Predictors and pathways of language and motor development in four prospective cohorts of young children in Ghana, Malawi, and Burkina Faso.
Document Type
Article
Publication Date
11-1-2017
Abstract
BACKGROUND: Previous reviews have identified 44 risk factors for poor early child development (ECD) in low- and middle-income countries. Further understanding of their relative influence and pathways is needed to inform the design of interventions targeting ECD.
METHODS: We conducted path analyses of factors associated with 18-month language and motor development in four prospective cohorts of children who participated in trials conducted as part of the International Lipid-Based Nutrient Supplements (iLiNS) Project in Ghana (n = 1,023), Malawi (n = 675 and 1,385), and Burkina Faso (n = 1,122). In two cohorts, women were enrolled during pregnancy. In two cohorts, infants were enrolled at 6 or 9 months. In multiple linear regression and structural equation models (SEM), we examined 22 out of 44 factors identified in previous reviews, plus 12 additional factors expected to be associated with ECD.
RESULTS: Out of 42 indicators of the 34 factors examined, 6 were associated with 18-month language and/or motor development in 3 or 4 cohorts: child linear and ponderal growth, variety of play materials, activities with caregivers, dietary diversity, and child hemoglobin/iron status. Factors that were not associated with child development were indicators of maternal Hb/iron status, maternal illness and inflammation during pregnancy, maternal perceived stress and depression, exclusive breastfeeding during 6 months postpartum, and child diarrhea, fever, malaria, and acute respiratory infections. Associations between socioeconomic status and language development were consistently mediated to a greater extent by caregiving practices than by maternal or child biomedical conditions, while this pattern for motor development was not consistent across cohorts.
CONCLUSIONS: Key elements of interventions to ensure quality ECD are likely to be promotion of caregiver activities with children, a variety of play materials, and a diverse diet, and prevention of faltering in linear and ponderal growth and improvement in child hemoglobin/iron status.
Publisher
Blackwell Publishers
Publication Title
Journal of child psychology and psychiatry, and allied disciplines
ISSN
1469-7610
Volume
58
Issue
11
First Page
1264
Last Page
1275
Recommended Citation
Prado, Elizabeth L; Souheila Abbeddou; Seth Adu-Afarwuah; Mary Arimond; Per Ashorn; Ulla Ashorn; Jaden Bendabenda; Kenneth H Brown; Sonja Y Hess; Emma Kortekangas; Anna Lartey; Kenneth Maleta; Brietta M Oaks; Eugenia Ocansey; Harriet Okronipa; Jean Bosco Ouédraogo; Anna Pulakka; Jérôme W Somé; Christine P Stewart; Robert C Stewart; Stephen A Vosti; Elizabeth Yakes Jimenez; and Kathryn G Dewey.
"Predictors and pathways of language and motor development in four prospective cohorts of young children in Ghana, Malawi, and Burkina Faso.."
Journal of child psychology and psychiatry, and allied disciplines
