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Published in: Indian Journal of Pediatrics 7/2018

01-07-2018 | Original Article

Cognitive Development of Toddlers: Does Parental Stimulation Matter?

Authors: Prahbhjot Malhi, Jagadeesh Menon, Bhavneet Bharti, Manjit Sidhu

Published in: Indian Journal of Pediatrics | Issue 7/2018

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Abstract

Objective

To examine the impact of quality of early stimulation on cognitive functioning of toddlers living in a developing country.

Methods

The developmental functioning of 150 toddlers in the age range of 12–30 mo (53% boys; Mean = 1.76 y, SD = 0.48) was assessed by the mental developmental index of the Developmental Assessment Scale for Indian Infants (DASII). The StimQ questionnaire- toddler version was used to measure cognitive stimulation at home. The questionnaire consists of four subscales including availability of learning materials (ALM), reading activities (READ), parent involvement in developmental activities (PIDA), and parent verbal responsivity (PVR). Multivariate regression analysis was used to predict cognitive scores using demographic (age of child), socio-economic status (SES) (income, parental education), and home environment (subscale scores of StimQ) as independent variables.

Results

Mean Mental Development Index (MDI) score was 91.5 (SD = 13.41), nearly one-fifth (17.3%) of the toddlers had MDI scores less than 80 (cognitive delay). Children with cognitive delay, relative to typically developing (TD, MDI score ≥ 80) cohort of toddlers, had significantly lower scores on all the subscales of StimQ and the total StimQ score. Despite the overall paucity of learning materials available to toddlers, typical developing toddlers were significantly more likely to have access to symbolic toys (P = 0.004), art materials (P = 0.032), adaptive/fine motor toys (P = 0.018), and life size toys (P = 0.036). Multivariate regression analysis results indicated that controlling for confounding socio-economic status variables, higher parental involvement in developmental activities (PIDA score) and higher parental verbal responsivity (PVR score) emerged as significant predictors of higher MDI scores and explained 34% of variance in MDI scores (F = 23.66, P = 0.001).

Conclusions

Disparities in child development emerge fairly early and these differences are not all linked to economic disparities. There is a need to develop evidence-based parenting interventions for primary prevention of developmental problems, especially in resource poor countries.
Literature
1.
go back to reference Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369:60–70.CrossRefPubMedPubMedCentral Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369:60–70.CrossRefPubMedPubMedCentral
2.
go back to reference Black MM, Walker SP, Fernald LC, et al, for the lancet early childhood development series steering Commitee. Early childhood development coming of age: science through the life course. Lancet. 2017;389:77-90.CrossRefPubMed Black MM, Walker SP, Fernald LC, et al, for the lancet early childhood development series steering Commitee. Early childhood development coming of age: science through the life course. Lancet. 2017;389:77-90.CrossRefPubMed
3.
go back to reference Singhi P, Kumar M, Malhi P, Kumar R. Utility of the WHO ten questions screen for disability detection in a rural community: the north-Indian experience. J Trop Pediatr. 2007;53:383–7.CrossRefPubMed Singhi P, Kumar M, Malhi P, Kumar R. Utility of the WHO ten questions screen for disability detection in a rural community: the north-Indian experience. J Trop Pediatr. 2007;53:383–7.CrossRefPubMed
4.
go back to reference Lu C, Black MM, Richter LM. Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level. Lancet Glob Health. 2016;4:e916-22.CrossRefPubMedPubMedCentral Lu C, Black MM, Richter LM. Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level. Lancet Glob Health. 2016;4:e916-22.CrossRefPubMedPubMedCentral
5.
go back to reference Aly Z, Taj F, Ibrahim S. Missed opportunities in surveillance and screening systems to detect developmental delay: a developing country perspective. Brain Dev. 2010;32:90–7.CrossRefPubMed Aly Z, Taj F, Ibrahim S. Missed opportunities in surveillance and screening systems to detect developmental delay: a developing country perspective. Brain Dev. 2010;32:90–7.CrossRefPubMed
6.
go back to reference Sidhu M, Malhi P, Jerath J. Multiple risks and early language development. Indian J Pediatr. 2010;77:391–5.CrossRefPubMed Sidhu M, Malhi P, Jerath J. Multiple risks and early language development. Indian J Pediatr. 2010;77:391–5.CrossRefPubMed
7.
9.
go back to reference Harper C, Marcus R, Moore K. Enduring poverty and the conditions of childhood: life course and intergenerational poverty transmissions. World Dev. 2003;31:535–54.CrossRef Harper C, Marcus R, Moore K. Enduring poverty and the conditions of childhood: life course and intergenerational poverty transmissions. World Dev. 2003;31:535–54.CrossRef
10.
go back to reference Landry SH, Smith KE, Swank PR, Guttentag CA. Responsive parenting intervention: the optimal timing across early childhood for impacting maternal behaviors and child outcomes. Dev Psychol. 2008;44:1335–53.CrossRefPubMedPubMedCentral Landry SH, Smith KE, Swank PR, Guttentag CA. Responsive parenting intervention: the optimal timing across early childhood for impacting maternal behaviors and child outcomes. Dev Psychol. 2008;44:1335–53.CrossRefPubMedPubMedCentral
11.
go back to reference Rodriguez ET, Tamis-LeMonda CS. Trajectories of the home learning environment across the first 5 years: associations with children’s vocabulary and literacy skills at prekindergarten. Child Dev. 2011;82:1058–75.CrossRefPubMed Rodriguez ET, Tamis-LeMonda CS. Trajectories of the home learning environment across the first 5 years: associations with children’s vocabulary and literacy skills at prekindergarten. Child Dev. 2011;82:1058–75.CrossRefPubMed
12.
go back to reference Tomopoulos S, Dreyer BP, Tamis-LeMonda C, et al. Books, toys, parent-child interaction, and development in young latino children. Ambul Pediatr. 2006;6:72-8.CrossRefPubMed Tomopoulos S, Dreyer BP, Tamis-LeMonda C, et al. Books, toys, parent-child interaction, and development in young latino children. Ambul Pediatr. 2006;6:72-8.CrossRefPubMed
13.
go back to reference Malhi P, Bharti B, Sidhu M. Reading achievement of Indian children: role of home literacy environment. J Indian Acad Appl Psychol. 2017;43:49–58. Malhi P, Bharti B, Sidhu M. Reading achievement of Indian children: role of home literacy environment. J Indian Acad Appl Psychol. 2017;43:49–58.
15.
go back to reference Misra N, Phatak P. Developmental assessments scales for Indian infants. Baroda: MS University of Baroda; 1996. Misra N, Phatak P. Developmental assessments scales for Indian infants. Baroda: MS University of Baroda; 1996.
16.
go back to reference Dooley M, Stewart J. Family income, parenting styles and child behavioural- emotional outcomes. Health Econ. 2007;16:145–62.CrossRefPubMed Dooley M, Stewart J. Family income, parenting styles and child behavioural- emotional outcomes. Health Econ. 2007;16:145–62.CrossRefPubMed
17.
go back to reference Kiernan KE, Mensah FK. Poverty, family resources and children’s early educational attainment: the mediating role of parenting. Br Educ Res J. 2011;37:317–36.CrossRef Kiernan KE, Mensah FK. Poverty, family resources and children’s early educational attainment: the mediating role of parenting. Br Educ Res J. 2011;37:317–36.CrossRef
18.
go back to reference Weisleder A, Fernald A. Talking to children matters: early language experience strengthens processing and builds vocabulary. Psychol Sci. 2013;24:2143–52.CrossRefPubMedPubMedCentral Weisleder A, Fernald A. Talking to children matters: early language experience strengthens processing and builds vocabulary. Psychol Sci. 2013;24:2143–52.CrossRefPubMedPubMedCentral
19.
go back to reference Malhi P, Sidhu M, Bharti B. Early stimulation and language development of economically disadvantaged young children. Indian J Pediatr. 2014;81:333–8.CrossRefPubMed Malhi P, Sidhu M, Bharti B. Early stimulation and language development of economically disadvantaged young children. Indian J Pediatr. 2014;81:333–8.CrossRefPubMed
20.
go back to reference Nair MKC, Philip E, Jeyaseelan L, George B, Mathews S, Padma K. Effect of child development centre model early stimulation among at-risk babies—a randomized controlled trial. Indian Pediatr. 2009;46:S20–6.PubMed Nair MKC, Philip E, Jeyaseelan L, George B, Mathews S, Padma K. Effect of child development centre model early stimulation among at-risk babies—a randomized controlled trial. Indian Pediatr. 2009;46:S20–6.PubMed
21.
go back to reference Vazir S, Engle P, Balakrishna N, et al. Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers. Matern Child Nutr. 2013;9:99–117.CrossRefPubMed Vazir S, Engle P, Balakrishna N, et al. Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers. Matern Child Nutr. 2013;9:99–117.CrossRefPubMed
22.
go back to reference Yousafzai AK, Rasheed MA, Rizvi A, Armstrong R, Bhutta ZA. Effect of integrated responsive stimulation and nutrition interventions in the lady health worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial. Lancet. 2014;384:1282–93.CrossRefPubMed Yousafzai AK, Rasheed MA, Rizvi A, Armstrong R, Bhutta ZA. Effect of integrated responsive stimulation and nutrition interventions in the lady health worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial. Lancet. 2014;384:1282–93.CrossRefPubMed
23.
go back to reference Walker SP, Chang SM, Younger N, Grantham-McGregor SM. The effect of psychosocial stimulation on cognition and behavior at 6 years in a cohort of term, low-birthweight Jamaican children. Dev Med Child Neurol. 2010;52:e148–54.CrossRefPubMed Walker SP, Chang SM, Younger N, Grantham-McGregor SM. The effect of psychosocial stimulation on cognition and behavior at 6 years in a cohort of term, low-birthweight Jamaican children. Dev Med Child Neurol. 2010;52:e148–54.CrossRefPubMed
24.
go back to reference Mendelsohn AL, Huberman HS, Berkule SB, Brockmeyer CA, Morrow LM, Dreyer BP. Primary care strategies for promoting parent-child interactions and school readiness in at-risk families: the Bellevue project for early language, literacy, and education success. Arch Pediatr Adolesc Med. 2011;165:33–41.PubMedPubMedCentral Mendelsohn AL, Huberman HS, Berkule SB, Brockmeyer CA, Morrow LM, Dreyer BP. Primary care strategies for promoting parent-child interactions and school readiness in at-risk families: the Bellevue project for early language, literacy, and education success. Arch Pediatr Adolesc Med. 2011;165:33–41.PubMedPubMedCentral
25.
go back to reference Reis HT, Collins WA, Berscheid E. Relationships in human behavior and development. Psychol Bull. 2000;126:844–72.CrossRefPubMed Reis HT, Collins WA, Berscheid E. Relationships in human behavior and development. Psychol Bull. 2000;126:844–72.CrossRefPubMed
26.
go back to reference Merz EC, Landry SH, Montroy JJ, Williams JM. Bidirectional associations between parental responsiveness and executive function during early childhood. Soc Dev. 2017;26:591–609.CrossRefPubMed Merz EC, Landry SH, Montroy JJ, Williams JM. Bidirectional associations between parental responsiveness and executive function during early childhood. Soc Dev. 2017;26:591–609.CrossRefPubMed
27.
go back to reference Hamadani JD, Nahar B, Huda SN, Tofail F. Integrating early child development programs into health and nutrition services in Bangladesh: benefits and challenges. Ann N Y Acad Sci. 2014;1308:192–203.CrossRefPubMed Hamadani JD, Nahar B, Huda SN, Tofail F. Integrating early child development programs into health and nutrition services in Bangladesh: benefits and challenges. Ann N Y Acad Sci. 2014;1308:192–203.CrossRefPubMed
28.
go back to reference Chang SM, Grantham-Mcgregor SM, Powell CA, et al. Integrating a parenting intervention with routine primary health care: a cluster randomised trial. Pediatrics. 2015;136:272–80.CrossRefPubMed Chang SM, Grantham-Mcgregor SM, Powell CA, et al. Integrating a parenting intervention with routine primary health care: a cluster randomised trial. Pediatrics. 2015;136:272–80.CrossRefPubMed
29.
go back to reference Aboud FE, Yousafzai AK. Global health and development in early childhood. Annu Rev Psychol. 2015;66:433–57.CrossRefPubMed Aboud FE, Yousafzai AK. Global health and development in early childhood. Annu Rev Psychol. 2015;66:433–57.CrossRefPubMed
Metadata
Title
Cognitive Development of Toddlers: Does Parental Stimulation Matter?
Authors
Prahbhjot Malhi
Jagadeesh Menon
Bhavneet Bharti
Manjit Sidhu
Publication date
01-07-2018
Publisher
Springer India
Published in
Indian Journal of Pediatrics / Issue 7/2018
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-018-2613-4

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