Cognitive Development of Toddlers: Does Parental Stimulation Matter?

  • Prahbhjot Malhi
  • Jagadeesh Menon
  • Bhavneet Bharti
  • Manjit Sidhu
Original Article
  • 48 Downloads

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.

Keywords

Early stimulation Cognitive functioning Toddlers 

Notes

Author’s Contributions

PM and BB conceptualized and designed the study and did the statistical analyses. JM collected the data, did the literature search, and assembled the pictorial booklet. MS led the training of the cognitive assessment of the toddlers and administration of the StimQ, and oversaw the data collection and helped in validating the StimQ. PM wrote the manuscript with critical inputs from all the authors and all the authors approved the final manuscript as submitted. BB will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

References

  1. 1.
    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.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    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.CrossRefPubMedGoogle Scholar
  3. 3.
    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.CrossRefPubMedGoogle Scholar
  4. 4.
    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.CrossRefPubMedGoogle Scholar
  5. 5.
    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.CrossRefPubMedGoogle Scholar
  6. 6.
    Sidhu M, Malhi P, Jerath J. Multiple risks and early language development. Indian J Pediatr. 2010;77:391–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Sidhu M, Malhi P, Jerath J. Early language development in Indian children: a population based pilot study. Ann Indian Acad Neurol. 2013;16:371–5.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Tamis-LeMonda CS, Luo R, McFadden KE, Bandel ET, Vallotton C. Early home learning environment predicts children’s 5th grade academic skills. Appl Dev Sci. 2017;  https://doi.org/10.1080/10888691.2017.1345634.
  9. 9.
    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.CrossRefGoogle Scholar
  10. 10.
    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.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    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.CrossRefPubMedGoogle Scholar
  12. 12.
    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.CrossRefPubMedGoogle Scholar
  13. 13.
    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.Google Scholar
  14. 14.
    Dreyer BP, Mendelsohn AL, Tamis-Lemonda CS. StimQ- The Cognitive Home Environment. 2009. Available at: http://pediatrics.med.nyu.edu/patient-care/for-healthcare-providers/stimq-cognitive-home-environment. Accessed on 18 July 2017.
  15. 15.
    Misra N, Phatak P. Developmental assessments scales for Indian infants. Baroda: MS University of Baroda; 1996.Google Scholar
  16. 16.
    Dooley M, Stewart J. Family income, parenting styles and child behavioural- emotional outcomes. Health Econ. 2007;16:145–62.CrossRefPubMedGoogle Scholar
  17. 17.
    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.CrossRefGoogle Scholar
  18. 18.
    Weisleder A, Fernald A. Talking to children matters: early language experience strengthens processing and builds vocabulary. Psychol Sci. 2013;24:2143–52.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Malhi P, Sidhu M, Bharti B. Early stimulation and language development of economically disadvantaged young children. Indian J Pediatr. 2014;81:333–8.CrossRefPubMedGoogle Scholar
  20. 20.
    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.PubMedGoogle Scholar
  21. 21.
    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.CrossRefPubMedGoogle Scholar
  22. 22.
    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.CrossRefPubMedGoogle Scholar
  23. 23.
    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.CrossRefPubMedGoogle Scholar
  24. 24.
    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.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Reis HT, Collins WA, Berscheid E. Relationships in human behavior and development. Psychol Bull. 2000;126:844–72.CrossRefPubMedGoogle Scholar
  26. 26.
    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.CrossRefPubMedGoogle Scholar
  27. 27.
    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.CrossRefPubMedGoogle Scholar
  28. 28.
    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.CrossRefPubMedGoogle Scholar
  29. 29.
    Aboud FE, Yousafzai AK. Global health and development in early childhood. Annu Rev Psychol. 2015;66:433–57.CrossRefPubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  • Prahbhjot Malhi
    • 1
  • Jagadeesh Menon
    • 2
  • Bhavneet Bharti
    • 1
  • Manjit Sidhu
    • 3
  1. 1.Department of PediatricsPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of GastroenterologyPost Graduate Institute of Medical Education and ResearchChandigarhIndia
  3. 3.Department of PsychologyMCM DAV College for WomenChandigarhIndia

Personalised recommendations