reported statistics. Our plan of analysis is pre-registered at PROSPERO under the code CRD42022314112.] |
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| Paper #2 | |||
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| Caregiver Education, Home-Stimulating Activities, and Child Development in Majority World Countries | |||
| Author information | Role | ||
| Hang Heather Do, University of Pennsylvania, United States | Presenting author | ||
| Dana C. McCoy, Harvard University, United States | Non-presenting author | ||
| Abstract | |||
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Research on caregiver education and home stimulation consistently shows positive associations with children’s development in high-income “Minority World” countries (Sirin, 2005; Harding et al., 2015). However, less is known about these processes in low- and middle-income, “Majority World” countries, where 250 million children under five are at risk of not reaching their developmental potential (Nielsen et al., 2017; Draper et al., 2022; Moriguchi et al., 2022). This paper explores how home stimulation mediates the relations between caregiver education and children’s social-emotional, language, cognitive, and motor development in infants and toddlers in Majority World countries. The sample includes 9,099 caregiver-child dyads from eight Majority World sites: 2,220 in Brazil, 197 in Guatemala, 1,194 in India, 387 in Jordan, 511 in Lebanon, 250 in Pakistan, 1,231 in the Philippines, and 3,109 in Zambia (50.7% female, ages 0-36 months; M = 18.50, SD = 10.70). Child development outcomes were measured using the Caregiver-Reported Early Development Instrument (CREDI), a population-level measure of early childhood development from birth to age three (McCoy et al., 2018). This measure captures a certain set of skills and behaviors in social-emotional, language, cognitive, and motor domains (M = 49.4-50.0; SD = 2.5-3.2). Caregiver education was assessed through a demographics survey prior to administering CREDI, and home stimulation was measured via the Multiple Indicator Cluster Survey focusing on six activities: reading books or looking at picture books, telling stories, singing songs, going outside the home, playing, and naming things (Kariger et al., 2012; UNICEF, 2020). A summary score index ranging from 0 (no caregiver engagement in all activities) to 6 (with full caregiver engagement in all activities) was generated. Approximately 43.1% of caregivers in the sample completed at least some primary education, and children received a moderate level of home stimulation (M = 3.5 of 6 stimulation practices, SD = 2.0). Path analyses using a structural equation modeling framework revealed that, controlling for child’s age and sex, home stimulation partially mediated the relations between caregiver education and all four developmental outcomes [social-emotional (β = 0.138, p < .001), language (β = 0.110, p < .001), cognitive (β = 0.153, p < .001), and motor (β = 0.157, p < .001)]. Multiple-group analysis was used to understand how these developmental processes operate differently based on the site’s geographical regions: Latin America, Asia, and Middle East & Africa (World Bank, 2017), and by child gender. Results showed significant differences in model fit by geographical regions (∆χ2 = 4177.90; p < .001) and also by child gender (∆χ2 = 73.35; p <.001), suggesting that the model operated differently for boys versus girls as well as between regions. These findings contribute to the field’s understanding of the universality and specificity of child development across settings. They also suggest the importance of supporting caregiver education and home stimulation activities as means of promoting children’s developmental outcomes, as well as the need to promote gender equity in the Majority World to ensure equal access to learning opportunities, especially opportunities in the home. |
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| Paper #3 | |
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| Influences of caregiver investments and early childhood outcomes in refugee and host households in Uganda | |
| Author information | Role |
| Lindsay Dusard, University of Pennsylvania, United States | Presenting author |
| Sarah Kabay, Innovations for Poverty Action, United States | Non-presenting author |
| Dana C. McCoy, Harvard University, United States | Non-presenting author |
| Sharon Wolf, Harvard University, United States | Non-presenting author |
| Abstract | |
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The Family Investment Model is a commonly applied framework for explaining the factors driving differential caregiver investments and their associations with child development outcomes (Conger & Donnellan, 2007). There is limited understanding of how these pathways present in contexts where families are experiencing many threats, beyond those related to socioeconomic status. Today, three quarters of the world’s 110 million forcibly displaced people are hosted in low- and middle-income countries (UNHCR, 2023). This study explores whether recent experiences of forced displacement moderate the relations between caregivers’ beliefs and experiences, patterns of caregiver investments, and children’s early development in a context where both refugee and host communities are experiencing significant economic deprivation (i.e., Uganda). It seeks to build on existing evidence of how caregiver psychological distress and beliefs about nurturing care shape caregiver investments, above and beyond experiences of poverty (Suntheimer et al., 2024). Survey data collected in the West Nile region of Uganda by BRAC and Innovations for Poverty Action (IPA) were used to explore these pathways. The sample (N=760), comprising refugee (n=626) and host (n=134) households, included dyads of a caregiver and their child, aged 24-72 months. Caregiver psychological distress was measured using the Kessler 10 (Ametaj et al., 2023) and beliefs about nurturing care using the six-item International Development and Early Learning Assessment (IDELA) Home Environment Questionnaire (Pisani et al., 2018). Early childhood outcomes were assessed using either the Caregiver Reported Early Development Instruments (CREDI) Long Form, for children ages 24-35 months (McCoy & Waldman, 2018), or the IDELA, for children ages 36-72 months (Pisani et al., 2018). Measures of caregiver investments included frequency of cognitive stimulation, access to learning materials in the home, and past enrollment in preschool (for older group) and were considered mediators. Each were constructed using survey responses, including the six play-activity items from UNICEF's Multiple Cluster Indicator Survey for frequency of cognitive stimulation (Kariger et al., 2012). Covariates, including caregiver education level and measures of household food security and socioeconomic status, were included. Observed child characteristics, including age in months (M = 47.42, SD = 10.37) and percent female (48%), were similar in the refugee and host communities. Nonparametric comparison tests of refugee and host communities’ household characteristics significantly differed on a number of key factors, including refugee caregivers reporting lower education levels and higher levels of psychological distress and household food insecurity. A series of structural equation models were constructed for younger versus older children, aligning with the use of CREDI and IDELA instruments. Although the magnitude of pathways differed across these models, the frequency of cognitive stimulation was consistently the strongest predictor of early childhood development outcomes for both age groups (β = .16-.34, p < .01), above and beyond other investments and covariates. Results from moderated mediation models that explore whether experiences of forced displacement moderated pathways will be presented in the final panel. Implications of these findings for adapting and delivering two generation programs for both refugee and host communities, in line with Ugandan policy, are discussed. |
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Exploring Influences of Caregiver Investments on Early Childhood Development: Research from Across the Global South
Submission Type
Paper Symposium
Description
| Session Title | Exploring Influences of Caregiver Investments on Early Childhood Development: Research from Across the Global South |