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RCT·pediatrics, public health, psychiatry, family medicine, epidemiology·PMC10268546

A Community-based Responsive Caregiving Program Improves Neurodevelopment in Two-year Old Children in a Middle-Income Country, Grenada, West Indies

Psychosocial Intervention · 11 authors, 5 centres

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TL;DR

Children whose caregivers received the intervention showed significantly higher scores in cognitive, motor, and language domains compared to a waitlist control group.

Full summary

691 CHARS

Caregivers and their two-year-old children were assigned to either the intervention group or a waitlist control group. The intervention focused on nurturing care components of safety, connection, and learning. After controlling for covariates like child age, assessor, and parent education, children in the intervention group scored significantly higher across the domains of cognition, fine motor, gross motor, and language compared to the control group. Effect sizes ranged from small to medium. A key finding was that the intervention improved neurodevelopmental outcomes without a concurrent significant change in caregiver beliefs, attitudes, or behaviors regarding corporal punishment.

STUDY TYPE

RCT

SPECIALTY

pediatrics

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100% · A

ORIGINAL PAPER

PMC10268546

A Community-based Responsive Caregiving Program Improves Neurodevelopment in Two-year Old Children in a Middle-Income Country, Grenada, West Indies

Psychosocial Intervention

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ABSTRACT

ABSTRACT Many young children in low- and middle-income countries (LMICs) are at risk of developmental delays. Early child development (ECD) interventions have been shown to improve outcomes, but few interventions have targeted culturally normative violence such as corporal punishment (CP). We partnered with an existing community-based ECD organization in the LMIC of Grenada to implement a parallel controlled-trial single-blind responsive caregiving intervention that educates parents about the developing brain and teaches alternatives to corporal punishment while building parental self-regulation skills and strengthening social-emotional connections between parent and child. Parents and primary caregivers with children under age two were eligible. Allocation to the intervention and waitlist control arms was unblinded and determined by recruitment into the program. Neurodevelopment was assessed by blinded testers when each child turned age two. Primary comparison consisted of neurodevelopmental scores between the intervention and waitlist control groups (Clinicaltrials.gov registration # NCT04697134). Secondary comparison consisted of changes in maternal mental health, home environment, and attitudes towards CP. Children in the intervention group (n = 153) had significantly higher scores than children in the control group ( n = 151) on measures of cognition ( p = .022), fine motor ( p < .0001), gross motor ( p = .015), and language development ( p = .013). No difference in secondary outcomes, including CP, was detected. Keywords: Child neurodevelopment, Early child development, Responsive caregiving, Social-emotional connection, Corporal punishment

CITATION EXPORT

Randall Waechter, Roberta Evans, Michelle Fernandes et al.. A Community-based Responsive Caregiving Program Improves Neurodevelopment in Two-year Old Children in a Middle-Income Country, Grenada, West Indies. Psychosocial Intervention. (2022). https://doi.org/10.5093/pi2022a6

AUTHORS

11 · 5 CENTRES

Randall Waechter, Roberta Evans, Michelle Fernandes, Becky Bailey, Stephanie Holmes, Toni Murray, Rashida Isaac, Bianca Punch, Nikita Cudjoe, Lauren Orlando, Barbara Landon

aGeorge’s University, Grenada , West Indies, St. George’s University, Grenada, West Indies
bCaribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, Grenada , West Indies, Caribbean Center for Child Neurodevelopment, Windward Islands Research and Education Foundation, Grenada, West Indies;
cUniversity Hospitals Southampton, Southampton , UK, University Hospitals Southampton, Southampton, UK;
dUniversity of Oxford, Oxford , UK, University of Oxford, Oxford, UK;
eConscious Discipline, Florida , USA, Conscious Discipline, Florida, USA