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Associations Among Early Stimulation, Stunting, and Child Development in Four Countries in the East Asia–Pacific

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Abstract

This study examined associations among preschool attendance, home learning activities, stunting status, and early child development using data from the validation study of the East Asia–Pacific Early Child Development Scales (EAP-ECDS). Participants were children aged 3 to 5 years from Cambodia (n = 1178; 30% stunted), Mongolia (n = 1226; 11% stunted), Papua New Guinea (n = 1697; 50% stunted), and Vanuatu (n = 674; 44% stunted). Child development was directly assessed using the EAP-ECDS and children’s preschool experiences and home learning activities were reported by parents. Preschool attendance, preschool duration, and home learning activities were positively related to child development for non-stunted and stunted children, demonstrating that stimulating interactions in the home environment and early childhood education serve as modifiable factors that can help to reduce the negative effects of stunting on children’s cognitive and non-cognitive development, and highlighting the importance of “nurturing care” for the development of both non-stunted and stunted children.

Résumé

Cette étude examine les liens entre la fréquentation préscolaire, les activités d’apprentissage à la maison, le retard de croissance et le développement des jeunes enfants en faisant appel aux données de l’étude de validation des Échelles de développement de la petite enfance en Asie Pacifique de l’Est (EAP-ECDS). Les participants sont des enfants de 3 à 5 ans du Cambodge (n = 1178; 30% avec retard de croissance), de Mongolie (n = 1226; 11% avec retard de croissance), de Papouasie-Nouvelle-Guinée (n = 1697; 50% avec retard de croissance) et du Vanuatu (n = 674; 44% avec retard de croissance). Le développement des enfants est évalué directement d’après les EAP-ECDS, et les expériences du préscolaire et les activités d’apprentissage à la maison des enfants sont rapportées par les parents. La fréquentation préscolaire, la durée de l’expérience préscolaire et les activités d’apprentissage à la maison sont liées de façon positive au développement des enfants avec ou sans retard de croissance. Ceci démontre que les interactions stimulantes dans l’environnement familial et l’éducation de la petite enfance constituent des facteurs modifiables qui peuvent contribuer à réduire les effets négatifs du retard de croissance sur le développement cognitif et non cognitif des enfants, et souligne l’importance de « soins attentifs » pour le développement des enfants qu’ils aient ou non un retard de croissance.

Resumen

Este estudio examinó los nexos entre la asistencia prescolar, las actividades de aprendizaje en casa, la condición de retraso en el crecimiento y el desarrollo de la primera infancia utilizando datos del estudio de validación de la Escala de Desarrollo en la Primera Infancia de la región oriental del Pacífico Asiático (EAP-ECDS por su abreviatura en inglés). Los participantes fueron niños entre 3 y 5 años de edad de Camboya (n = 1178; 30% de retraso en el crecimiento), Mongolia (n = 1226; 11% de retraso en el crecimiento), Papua Nueva Guinea (n = 1697; 50% de retraso en el crecimiento), y Vanuatu (n = 674; 44% de retraso en el crecimiento). El desarrollo de los niños se evaluó directamente utilizando la escala EAP-ECDS y las experiencias preescolares de los niños, junto con actividades de aprendizaje en casa reportadas por los padres. La asistencia y duración de la escuela preescolar y las actividades de aprendizaje en casa tuvieron una relación positiva con el desarrollo de niños con y sin retraso en el crecimiento, lo que demuestra que las interacciones de estimulación en el ambiente familiar y la educación infantil temprana sirven como factores modificables que pueden ayudar a reducir los efectos negativos del desarrollo cognitivo y no cognitivo de niños con retraso en el crecimiento, y a su vez resalta la importancia del “cuidado amoroso” para el desarrollo de ambos grupos de niños.

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Availability of Data and Material

The data that support the findings of this study are available from the Asia–Pacific Regional Network for Early Childhood (ARNEC). Restrictions apply to the availability of these data, which were used under license for this study. Data are available from https://arnec.net/with the permission of ARNEC.

Code Availability

Statistical analyses were carried out using Stata 13.1. Code is available from the authors upon request.

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Funding

This project was funded by UNICEF, ARNEC, and the Open Society Foundation. We thank Cliff Meyers and Chemba Raghavan from UNICEF and Junko Miyahara from ARNEC for their support at different stages of the project. Great appreciation is expressed to members of our research team: Prof. Patrice L. Engle (dec.), Dr. Marie Ng, Dr. Diana Lee, and Dr. Yvonne Becher. We are particularly grateful to the country teams including the team leaders, the Government officers, university researchers and the UNICEF focal points from Cambodia, Mongolia, Papua New Guinea, and Vanuatu who conducted the study with dedication and persistence despite the many stumbling blocks along the way.

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Authors and Affiliations

  1. Faculty of Education, The University of Hong Kong, Hong Kong, SAR, China

    Nirmala Rao, Ben Richards & Carrie Lau

  2. School of Community Health Sciences, University of Nevada, Reno, USA

    Ann M. Weber

  3. Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, SAR, China

    Jin Sun

  4. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    Gary L. Darmstadt

  5. Child Health, Development, and Education, Telethon Kids Institute, The University of Western Australia, Adelaide, Australia

    Alanna Sincovich

  6. Social Sciences Research Centre, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, SAR, China

    John Bacon-Shone

  7. Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China

    Patrick Ip

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  1. Nirmala Rao
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  2. Ben Richards
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  3. Carrie Lau
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  4. Ann M. Weber
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Correspondence to Nirmala Rao.

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Rao, N., Richards, B., Lau, C. et al. Associations Among Early Stimulation, Stunting, and Child Development in Four Countries in the East Asia–Pacific. IJEC 52, 175–193 (2020). https://doi.org/10.1007/s13158-020-00270-8

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