Characterizing the Association between Household Stimulation during the first year of life and Child Development at seven years among Mexican Children Open Access

Kim, Juhui (Spring 2020)

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Background: The Lancet 2017 reported that 250 million children under 5 years from low-income and middle-income countries were at risk of not meeting their full developmental potential. The household and family environment during early childhood provides important opportunities to improve childhood development. In Mexico, the household environment might be particularly important to promote childhood development because access to daycare is limited.

Objective: The objective of this research was to assess the potential role of the household learning environment on global cognitive development, independently of SES, maternal and child nutrition status, in a birth cohort from Cuernavaca, Mexico.

Methods: Data for this study come a birth cohort of children whose mothers participated in a randomized controlled trial (POSGRAD) of the impact of prenatal supplementation with Omega-3 on child growth and development. We used multivariate linear regression to test associations between the household objective measurement of the environment (HOME) inventory and intelligence quotient (IQ) measured at 7 years of age using the Weshcler Abbreviated Scale of Intelligence (WASI), and to adjust for maternal and child characteristics. We conducted stratified analysis to assess if predictors of cognitive development differed by sex.

Results: The sample for this study was of Mexican children with information on the HOME inventory in the first year of life and IQ at 7 years of age. After adjustment of all covariates, HOME inventory score was associated with all the IQ scores except performance IQ among overall population and among boys. HOME inventory score among girls was associated with none of IQ scores. SES was associated with all IQ scores among overall sample, however, when stratified by sex, SES was associated only with male verbal IQ.

Conclusions: We found positive associations between HOME inventory and child development, SES and child development as well as mothers’ intelligence/education and child development. There were differences by sex in some predictors such as maternal schooling, which was positively associated with development in girls but not in boys. This work highlights the importance of sex in the study of predictors of development and can inform the design of targeted intervention to improve cognitive ability of girls and boys. Also, this study contributes to identifying early predictors which could be influencing child development among Mexican children.

Table of Contents

Chapter 1. Introduction (1)

1.1 Introduction and rationale (1)

1.2 Problem statement (3)

1.3 Significance statement (3)

1.4 Research goal, hypothesis and aims (4)

Chapter 2. Literature Review (5)

2.1 Importance of child development (5)

2.2 World status of child development (5)

2.3 Factors affecting child development (8)

2.4 Summary (17)

Chapter 3. Methods (18)

3.1 Parent study (18)

3.2 Variables of interest (18)

3.3 Statistical analysis (20)

3.4 Ethical considerations (21)

Chapter 4. Results (22)

4.1 Sample size (22)

4.2 Descriptive data (22)

4.3 Associations between HOME and WASI (23)

4.4 Associations between SES and WASI (24)

4.5 Other significant confounders (24) 

Chapter 5. Discussion (26)

5.1 Results for the overall sample (26)

5.2 Results stratified by sex (27)

5.3 Additional findings (28)

5.4 Limitations (29)

5.5 Strengths (29)

5.6 Conclusion (30)

Chapter 6. Implications and Recommendations (31)

6.1 Public health implications (31)

6.2 Recommendations (31)  

References (35)

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