An observational approach for exploring variability in young children's regulation-related skills within classroom contexts.

Prior work has conceptualized children's executive function and self-regulation skills as relatively stable across short periods of time. Grounded in long-standing contextual theories of human development, this study introduces a new observational tool for measuring children's regulatory skills across different naturally occurring situations within early childhood classrooms. Using 460 observations of 91 children (M age = 5.54 years) in 16 socio-demographically diverse Prekindergarten and Kindergarten classrooms, we found that this tool-the Regulation-Related Skills Measure (RRSM)-reliably captured observed dimensions of young children's attention control and inhibitory control, but failed to appropriately represent more "internal" regulatory processes (e.g., working memory). Associations between the RRSM and other measures of children's executive function and self-regulation (i.e., direct assessments, adult reports) were low to moderate (r = 0.03 to 0.44), suggesting these tools are likely to be complementary in that they provide overlapping but ultimately distinct information regarding children's regulatory performance. Finally, results suggested substantial within-child variation in regulatory behaviors across different situations within the classroom, with the same children demonstrating consistently stronger attention control and inhibitory control during transitions than during either teacher- or student-directed activities. These findings underscore the situationally-dependent nature of children's self-regulatory performance, with implications for both theory and practice. Future research is needed to replicate these findings in more diverse, representative samples of children.

Maternal knowledge, stimulation, and early childhood development in low-income families in Colombia.

Theoretical models assume that parental knowledge about child development and caregiving motivates parental stimulation, shaping child development. Evidence supporting these models is scarce in low- and middle-income countries (LMICs). This study tests the relations between maternal knowledge, stimulation, and child development in a Colombian sample of 1,277 low-income mothers and their children under the age of five. Mothers showed diverse knowledge about child development and caregiving. Moreover, maternal knowledge when children were 9-26 months old indirectly predicted growth in children's cognitive, receptive language, and gross motor skills at ages 27-46 months, partially through maternal engagement in stimulating activities with the child.

The role of executive function and social-emotional skills in the development of literacy and numeracy during preschool: a cross-lagged longitudinal study.

The majority of evidence on the interplay between academic and non-academic skills comes from high-income countries. The aim of this study was to examine the bidirectional associations between Ghanaian children's executive function, social-emotional, literacy, and numeracy skills longitudinally. Children (N = 3,862; M age = 5.2 years at time 1) were assessed using direct assessment at three time points over the course of two school years. Controlling for earlier levels of the same skill, early executive function predicted higher subsequent literacy and numeracy skills, and early literacy and numeracy skills predicted higher subsequent executive function, indicating that the development of executive function and academic skills is inter-related and complementary over time. Early literacy and numeracy predicted subsequent social-emotional skills, but early social-emotional skills did not predict subsequent literacy and numeracy skills. The findings provide longitudinal evidence on children's learning and development in West Africa and contribute to a global understanding of the relations between various developmental skills over time.

Household Socioeconomic Status and Parental Investments: Direct and Indirect Relations With School Readiness in Ghana.

This study examines how parent socioeconomic status (SES) directly and indirectly predicts children's school readiness through pathways of parental investment. Data come from direct assessments with preschool children and surveys with their primary caregivers in Ghana at the start of the 2015-2016 school year (N = 2,137; Mage  = 5.2 years). Results revealed SES-related gaps in all parental investment characteristics and child school readiness skills. Preschool involvement served as the primary mediating mechanism in the path from SES to most school readiness skills, though it did not predict executive function. The number of books in the household was marginally positively predictive of early literacy, whereas at-home stimulation was negatively related to motor, literacy, and numeracy skills.

Correction to: "His mind will work better with both of us": a qualitative study on fathers' roles and coparenting of young children in rural Pakistan.

After publication of the original article [1], the authors wanted to make an amendment in the Acknowledgments section as Muneera Rasheed requested to be removed. This correction article shows the original and revised version of the "Acknowledgments". The original article was not updated.

"His mind will work better with both of us": a qualitative study on fathers' roles and coparenting of young children in rural Pakistan.

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

Prenatal nutrition, stimulation, and exposure to punishment are associated with early child motor, cognitive, language, and socioemotional development in Dar es Salaam, Tanzania.

BACKGROUND: Despite growing evidence that early life experiences and exposures can impact child development, there is limited research on how prenatal and early life nutrition and early life parenting practices predict specific domains of child development in resource-limited settings. This study examines the association between prenatal factors, birth outcomes, and early life characteristics with motor, cognitive/language, and socioemotional development in Tanzania. METHODS: We assessed motor, cognitive/language, and socioemotional development among a cohort of 198 children aged 20-39 months in Dar es Salaam, Tanzania, whose mothers were previously enrolled in a randomized, placebo-controlled trial of prenatal vitamin A and zinc supplementation. Linear regression models were used to assess standardized mean differences in child development scores for randomized prenatal regimen and pregnancy, delivery, and early childhood factors. RESULTS: Children born to mothers randomized to prenatal vitamin A had significantly lower reported motor scores in minimally adjusted and multivariate analyses, -0.29 SD, 95% CI [-0.54, -0.04], p = 0.03, as compared with children whose mothers did not receive vitamin A. There was no significant effect of randomized prenatal zinc on any development domain. Greater caregiver-child stimulation was associated with 0.38 SD, 95% CI [0.14, 0.63], p < 0.01, better cognitive/language scores, whereas children who experienced both verbal and physical punishment had 0.29 SD, 95% CI [-0.52, -0.05], p = 0.02, lower scores in socioemotional development. Maternal completion of primary school was associated with higher reported motor and cognitive/language development. Further, children of mothers who were <155 cm tall had lower cognitive and language scores. CONCLUSION: Prenatal vitamin A supplements in a setting with low levels of vitamin A deficiency may not provide child development benefits. However, integrated environmental, educational, parenting, and stimulation interventions may have large positive effects across child development domains in resource-limited settings.

Correction: Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modelling.

[This corrects the article DOI: 10.1371/journal.pmed.1002034.].

Development and validation of an early childhood development scale for use in low-resourced settings.

BACKGROUND: Low-cost, cross-culturally comparable measures of the motor, cognitive, and socioemotional skills of children under 3 years remain scarce. In the present paper, we aim to develop a new caregiver-reported early childhood development (ECD) scale designed to be implemented as part of household surveys in low-resourced settings. METHODS: We evaluate the acceptability, test-retest reliability, internal consistency, and discriminant validity of the new ECD items, subscales, and full scale in a sample of 2481 18- to 36-month-old children from peri-urban and rural Tanzania. We also compare total and subscale scores with performance on the Bayley Scales of Infant Development (BSID-III) in a subsample of 1036 children. Qualitative interviews from 10 mothers and 10 field workers are used to inform quantitative data. RESULTS: Adequate levels of acceptability and internal consistency were found for the new scale and its motor, cognitive, and socioemotional subscales. Correlations between the new scale and the BSID-III were high (r > .50) for the motor and cognitive subscales, but low (r < .20) for the socioemotional subscale. The new scale discriminated between children's skills based on age, stunting status, caregiver-reported disability, and adult stimulation. Test-retest reliability scores were variable among a subset of items tested. CONCLUSIONS: Results of this study provide empirical support from a low-income country setting for the acceptability, reliability, and validity of a new caregiver-reported ECD scale. Additional research is needed to test these and other caregiver reported items in children in the full 0 to 3 year range across multiple cultural and linguistic settings.

Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling.

BACKGROUND: The development of cognitive and socioemotional skills early in life influences later health and well-being. Existing estimates of unmet developmental potential in low- and middle-income countries (LMICs) are based on either measures of physical growth or proxy measures such as poverty. In this paper we aim to directly estimate the number of children in LMICs who would be reported by their caregivers to show low cognitive and/or socioemotional development. METHODS AND FINDINGS: The present paper uses Early Childhood Development Index (ECDI) data collected between 2005 and 2015 from 99,222 3- and 4-y-old children living in 35 LMICs as part of the Multiple Indicator Cluster Survey (MICS) and Demographic and Health Surveys (DHS) programs. First, we estimate the prevalence of low cognitive and/or socioemotional ECDI scores within our MICS/DHS sample. Next, we test a series of ordinary least squares regression models predicting low ECDI scores across our MICS/DHS sample countries based on country-level data from the Human Development Index (HDI) and the Nutrition Impact Model Study. We use cross-validation to select the model with the best predictive validity. We then apply this model to all LMICs to generate country-level estimates of the prevalence of low ECDI scores globally, as well as confidence intervals around these estimates. In the pooled MICS and DHS sample, 14.6% of children had low ECDI scores in the cognitive domain, 26.2% had low socioemotional scores, and 36.8% performed poorly in either or both domains. Country-level prevalence of low cognitive and/or socioemotional scores on the ECDI was best represented by a model using the HDI as a predictor. Applying this model to all LMICs, we estimate that 80.8 million children ages 3 and 4 y (95% CI 48.1 million, 113.6 million) in LMICs experienced low cognitive and/or socioemotional development in 2010, with the largest number of affected children in sub-Saharan Africa (29.4.1 million; 43.8% of children ages 3 and 4 y), followed by South Asia (27.7 million; 37.7%) and the East Asia and Pacific region (15.1 million; 25.9%). Positive associations were found between low development scores and stunting, poverty, male sex, rural residence, and lack of cognitive stimulation. Additional research using more detailed developmental assessments across a larger number of LMICs is needed to address the limitations of the present study. CONCLUSIONS: The number of children globally failing to reach their developmental potential remains large. Additional research is needed to identify the specific causes of poor developmental outcomes in diverse settings, as well as potential context-specific interventions that might promote children's early cognitive and socioemotional well-being.

Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels.

BACKGROUND: Stunting affects one-third of children under 5 y old in developing countries, and 14% of childhood deaths are attributable to it. A large number of risk factors for stunting have been identified in epidemiological studies. However, the relative contribution of these risk factors to stunting has not been examined across countries. We estimated the number of stunting cases among children aged 24-35 mo (i.e., at the end of the 1,000 days' period of vulnerability) that are attributable to 18 risk factors in 137 developing countries. METHODS AND FINDINGS: We classified risk factors into five clusters: maternal nutrition and infection, teenage motherhood and short birth intervals, fetal growth restriction (FGR) and preterm birth, child nutrition and infection, and environmental factors. We combined published estimates and individual-level data from population-based surveys to derive risk factor prevalence in each country in 2010 and identified the most recent meta-analysis or conducted de novo reviews to derive effect sizes. We estimated the prevalence of stunting and the number of stunting cases that were attributable to each risk factor and cluster of risk factors by country and region. The leading risk worldwide was FGR, defined as being term and small for gestational age, and 10.8 million cases (95% CI 9.1 million-12.6 million) of stunting (out of 44.1 million) were attributable to it, followed by unimproved sanitation, with 7.2 million (95% CI 6.3 million-8.2 million), and diarrhea with 5.8 million (95% CI 2.4 million-9.2 million). FGR and preterm birth was the leading risk factor cluster in all regions. Environmental risks had the second largest estimated impact on stunting globally and in the South Asia, sub-Saharan Africa, and East Asia and Pacific regions, whereas child nutrition and infection was the second leading cluster of risk factors in other regions. Although extensive, our analysis is limited to risk factors for which effect sizes and country-level exposure data were available. The global nature of the study required approximations (e.g., using exposures estimated among women of reproductive age as a proxy for maternal exposures, or estimating the impact of risk factors on stunting through a mediator rather than directly on stunting). Finally, as is standard in global risk factor analyses, we used the effect size of risk factors on stunting from meta-analyses of epidemiological studies and assumed that proportional effects were fairly similar across countries. CONCLUSIONS: FGR and unimproved sanitation are the leading risk factors for stunting in developing countries. Reducing the burden of stunting requires a paradigm shift from interventions focusing solely on children and infants to those that reach mothers and families and improve their living environment and nutrition.

Neighborhood crime as a predictor of individual differences in emotional processing and regulation.

Emerging research suggests that early exposure to environmental adversity has important implications for the development of brain regions associated with emotion regulation, yet little is known about how such adversity translates into observable differences in children's emotion-related behavior. The present study examines the relationship between geocoded neighborhood crime and urban pre-adolescents' emotional attention, appraisal, and response. Results indicate that living in a high-crime neighborhood is associated with greater selective attention toward negatively valenced emotional stimuli on a dot probe task, less biased appraisal of fear on a facial identification task, and lower rates of teacher-reported internalizing behaviors in the classroom. These findings suggest that children facing particularly high levels of environmental threat may develop different regulatory processes (e.g. greater use of emotional suppression) than their peers from low-crime neighborhoods in order to manage the unique stressors and social demands of their communities.

Differential Effectiveness of Head Start in Urban and Rural Communities.

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

Malnutrition and Its Determinants Are Associated with Suboptimal Cognitive, Communication, and Motor Development in Tanzanian Children.

BACKGROUND: A large volume of literature has shown negative associations between stunting and child development; however, there is limited evidence for associations with milder forms of linear growth faltering and determinants of malnutrition in developing countries. OBJECTIVE: The objective of this study was to assess the association between anthropometric growth indicators across their distribution and determinants of malnutrition with development of Tanzanian children. METHODS: We used the Bayley Scales of Infant Development III to assess a cohort of 1036 Tanzanian children between 18 and 36 mo of age who were previously enrolled in a neonatal vitamin A trial. Linear regression models were used to assess standardized mean differences in child development for anthropometry z scores, along with pregnancy, delivery, and early childhood factors. RESULTS: Height-for-age z score (HAZ) was linearly associated with cognitive, communication, and motor development z scores across the observed range in this population (all P values for linear relation < 0.05). Each unit increase in HAZ was associated with +0.09 (95% CI: 0.05, 0.13), +0.10 (95% CI: 0.07, 0.14), and +0.13 (95% CI: 0.09, 0.16) higher cognitive, communication, and motor development z scores, respectively. The relation of weight-for-height z score (WHZ) was nonlinear with only wasted children (WHZ <-2) experiencing deficits (P values for nonlinear relation < 0.05). Wasted children had -0.63 (95% CI: -0.97, -0.29), -0.32 (95% CI: -0.64, 0.01), and -0.54 (95% CI: -0.86, -0.23) z score deficits in cognitive, communication, and motor development z scores, respectively, relative to nonwasted children. Maternal stature and flush toilet use were associated with higher cognitive and motor z scores, whereas being born small for gestational age (SGA) was associated with a -0.16 (95% CI: -0.30, -0.01) z score deficit in cognition. CONCLUSIONS: Mild to severe chronic malnutrition was associated with increasing developmental deficits in Tanzanian children, whereas only wasted children exhibited developmental delays during acute malnutrition. Interventions to reduce SGA, improve sanitation, and increase maternal stature may have positive effects on child development. This trial was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12610000636055.

Neighborhood Economic Disadvantage and Children's Cognitive and Social-Emotional Development: Exploring Head Start Classroom Quality as a Mediating Mechanism.

Past research has shown robust relationships between neighborhood socioeconomic disadvantage and children's school achievement and social-emotional outcomes, yet the mechanisms for explaining these relationships are poorly understood. The present study uses data from 1,904 Head Start participants enrolled in the Head Start Impact Study to examine the role that classroom structural and relational quality play in explaining the association between neighborhood poverty and children's developmental gains over the preschool year. Results suggest that neighborhood poverty is directly related to lower levels of classroom quality, and lower gains in early literacy and math scores. Indirect relationships were also found between neighborhood poverty and children's social-emotional outcomes (i.e., approaches to learning and behavior problems) via differences in the physical resources and negative student-teacher relationships within classrooms. These findings highlight the need for policy initiatives to consider community characteristics as potential predictors of disparities in classroom quality and children's cognitive and social-emotional development in Head Start.

Diurnal cortisol rhythms in youth from risky families: effects of cumulative risk exposure and variation in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) [corrected].

Building on research on cumulative risk and psychopathology, this study examines how cumulative risk exposure is associated with altered diurnal cortisol rhythms in an ethnically diverse, low-income sample of youth. In addition, consistent with a diathesis-stress perspective, this study explores whether the effect of environmental risk is moderated by allelic variation in the promoter region of the serotonin transporter gene-linked polymorphic region (5-HTTLPR). Results show that youth with greater cumulative risk exposure had flatter diurnal cortisol slopes, regardless of 5-HTTLPR genotype. However, the association of cumulative risk with average cortisol output (area under the curve [AUC]) was moderated by the 5-HTTLPR genotype. Among youth homozygous for the long allele, greater cumulative risk exposure was associated with lower cortisol AUC, driven by significant reductions in cortisol levels at waking. In contrast, there was a trend-level association between greater cumulative risk and higher cortisol AUC among youth carrying the short allele, driven by a trend-level increase in bedtime cortisol levels. Findings are discussed with regard to the relevance of dysregulated diurnal cortisol rhythms for the development of psychopathology and the implications of genetically mediated differences in psychophysiological adaptations to stress.

Principles for Adapting Assessments of Executive Function across Cultural Contexts.

Direct assessments of executive functions (EFs) are increasingly used in research and clinical settings, with a central assumption that they assess "universal" underlying skills. Their use is spreading globally, raising questions about the cultural appropriateness of assessments devised in Western industrialized countries. We selectively reviewed multidisciplinary evidence and theory to identify sets of cultural preferences that may be at odds with the implicit assumptions of EF assessments. These preferences relate to motivation and compliance; cultural expectations for interpersonal engagement; contextualized vs. academic thinking; cultural notions of speed and time; the willingness to be silly, be incorrect, or do the opposite; and subject-matter familiarity. In each case, we discuss how the cultural preference may be incompatible with the assumptions of assessments, and how future research and practice can address the issue. Many of the cultural preferences discussed differ between interdependent and independent cultures and between schooled and unschooled populations. Adapting testing protocols to these cultural preferences in different contexts will be important for expanding our scientific understanding of EF from the narrow slice of the human population that has participated in the research to date.

Predicting individual differences in low-income children's executive control from early to middle childhood.

The present longitudinal study tested the roles of early childhood executive control (EC) as well as exposure to poverty-related adversity at family and school levels as key predictors of low-income children's EC in elementary school (n = 391). Findings suggest that children's EC difficulties in preschool and lower family income from early to middle childhood are robust predictors of later EC difficulties as rated by teachers in 2nd and 3rd grades. Findings also suggest enrollment in unsafe elementary schools is significantly predictive of higher levels of teacher-rated EC difficulty, but only for those children who showed initially elevated levels of EC difficulty in early childhood. Implications for scientific models of cognitive development and poverty-related adversity are discussed.

Neighborhood crime and school climate as predictors of elementary school academic quality: a cross-lagged panel analysis.

Past research has found negative relationships between neighborhood structural disadvantage and students' academic outcomes. Comparatively little work has evaluated the associations between characteristics of neighborhoods and schools themselves. This study explored the longitudinal, reciprocal relationships between neighborhood crime and school-level academic achievement within 500 urban schools. Results revealed that higher neighborhood crime (and particularly violent crime) predicted decreases in school academic achievement across time. School climate emerged as one possible mechanism within this relationship, with higher neighborhood crime predicting decreases in socioemotional learning and safety, but not academic rigor. All three dimensions of school climate were predictive of changes in academic achievement. Although this research supports a primarily unidirectional hypothesis of neighborhoods' impacts on embedded settings, additional work is needed to understand these relationships using additional conceptualizations of neighborhood climate.

Systemic barriers and opportunities for implementing school-based social-emotional learning interventions in low-income and conflict-affected settings.

Children living in low-income and conflict-affected settings face unique systemic risk factors that shape their social, emotional, and mental well-being. However, little is known about how these and other systemic factors may impede or support the delivery of social-emotional learning (SEL) interventions in these contexts. In this article, we draw from our experience delivering and evaluating a classroom-based SEL curriculum in Rio de Janeiro, Brazil to surface systemic barriers and opportunities for implementing SEL interventions in low-income, conflict-affected settings. Specifically, we identify (1) culture, (2) timing, and (3) government support and stability as factors underlying SEL program demand, dosage, quality, and effectiveness. We provide recommendations for improving implementation of SEL programs in low-income and conflict-affected contexts, including the importance of building pro-active partnerships, using qualitative research, and investing in adaptation to both understand and address systemic barriers.