characteristics
CREDI, Caregiver-Reported Early Development Instrument; D-score, Developmental Score; IYCD, Infant and Young Child Development.
Information about children’s risk for poor development is important, as is identifying areas for intervention. To track these, a proxy measure of population levels of young children at risk of suboptimal development has been calculated.
Stunting and poverty were used in the first published estimation in 2007 of the global prevalence of risk to children’s development. The initial choice of indicators was based on evidence that they both predict poor cognitive development and school performance. 19 20 Additional advantages are that their definitions are standardised and many countries have data on both indicators. 21
Lu et al 21 updated the earlier values to 2010, using the 2006 WHO growth standards and World Bank poverty rates (US$1.25 per person per day), leading to an estimate of 249 million children or 43% of all children under 5 years of age in LMICs being at risk of poor childhood development. The accuracy and comparability of the later estimates benefited greatly from major advances in both data availability and estimation methods. 21
To estimate the long-term consequences of poor ECD, studies focus on estimating the impact on subsequent schooling and labour market participation and wages. The current estimate, that the average percentage of annual adult income lost as a result of stunting and extreme poverty in early childhood is about 26%, is supported by follow-up adult data from early life interventions. Two programmes have found wage increases between 25% in Jamaica attributed to a psychosocial intervention 22 and 46% in Guatemala attributed to a protein supplement. 23
In order to improve the estimate of risk, efforts are under way to include additional risks experienced in ECD known to affect health and well-being across the life course. For example, adding low maternal schooling and exposure to harsh punishment to stunting and extreme poverty, for 15 countries with available data from MICS in 2010/2011, increased the number of children estimated to be at risk of poor childhood development substantially. 5
Population-based measures of early child development and proxies of children at risk give an indication of prevalence, and indicators of disparity can be derived according to gender, urban–rural location and socioeconomic status. However, they do not include drivers, determinants nor coverage of interventions that could improve childhood development.
The Countdown to 2015 for Maternal, Newborn and Child Survival , established in 2005, set a precedent by creating mechanisms to portray multidimensional aspects of progress towards improving maternal and child health, and is testimony of its value. 24 Countdown to 2030 , which tracks maternal, child and adolescent health and nutrition goals, has expanded to address the broader SDG agenda, including ECD, health in humanitarian settings and conflict, and adolescent health and well-being. 25 26 It includes coverage and equity of essential interventions, as well as indicators of determinants and the enabling environment provided by policies.
This approach has been applied to ECD using the Nurturing Care Framework, 27 launched at the 71st World Health Assembly. The concept of nurturing care was introduced in the 2017 Lancet Series Advancing Early Child Development: From Science to Scale . Nurturing Care Framework comprises conditions for early development: good health and nutrition; protection from environmental and personal harm; affectionate and encouraging responses to young children’s communications; and opportunities for young children to learn through exploration and interpersonal interactions. 7
These early experiences are nested in caregiver–child and family relationships. In turn, parents, families and other caregivers require support from a facilitating environment of policies, services and communities. Policies, services and programmes can protect women’s health and well-being, safeguard pregnancy and birth, and enable families and caregivers to promote and protect young children’s development. 6
The Nurturing Care Framework has been used to produce ECD profiles for 91 LMICs. 28 Countries were selected either to ensure alignment of ECD with Countdown to 2030 , or because more than 30% of children are estimated to be at risk of poor ECD in 2010, using the methods described in Lu et al 21 and Black et al . 7
These country profiles, which consist of currently available data from LMICs, are laid out to represent the Nurturing Care Framework. The profiles consist of the following sections:
Most of the existing data are published in Unicef’s annual State of the World’s Children. Convention and policy data come from, among others, the United Nations Treaty Collections and the International Labour Organization.
Figure 1 shows an example of the country profiles, with the country name replace by ‘Country Profiles’.
An example of an early childhood development (ECD) country profile. CRC, convention on the rights of the child.
In a forthcoming paper, Lu and Richter (2019) describe in detail the updated estimates of children at risk of poor childhood development using the newly released poverty line of US$1.9 per person per day to estimate that, in 2015, 233 million children or 40.5% of children under 5 years of age were at risk of poor childhood development. Figures 2 and 3 show the estimates of risk for poor ECD across a decade, from 2005 to 2010 and 2015, and using the 2010 data variations between children at risk living in rural and urban areas. Gender is not illustrated here because, in most countries, the differences are small and not statistically significant.
Decline in the number of countries with high proportions of young children at risk of poor development between 2005 and 2015.
Differences in risk of poor development among urban and rural children in 63 countries (most recent years with available data).
Figure 2 shows that, between 2005 and 2010, countries with two-thirds of young children at risk (>67%) declined in both central Europe and South-East Asia. There was little change in countries with high proportions of young children at risk in sub-Saharan Africa during this period, and by 2015 countries with the highest proportion of children at risk were in Central and Southern Africa.
Estimates on the prevalence of children at risk of poor development in urban and rural areas were derived using DHS, MICS and country data for 63 countries with available data in most recent years ( figure 3 ). The differences are strikingly high, with more rural children at risk than their urban counterparts in 50 countries (differences of more than 20%). Almost all countries with 40% point differences were in sub-Saharan Africa. 28
There are additional indicators that ideally should be included in a monitoring framework, but currently lack comparable country data. Data are usually unavailable because reliable, valid instruments feasible for multicountry administration are still in development, or the instruments are not yet included in representative surveys. In particular, there are as yet no global population-based indicators for assessing responsive caregiving. Suggestions have been made that data should be collected on whether information about ECD and caregiver–child interaction is publicly disseminated, whether home visits or groups are provided for parents at high risk of experiencing difficulties providing their children with nurturing care, and whether affordable good quality child day care is available for families who need it. 29 National data on laws and policies that support responsive caregiving are also insufficient, for example, wages and other forms of income to enable families to provide for their young children. 30
Additional data gaps concern risks arising from poor parental mental health, 31 low maternal schooling, and maternal tobacco and alcohol use, among others, prevalence of childhood developmental delays and disabilities, 32 and maltreatment and institutionalisation of young children. 33 There is also no comparable information on government budget allocation to ECD or household expenditure on ECD services care, among others.
Multidisciplinary scientific evidence and political momentum are focusing on ECD as a critical phase in enhancing health and well-being across the life course. Additional measurements and indicators for monitoring and evaluation are urgently needed to support expansions in implementation and investment, and to report progress. New data will stimulate global, regional and national action, and in turn motivate for more areas of ECD to be covered in national surveys.
The Nurturing Care Framework provides a platform for three important areas of work. First, very significant progress is being made through the revision of the ECDI and the development of the GSED, a short caregiver-reported population measure of ECD that could feasibly be included in DHS, MICS and other nationally representative household surveys. The GSED will enable ECD to be tracked at population levels, and for programmes and services to be monitored and evaluated in comparable ways.
Second, a country-comparable proxy of the risk of poor ECD developed from 2004 data and updated with 2010 data has been extended to 2015, enabling comparisons to be made globally, regionally and by country across the last decade. Plans are in place to update these estimates regularly, and to add new risks as data for more countries become available.
Third, using these estimates, data included in Countdown to 2030 , and additional data from MICS and policy databases, initial profiles have been constructed for 91 LMICs. The profiles are organised according to the ecological model of the Nurturing Care Framework with policies, services and programmes supporting families and caregivers to provide good health and nutrition, security and safety, opportunities for early learning, and responsive caregiving for young children to thrive. The further development of these profiles is overseen by a multiagency committee as part of Countdown to 2030 and are freely available ( http://www.ecdan.org/countries.html and https://nurturing-care.org/?page_id=703 ). Unicef will update the country data annually and the profiles will be reproduced every 2 years.
However, as indicated earlier, substantial gaps in national and global data on topics of concern to ECD remain. The current global estimation on burden of risks, for example, does not include known risk factors other than stunting and extreme poverty, as a result of which the existing burden calculation is considerably underestimated. 5 The limited information on ECD investments at the country and global levels is exacerbated by the lack of appreciation of what constitute essential and continuous services, standard indicators for measuring ECD interventions and policies, as well as systematically collected data. Country capacity needs to be strengthened and ECD costing modules integrated into existing household income or expenditure surveys, and routinely collected from specific types of programmes. Clear definitions are needed to track donor contributions to ECD, and efforts should be made to address data issues, including collecting data from emerging donor countries (eg, China), foundations and international non-governmental organisations that are playing an increasing role in financing ECD, as has been called for by the G20. 33 National policies, strategic plans and laws which support ECD through nurturing care should be tracked for this intersectoral area.
To improve measurements of risks, intervention coverage, policies, financial commitments and impact on young children’s development, more investment is needed to regularly collect and disseminate data at the national and subnational levels. Analytical gaps at the country and global levels exist, especially with respect to equity analyses by household wealth, maternal education and rural–urban location, as well as by gender and child age within 0–5 years.
In conclusion, progress has been extremely positive, but too slow and too fragmented for the bold global agenda of ECD and the Nurturing Care Framework. The alliance with Countdown to 2030 is helpful as there is much to be learnt from the initiative’s experience under the Millennium Development Goals (MDGs), as well as collaboration with the SDGs. The country profiles boldly portray what we currently know about ECD in some of the most at-risk conditions and will prove a valuable tool for advocacy and implementation, including to improve measurement. Successful implementation and impact are dependent on accountability supported by regularly updated reliable and valid information.
Robert Inglis (Jive Media Africa, Pietermaritzburg, South Africa) and Frank Sokolic (EduAction, Durban, South Africa) for assistance with the country profiles and maps.
Handling editor: Seye Abimbola
Contributors: All authors meet the conditions for authorship: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data; drafting the work or revising it critically for important intellectual content; final approval of the version published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding: This study has been funded by Conrad N Hilton Foundation and the Bill and Melinda Gates Foundation.
Competing interests: None declared.
Patient consent for publication: Not required.
Provenance and peer review: Not commissioned; externally peer reviewed.
Data sharing statement: Data on the country profiles are publicly available on the websites cited in the paper.
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Perhaps more than ever, mental health and social interactions have been on the minds of many over the past year. A pandemic, ongoing systemic injustices, and a contentious political season combined to create uncertainty and stress for adults and children alike. What do these stressors mean for the mental health of our youngest learners? In what ways can early childhood educators nurture the social and emotional lives and learning of children from birth through age 8?
This issue of Young Children offers research-supported responses to these questions with a cluster of articles devoted to intentional practices that promote social and emotional development: The first four articles in this cluster focus on the specific social and emotional needs of infants and toddlers, and the development of these important articles represents a unique collaboration between NAEYC and ZERO TO THREE to collectively concentrate our respective journals on the emotional health of infants and toddlers.
The catalyst for this issue was threefold:
Mary Jane Maguire-Fong opens this Young Children cluster with “What Babies Ask of Us: Contexts to Support Learning about Self and Other.” She details how early childhood educators can listen to, observe, and guide infants and toddlers through thoughtfully prepared play spaces, daily routines, and everyday interactions. In “‘You’re Okay’ May Not be Okay: Using Emotion Language to Promote Toddlers’ Social and Emotional Development,” Elizabeth K. King harnesses that keen awareness and planning to outline how educators can use anti-oppressive emotion language strategies with toddlers.
Tapping into these same powers of observation and reflection, Claire Vallotton, Jennifer Mortensen, Melissa Burnham, Kalli Decker, and Marjorie Beeghly present “Becoming a Better Behavior Detective: Applying a Developmental and Contextual Lens on Behavior to Promote Social and Emotional Development.” Educators can use this 5-Step Reflective Cycle to identify and be responsive to infants’ and toddlers’ behaviors and needs. Of course, following these steps depends on our own emotional presence and well-being. In an accompanying piece to this article, Holly Hatton-Bowers and colleagues offer recommendations for “Cultivating Self-Awareness in Our Work with Infants, Toddlers, and Their Families: Caring for Ourselves as We Care for Others.”
Finally, in “When in Doubt, Reach Out: Teaming Strategies for Inclusive Early Childhood Settings,” Christine Spence, Deserai Miller, Catherine Corr, Rosa Milagros Santos, and Brandie Bentley capture how an early childhood educator learns to actively participate in early intervention processes through effective communication and collaboration. This cluster also features a special Rocking and Rolling column defining IECMH and outlining how early childhood educators play a role in fostering infants’ and toddlers’ emotional well-being.
For educators of older children, it is vital to understand that the roots of social and emotional learning begin in infancy. In addition to the cluster articles, you’ll find pieces devoted to social and emotional learning in preschool and elementary settings, including articles that
The articles in the ZERO TO THREE Journal explore a variety of issues related to IECMH in early childhood education settings, including: how infants’ and toddlers’ mental health is paramount to their ability to form healthy relationships, regulate their emotions, and learn; the role of IECMH consultation, the impact of COVID, and equity and power dynamics; and trauma-informed care and the importance of teachers’ mental health, particularly in the context of multiple, long-term stressors affecting every layer of the early childhood education system and society as a whole. The issue also recognizes the valuable role of advocacy and policy and provides suggestions for how early childhood professionals can bring their expertise to influence effective policy change for babies and families.
We hope that the readers of Young Children and the ZERO TO THREE Journal will turn to both publications to discover perspectives and find valuable resources to support their work with infants, toddlers, and their families. Links to selected articles from each issue are available on each journal’s web page.
—Annie Moses, editor in chief, with Stefanie Powers, editor in chief, ZERO TO THREE Journal , and Kathy Reschke, editorial assistant, ZERO TO THREE Journal
Above: Children in Maureen Linnane’s toddler class used cardboard materials to create a collage.
Below: This piece comes from Chandler, the young toddler son of an NAEYC staff member, as he explored art materials.
Is your classroom full of children’s artwork? To feature it in Young Children , see the link at the bottom of the page or email [email protected] for details.
Send your thoughts on this issue, and on topics you’d like to read about in future issues of Young Children, to [email protected] .
Would you like to see your children’s artwork featured in these pages? For guidance on submitting print-quality photos (as well as details on permissions and licensing), see NAEYC.org/resources/pubs/authors-photographers/photos .
Annie Moses, PhD, is director of periodicals at NAEYC and serves as editor in chief of Young Children and Teaching Young Children .
Stephanie Powers is the editor in chief at ZERO TO THREE Journal.
Kathy L. Reschke, PhD, is senior content specialist for ZERO TO THREE. Dr. Reschke contributes to the design and development of competency-based professional development products and services. She developed the content for the ZERO TO THREE Critical Competencies for Infant-Toddler Educators™ course manuals, online course, and coaching program. [email protected]
Vol. 76, No. 1
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Subscribe to the center for universal education bulletin, andres s. bustamante , andres s. bustamante assistant professor of education - university of california, irvine eric dearing , eric dearing professor, applied developmental & educational psychology - boston college henrik daae zachrisson , henrik daae zachrisson professor, department of special needs education - university of oslo deborah lowe vandell , and deborah lowe vandell professor, school of education - university of california, irvine kathy hirsh-pasek kathy hirsh-pasek senior fellow - global economy and development , center for universal education.
November 4, 2021
Debate continues on Biden’s “ Build Back Better” social infrastructure bill offering a historic expansion of child care and universal preschool. Early childhood education is a socially popular endeavor with strong bipartisan support and impressive evidence for meaningful impacts in the short and long term . Economic research examining the return on investment for early education suggests tremendous value ranging from $4 to $13 in return for every $1 spent from impacts on educational attainment, employment, health, truancy, and criminality.
Much of the data used in these projections come from classic “gold standard” interventions like the Abecedarian and Perry preschool studies. These were highly resourced projects that provided high-quality early education experiences to families from under-resourced communities. Can the findings from these studies be generalized to large-scale modern programs with children from a range of economic backgrounds? This is what is proposed in the new infrastructure bill as a universal pre-K model.
A new study published in Child Development strongly suggests that sustained high-quality early education can have long-lasting impacts. Using the National Institute of Child Health and Human Development study of early child care and youth development as its base, this research followed 814 subjects of the original sample until the young adults were 26 years of age. These young adults had attended a variety of child care and preschool settings that varied widely in their quality of care. As this was a study of development of everyday children in everyday environments, it included families from low-, middle-, and high-income backgrounds in several locations around the country with access to high, middling, or lower quality of care when they were in early childhood. Remarkably, children from low-income backgrounds who had access to 24 months or more of high-quality early childhood education in their first five years were more likely to graduate from college and had higher salaries at age 26. In fact, the outcomes for these young adults who experienced sustained high-quality care were statistically indistinguishable from their higher-income peers.
Community-based early care and education, delivered at scale, can provide lasting impacts, and may serve as a catalyst for children’s success later in life—particularly for those from less resourced environments. Importantly, high quality was necessary for achieving these long-term outcomes. Recent findings from a study by University of Virginia Professor Bob Pianta and his colleagues make a similar point. High-quality early child care increases children’s readiness for school and narrows the so-called achievement gap by half. This means access to early education is not enough. Warm, safe, supporting environments that are rich with language and conversations, and offer many opportunities to play and engage in hands-on exploration are key. Sustained access is also critical in predicting long-term outcomes. Higher salary and college graduation rates were only evident for children who had two or more years of high-quality care.
The data are clear. Early childhood programs that are sustained and high quality can have long-lasting impacts on children, preparing them for formal schooling and beyond with the added factor that early education paves the way for parents to be in the workforce.
The data are clear. Early childhood programs that are sustained and high quality can have long-lasting impacts on children, preparing them for formal schooling and beyond with the added factor that early education paves the way for parents to be in the workforce. This is a win-win-win for society. But access alone and custodial care will not sow the benefits provided by high-quality early care programs.
As we continue the debate, let us keep the science of early learning clearly in mind. We need high-quality early childhood care to set children on trajectories that will enable them (and society) to thrive. The new research suggests that this goal is within our grasp and that it is scalable within everyday contexts.
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