The Indian Journal of Pediatrics

, Volume 85, Issue 7, pp 498–503 | Cite as

Cognitive Development of Toddlers: Does Parental Stimulation Matter?

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



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


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.


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).


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.


Early stimulation Cognitive functioning Toddlers 


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



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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

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