Early executive functioning in a global context: Developmental continuity and family protective factors.

This study extends the methodological and theoretical understanding of executive functions (EFs) in preschoolers from low- and middle-income countries (LMIC). First, the authors describe a rigorous process of adapting and evaluating six EF tasks to produce a culturally and developmentally appropriate measure of emerging EFs in a large sample of at-risk children in rural Pakistan. Next, the authors identify critical developmental and family factors that relate to preschoolers' EFs over the first 4 years of life. Direct assessment of children's general cognitive skills at age two showed developmental continuity with EFs at age four, and these early cognitive skills mediated the effect of an antecedent parenting intervention on EFs as well as associations of targeted individual and family factors with EFs. Furthermore, directly assessed maternal cognitive capacities and observed maternal scaffolding uniquely predicted EFs in preschoolers. This study is also the first to demonstrate a significant overlap between direct assessments of IQ and EFs in young children from LMIC. Children's general intelligence mediated the associations of EFs with antecedent physical growth and cognitive skills as well as concurrent family factors (maternal verbal intelligence, maternal scaffolding, and home stimulation). After controlling for shared variance between preschoolers' general intelligence and EFs, three factors emerged as unique predictors of EFs: exposure to an early parenting intervention, physical growth status at age two, and number of older siblings. The findings have important implications for the design of interventions that aim to improve EFs in young children in LMIC. A video abstract of this article can be viewed at https://vimeo.com/316329544/5abde94cd7.

Biological Sensitivity to Family Income: Differential Effects on Early Executive Functioning.

The study examined how the interplay between children's cortisol response and family income is related to executive function (EF) skills. The sample included one hundred and two 5- to 6-year-olds (64% minority). EF skills were measured using laboratory tasks and observer ratings. Physiological reactivity was assessed via cortisol response during a laboratory visit. A consistent, positive association between family income and EF skills emerged only for children who showed high cortisol response, a marker of biological sensitivity to context. In contrast, family income was not related to EF skills in children who displayed low cortisol response. Follow-up analyses revealed a disordinal interaction, suggesting that differential susceptibility can be detected at the level of basic cognitive and self-regulatory skills that support adaptive functioning.

An integrative view of school functioning: transactions between self-regulation, school engagement, and teacher-child relationship quality.

This study investigates the dynamic interplay between teacher-child relationship quality and children's behaviors across kindergarten and first grade to predict academic competence in first grade. Using a sample of 338 ethnically diverse 5-year-old children, nested path analytic models were conducted to examine bidirectional pathways between children's behaviors and teacher-child relationship quality. Low self-regulation in kindergarten fall, as indexed by inattention and impulsive behaviors, predicted more conflict with teachers in kindergarten spring and this effect persisted into first grade. Conflict and low self-regulation jointly predicted decreases in school engagement which in turn predicted first-grade academic competence. Findings illustrate the importance of considering transactions between self-regulation, teacher-child relationship quality, and school engagement in predicting academic competence.

Maternal scaffolding in a disadvantaged global context: The influence of working memory and cognitive capacities.

The current study focuses on maternal cognitive capacities as determinants of parenting in a highly disadvantaged global context, where children's experiences at home are often the 1st and only opportunity for learning and intellectual growth. In a large sample of 1,291 biological mothers of preschool-aged children in rural Pakistan, we examined the unique association of maternal working memory skills (independent of related cognitive capacities) with cognitively stimulating parenting behaviors. Path analysis revealed that directly assessed working memory, short-term memory, and verbal intelligence independently predicted greater levels of observed maternal scaffolding behaviors. Mothers from poorer families demonstrated lower levels of working memory, short-term memory, and verbal intelligence. However, mothers' participation in an early childhood parenting intervention that ended 2 years prior to this study contributed to greater levels of working memory skills and verbal intelligence. Further, all 3 domains of maternal cognitive capacity mediated the effect of family economic resources on maternal scaffolding, and verbal intelligence also mediated the effect of early parenting intervention exposure on maternal scaffolding. The study demonstrates the unique relevance of maternal working memory for scaffolding behaviors that required continuously monitoring the child's engagement, providing assistance, and minimizing external distractions. These results highlight the importance of directly targeting maternal cognitive capacities in poor women with little or no formal education, using a 2-generation intervention approach that includes activities known to promote parental executive functioning and literacy. (PsycINFO Database Record

Effects of responsive stimulation and nutrition interventions on children's development and growth at age 4 years in a disadvantaged population in Pakistan: a longitudinal follow-up of a cluster-randomised factorial effectiveness trial.

BACKGROUND: A previous study in Pakistan assessed the effectiveness of delivering responsive stimulation and enhanced nutrition interventions to young children. Responsive stimulation significantly improved children's cognitive, language, and motor development at 2 years of age. Both interventions significantly improved parenting skills, with responsive stimulation showing larger effects. In this follow-up study, we investigated whether interventions had benefits on children's healthy development and care at 4 years of age. METHODS: We implemented a follow-up study of the initial, community-based cluster-randomised effectiveness trial, which was conducted through the Lady Health Worker programme in Sindh, Pakistan. We re-enrolled 1302 mother-child dyads (87% of the 1489 dyads in the original enrolment) for assessment when the child was 4 years of age. The children were originally randomised in the following groups: nutrition education and multiple micronutrient powders (enhanced nutrition; n=311), responsive stimulation (n=345), combined responsive stimulation and enhanced nutrition (n=315), and routine health and nutrition services (control; n=331). The data collection team were masked to the allocated intervention. The original enrolment period included children born in the study area between April 1, 2009, and March 31, 2010, if they were up to 2·5 months old without signs of severe impairments. The primary endpoints for children were development and growth at 4 years of age. Interventions were given in monthly group sessions and in home visits. The primary endpoint for mothers was wellbeing and caregiving knowledge, practices, and skills when the child was 4 years of age. Analysis was by intention to treat. The original trial is registered with ClinicalTrials.gov, number NCT00715936. FINDINGS: 1302 mother-child dyads were re-enrolled between Jan 1, 2013, and March 31, 2013, all of whom were followed up at 4 years of age. Children who received responsive stimulation (with or without enhanced nutrition) had significantly higher cognition, language, and motor skills at 4 years of age than children who did not receive responsive stimulation. For children who received responsive stimulation plus enhanced nutrition, effect sizes (Cohen's d) were 0·1 for IQ (mean difference from control 1·2, 95% CI -0·3 to 2·7), 0·3 for executive functioning (0·18, -0·07 to 0·29), 0·5 for pre-academic skills (7·53, 5·14 to 9·92) and 0·2 for pro-social behaviours (0·08, 0·03 to 0·13). For children who received responsive stimulation alone, effect sizes were 0·1 for IQ (mean difference with controls 1·7, -0·3 to 3·7), 0·3 for executive functioning (0·17, 0·07 to 0·27), 0·2 for pre-academic skills (3·86, 1·41 to 6·31), and 0·2 for pro-social behaviours (0·07, 0·02 to 0·12). Enhanced nutrition improved child motor development, with effect size of 0·2 for responsive stimulation plus enhanced nutrition (0·56, -0·03 to 1·15), and for enhanced nutrition alone (0·82, 0·18 to 1·46). Mothers who received responsive stimulation (with or without enhanced nutrition) had significantly better responsive caregiving behaviours at 4 years of child age than those who did not receive intervention. Effect size was 0·3 for responsive stimulation plus enhanced nutrition (1·95, 0·75 to 3·15) and 0·2 for responsive stimulation (2·01, 0·74 to 3·28). The caregiving environment had a medium effect size of 0·3 for all interventions (responsive stimulation plus enhanced nutrition 2·99, 1·50 to 4·48; responsive stimulation alone 2·82, 1·21 to 4·43; enhanced nutrition 3·52, 1·70 to 5·34). INTERPRETATION: Responsive stimulation delivered in a community health service can improve child development and care, 2 years after the end of intervention. Future analyses of these data are needed to identify which children and families benefit more or less over time. FUNDING: Grand Challenges Canada.

Implementing the foundations of learning project: considerations for preschool intervention research.

While studies have documented the importance of strong implementation in intervention studies (e.g., see Durlak & Dupre, 2008 ), more information is needed about how to ensure strong fidelity and quality of program implementation when delivering interventions under "real world conditions" and on a large scale. In this article, key lessons in implementing a demonstration and evaluation project known as the Foundations of Learning (FOL) demonstration are presented. Our discussion highlights several key components to the success of the project, including the building of effective coalitions before, and during, the delivery of the intervention to support the implementation process, as well as intensive, collaborative, and multilayered technical assistance provided as the intervention was delivered. Key lessons learned over the course of this project represent some that are highly consistent with prior research on this topic, as well as some that are unique, thus representing new areas for exploration in this burgeoning area of study.