Developing Culturally Appropriate Content for a Child-Rearing App to Support Young Children’s Socioemotional and Cognitive Development in Afghanistan: Co-Design Study

The influence of the neighborhood physical environment on early child health and development: A review and call for research

Parental technology use in a child's presence (hereafter, PTU), often referred to as technoference, is a growing concern in family dynamics, and no studies have quantitatively synthesized associations with children's health and development. To systematically review and synthesize literature on associations between PTU in their child's presence and motor development, cognitive development, psychosocial health, physical activity, screen time, and sleep in early childhood. Peer-reviewed studies from MEDLINE, CINAHL, SPORTDiscus, PsycINFO, PsycArticles, Web of Science, Scopus, and ProQuest published from inception to July 2024. A total of 6212 studies were initially identified. Studies were included if they examined associations between PTU in the presence of their apparently healthy children (birth to age 4.9 years) and motor development, cognitive development, psychosocial health, physical activity, screen time, or sleep. PRISMA guidelines were followed. Random-effect models were conducted to determine the pooled estimates of the associations and moderating effects of the type of exposure (distraction/interruption). The risk of bias was assessed using the JBI critical appraisal tools. Association between PTU in the child's presence and motor development, cognitive development, psychosocial health, physical activity, screen time, and sleep. Twenty-one studies involving 14 900 participants from 10 countries were included in the meta-analysis. Significant associations were found between parental technology use in the child's presence and cognition (r = -0.14; 95% CI, -0.23 to -0.04), internalizing behavior and emotions (r = 0.13; 95% CI, 0.08 to 0.19), externalizing behavior (r = 0.15; 95% CI, 0.09 to 0.21), prosocial behavior (r = -0.08; 95% CI, -0.13 to -0.02), attachment (r = -0.10; 95% CI, -0.19 to -0.01), and screen time (r = 0.23; 95% CI, 0.13 to 0.32). No moderating effects of the type of PTU exposure on any associations were found. No study examined motor development, physical activity, or sleep. Parents' use of technology in their child's presence was negatively associated with cognitive and psychosocial outcomes and screen time among young children, although the effect sizes were small. Further research focusing on potential impacts on physical activity, sleep, and motor skills is needed. Understanding these associations is crucial for informing research and guidelines aimed at minimizing the potential negative effects of this phenomenon on early childhood development.

BackgroundThe social environment is a fundamental determinant of early child development and, in turn, early child development is a determinant of health, well-being, and learning skills across the life course. Redistributive policies aimed at reducing social inequalities, such as a welfare state and labour market policies, have shown a positive association with selected health indicators. In this study, we investigated the influence of redistributive policies specifically on the social environment of early child development in five countries with different political traditions. The objective of this analysis was to highlight similarities and differences in social and health services between the countries and their associations with other health outcomes that can inform better global early child development policies and improve early child health and development.MethodsFour social determinants of early child development were selected to provide a cross-section of key time periods in a child’s life from prenatal to kindergarten. They included: 1) prenatal care, 2) maternal leave, 3) child health care, and 4) child care and early childhood education. We searched international databases and reports (e.g. Organization for Economic Cooperation and Development, World Bank, and UNICEF) to obtain information about early child development policies, services and outcomes.ResultsAlthough a comparative analysis cannot claim causation, our analysis suggests that redistributive policies aimed at reducing social inequalities are associated with a positive influence on the social determinants of early child development. Generous redistributive policies are associated with a higher maternal leave allowance and pay and more preventive child healthcare visits. A decreasing trend in infant mortality, low birth weight rate, and under five mortality rate were observed with an increase in redistributive policies. No clear influence of redistributive policies was observed on breastfeeding and immunization rates. In the analysis of child care and early education, the lack of uniform measures of early child development outcomes was apparent.ConclusionsThis paper provides further support for an association between redistributive policies and early child health and development outcomes, along with the organization of early child health and development services.

Digital technologies are widely recognized for their equalizing effect, improving access to affordable health care regardless of gender, ethnicity, socioeconomic status, or geographic region. The Thrive by Five app is designed to promote positive interactions between children and their parents, extended family, and trusted members of the community to support socioemotional and cognitive development in the first 5 years of life and to strengthen connections to culture and community. This paper aims to describe the iterative co-design process that underpins the development and refinement of Thrive by Five's features, functions, and content. Minderoo Foundation commissioned this work as a quality improvement activity to support an engaging user experience and inform the development of culturally appropriate and relevant content for parents and caregivers in each country where the app is implemented. The app content, referred to as Collective Actions, comprises "The Why," that presents scientific principles that underpin socioemotional and cognitive development in early childhood. The scientific information is coupled with childrearing activities for parents, extended family, and members of the community to engage in with the children to support their healthy development and to promote positive connections between parents, families, and communities and these young children. Importantly, the initial content is designed and iteratively refined in collaboration with a subject matter expert group from each country (ie, alpha testing). This content is then configured into the app (either a beta version or localized version) for testing (ie, beta testing) by local parents and caregivers as well as experts who are invited to provide their feedback and suggestions for improvements in app content, features, and functions via a brief web-based survey and a series of co-design workshops. The quantitative survey data will be analyzed using descriptive statistics, whereas the analysis of qualitative data from the workshops will follow established thematic techniques. To date, the co-design protocol has been completed with subject matter experts, parents, and caregivers from 9 countries, with the first results expected to be published by early 2023. The protocol will be implemented serially in the remaining 21 countries. Mobile technologies are the primary means of internet connection in many countries worldwide, which underscores the potential for mobile health programs to improve access to valuable, evidence-based, and previously unavailable parenting information. However, for maximum impact, it is critically important to ensure that mobile health programs are designed in collaboration with the target audience to support the alignment of content with parents' cultural values and traditions and its relevance to their needs and circumstances. DERR1-10.2196/39225.

Developmental potential is the ability to think, learn, remember, relate, and articulate ideas appropriate to age and level of maturity, and an estimated 39 percent of the world’s children under age five years do not attain this potential (Grantham-McGregor and others 2007).The main reason for giving prominent attention to mental development from conception through the first 24 months of life is that early unfavorable conditions can impair the normal development of the brain. The impairment is often incremental and unnoticed until schooling begins. The most striking example of impairment is the gradual deletion of unused brain synapses. The lack of use may be due to the absence of stimulation in the family environment or lack of available energy for brain activity. Regenerating those lost synapses may occur at an older age but with additional costs. For example, children who do not acquire a good vocabulary in the early years will have difficulty learning how to read; children who do not acquire simple problem-solving strategies in the first 24 months will have difficulty understanding math concepts; children who do not develop secure emotional attachments to adults will have difficulty coping with stresses and challenges throughout life. The plasticity of the brain diminishes with age, but greater plasticity in the very early years suggests that brain development has a greater chance of being modified by protective interventions than by interventions later in life (Werker and Hensch 2015).A second reason for attending to early mental development is that individuals, communities, and societies are healthier and more productive if they have mature mental skills. More educated adults are healthier and wealthier than less educated adults. Educated mothers have healthier children and are more likely to recognize symptoms of illness, follow medical advice, feed their children nutritious foods, and keep their homes clean (Boyle and others 2006; Cleland and van Ginneken 1988). Educated husbands are less likely to condone or use violence to resolve domestic conflicts (Abraham and others 2006). Follow-up data of adults who participated in early psychosocial stimulation programs demonstrate some of these long-term benefits (Gertler and others 2014).This chapter discusses mental development from birth to age 24 months in low- and middle-income countries (LMICs). We include recent literature published since the 2011 child development series in The Lancet. Although we focus on cognitive and language domains, we touch on socioemotional, fine motor, and gross motor development. First, a description of how these domains are measured provides an operational definition of the term mental development. Second, conditions that derail early child development are examined. These conditions arise during the prenatal period and continue throughout the next 24 months; they include psychosocial stimulation, prenatal and postnatal nutrition, the physical environment, and maternal mental health. Finally, the results of several systematic reviews and meta-analyses are presented to show the effects of stimulation and nutrition, along with disease-related interventions to promote mental development. Maternal interventions related to nutrition and mental health are also reviewed. A framework of critical components to include in programs is outlined.

The ongoing conflict in Afghanistan poses a great danger to the Afghanistan state itself as well as for the neighboring countries. A decreasing interest from the United States of America, NATO and other key players due to a long war and other geopolitical challenges will leave Afghanistan with the minimum outer support for the future. The science of conflict resolution is offering a variety of theories that could lead endless wars and conflicts to an end. The ongoing conflict in Afghanistan is challenging those theories, while the resolution is crucial for the Afghanistan people right now. But are those theories reflected in the current actions of the US, NATO and Afghanistan governments? And do those theoretical actions lead to a better future regarding conflict resolution? The purpose of this article was to analyze the current policies of third parties influencing the current conflict in Afghanistan to determine the most relevant conflict prevention theory that could support conflict resolution most effectively in the future. To achieve the mentioned purpose, the following tasks were designed. First, the most relevant conflict prevention theories, applicable to the Afghanistan case, were analyzed and the main characteristics were identified. Secondly, the actions of NATO, US and Afghanistan, connected to the conflict resolution efforts, were identified and analyzed. After that, actions mentioned above were compared with theoretical approaches from different theories and certain trends were detected. Later on, research was focused to detect particular elements that were relevant to each theory and further actions concentrated on identifying the trend of these elements for each theory, while doing a comparative comparison analysis, which was based on selected timeframes. Afterward, the trends for each theory were compared and – by doing this – the most applicable theory was identified that could be later used in practice to resolve the current conflict. Research showed that:All conflict prevention theories showed that resolution is possible only if all parties are involved in the processes and practically commit to actions. Currently this is not the case in Afghanistan.Some conflict resolution theories consider similar actions that currently the NATO, US and Afghanistan governments are using in the region.One of the analyzed conflict resolution theories could be applied practically in the Afghanistan case. The conflict prevention theory is the most flexible and has the widest action set in comparison with other theories.The conflict prevention theory reflects the current US actions in Afghanistan, when the decreasing US support for the Afghanistan government in security, governance and in other sectors influences the weakening security situation. The effectiveness of conflict prevention theory is low due to the Taliban’s absence in the negotiations, and this fact does not influence any recognition that the most relevant theory that could support current conflict resolution in the most effective way in Afghanistan is the conflict prevention theory.

Introduction: The percentage of the Palestinian children considered “below level” – or “not on track” in their early childhood development is higher than their peers in neighbouring countries. This research presents a framework to explain pathways between water stress, child health, family wealth, parental support, and early childhood development in Palestine, and presents a different perspective in water stress and policies and services addressing children. Objective: To assess evidence of the link between water stress and vulnerability in early childhood development and to examine the implications of this relationship for services and policies in Palestine. Method and Results: Demographic and health data obtained from nationally representative surveys were merged and analysed. Descriptive analysis was used to investigate the features of household water stress and show its association with risk for delayed early childhood development in Palestine. Data on social, economic, health, and environmental conditions in 52 communities in Palestine were aggregated to develop a Child-Water Stress Index to be used as a single summary measure that captures the multidimensional influence of water stress. At the household level, a Mediation Model was developed and applied to investigate the pathways through which water stress interacts with child health, family care, and wealth level and in turn, influences early childhood development. An evaluation strategy is presented, with new perspectives for enhancing the effectiveness of early childhood programmes and policies in the Palestinian context. Qualitative data using focus group discussions with parents and semi structured interviews with practitioners were conducted to provide in depth analysis of the findings. Conclusion: Children experiencing water stress are more likely to not be on track in their early childhood development. Water stress is more likely to influence childhood development through indirect pathways by interacting with determinants of optimal early childhood development including disrupted family support, wealth level, and child health. Water stress exacerbates the impact of limited wealth and inadequate family support on early childhood health and development, suggesting the need for a holistic perspective in evaluating services and policies.

Screen time has become an integral part of children's daily lives. Nevertheless, the developmental consequences of screen exposure in young children remain unclear. To investigate the screen time trajectory from 6 to 72 months of age and its association with children's development at age 72 months in a prospective birth cohort. Women in Shanghai, China, who were at 34 to 36 gestational weeks and had an expected delivery date between May 2012 and July 2013 were recruited for this cohort study. Their children were followed up at 6, 9, 12, 18, 24, 36, 48, and 72 months of age. Children's screen time was classified into 3 groups at age 6 months: continued low (ie, stable amount of screen time), late increasing (ie, sharp increase in screen time at age 36 months), and early increasing (ie, large amount of screen time in early stages that remained stable after age 36 months). Cognitive development was assessed by specially trained research staff in a research clinic. Of 262 eligible mother-offspring pairs, 152 dyads had complete data regarding all variables of interest and were included in the analyses. Data were analyzed from September 2019 to November 2021. Mothers reported screen times of children at 6, 9, 12, 18, 24, 36, 48, and 72 months of age. The cognitive development of children was evaluated using the Wechsler Intelligence Scale for Children, 4th edition, at age 72 months. Social-emotional development was measured by the Strengths and Difficulties Questionnaire, which was completed by the child's mother. The study described demographic characteristics, maternal mental health, child's temperament at age 6 months, and mental development at age 12 months by subgroups clustered by a group-based trajectory model. Group difference was examined by analysis of variance. A total of 152 mother-offspring dyads were included in this study, including 77 girls (50.7%) and 75 boys (49.3%) (mean [SD] age of the mothers was 29.7 [3.3] years). Children's screen time trajectory from age 6 to 72 months was classified into 3 groups: continued low (110 [72.4%]), late increasing (17 [11.2%]), and early increasing (25 [16.4%]). Compared with the continued low group, the late increasing group had lower scores on the Full-Scale Intelligence Quotient (β coefficient, -8.23; 95% CI, -15.16 to -1.30; P < .05) and the General Ability Index (β coefficient, -6.42; 95% CI, -13.70 to 0.86; P = .08); the early increasing group presented with lower scores on the Full-Scale Intelligence Quotient (β coefficient, -6.68; 95% CI, -12.35 to -1.02; P < .05) and the Cognitive Proficiency Index (β coefficient, -10.56; 95% CI, -17.23 to -3.90; P < .01) and a higher total difficulties score (β coefficient, 2.62; 95% CI, 0.49-4.76; P < .05). This cohort study found that excessive screen time in early years was associated with poor cognitive and social-emotional development. This finding may be helpful in encouraging awareness among parents of the importance of onset and duration of children's screen time.

BackgroundThe primary objective of this study was to explore the feasibility of a virtual study protocol for a future longitudinal study, including recruitment, study measures, and procedures. The secondary objective was to examine preliminary hypotheses of associations, including 1) the correlations between total duration and patterns of screen time and cognitive development, and 2) the differences in quality of parent–child interactions for two screen-based tasks and a storybook reading task.MethodsParticipants included 44 children aged 3 years and their parents from Edmonton, Alberta and surrounding areas. Children’s screen time patterns (i.e., type, device, content, context) were parental-reported using a 2-week online daily diary design. Children’s cognitive development (i.e., working memory, inhibitory control, self-control, and language) was measured virtually through a recorded Zoom session. Parent–child interactions during three separate tasks (i.e., video, electronic game, and storybook reading) were also measured virtually through a separate recorded Zoom session (n = 42). The quality of the interactions was determined by the Parent–Child Interaction System (PARCHISY). Descriptive statistics, Intra-class correlations (ICC), Spearman’s Rho correlations, and a one-way repeated measures ANOVA with a post-hoc Bonferroni test were conducted.ResultsAll virtual protocol procedures ran smoothly. Most (70%) participants were recruited from four 1-week directly targeted Facebook ads. High completion rates and high inter-rater reliability in a random sample (Diary: 95% for 13/14 days; Cognitive development: 98% 3/4 tests, ICC > 0.93; Parent–child interactions: 100% for 3 tasks, Weighted Kappa ≥ 0.84) were observed for measures. Across cognitive development outcomes, medium effect sizes were observed for five correlations, with positive correlations observed with certain content (i.e., educational screen time) and negative associations observed for total screen time and certain types (show/movie/video viewing) and contexts (i.e., co-use). Medium and large effect sizes were observed for the differences in parent–child interaction quality between the three tasks.ConclusionsThe virtual study protocol appeared feasible. Preliminary findings suggest it may be important to go beyond total duration and consider type, content, and context when examining the association between screen time and cognitive development. A future longitudinal study using this virtual protocol will be conducted with a larger and more generalizable sample.

ObjectiveMany children in low-income and middle-income countries are disadvantaged in achieving early developmental potential in childhood as they lack the necessary support from their surroundings, including from parents and caregivers....

The purpose of this study is to determine the effects of device use and maternal bonding on early childhood cognitive and motor development in Situbondo Regency. In this research, the sample used was 311 respondents using quantitative methods. The multiple linear regression analysis technique was carried out using SPSS version 22 software. The data collection technique used in this research was observation, interviews, filling out Google forms and also direct questionnaires. The results of this research show a partial contribution, namely between the use of gadgets on cognitive development in early childhood, there is a partial contribution, namely between maternal attachment to cognitive development in early childhood, then there is a partial contribution between the use of gadgets and motor development in early childhood. , while there is no partial contribution of maternal attachment to motor development in early childhood. The use of devices in early childhood requires care and supervision, and also the mother’s role in the operation, as overuse of the device by the child can lead to addiction to playing with the device. This negatively affects the child’s growth and development process, especially the development of cognitive and motor skills. Dependence on the use of gadgets hinders the child’s growth and development process. Keywords: Gadget Use, Maternal Attachment, Cognitive Development, Motor Development

Association between water supply and early childhood development in Palestine: a descriptive analysis of demographic and health survey data

The associations of screen use with children's cognition are not well evidenced and recent, large, longitudinal studies are needed. We aimed to assess the associations between screen use and cognitive development in the French nationwide birth cohort. Time and context of screen use were reported by parents at ages 2, 3.5 and 5.5. Vocabulary, non-verbal reasoning and general cognitive development were assessed with the MacArthur-Bates Communicative Development Inventory (MB) at age 2, the Picture Similarities subtest from the British Ability Scales (PS) at age 3.5 and the Child Development Inventory (CDI) at ages 3.5 and 5.5. Outcome variables were age-adjusted and standardized (mean = 100, SD = 15). Multiple imputations were performed among children (N = 13,763) with ≥1 screen use information and ≥1 cognitive measures. Cross-sectional and longitudinal associations between screen use and cognitive development were assessed by linear regression models adjusted for sociodemographic and birth factors related to the family and children, and children's lifestyle factors competing with screen use. Baseline cognitive scores were further considered in longitudinal analysis. TV-on during family meals at age 2, not screen time, was associated with lower MB scores at age 2 (β [95% CI] = -1.67 [-2.21, -1.13]) and CDI scores at age 3.5 (-0.82 [-1.31, -0.33]). In cross-sectional analysis, screen time was negatively associated with CDI scores at ages 3.5 (-0.67 [-0.94, -0.40]) and 5.5 (-0.47 [-0.77, -0.16]), and, in contrast, was positively associated with PS scores (0.39 [0.07, 0.71]) at age 3.5. Screen time at age 3.5 years was not associated with CDI scores at age 5.5 years. Our study found weak associations of screen use with cognition after controlling for sociodemographic and children's birth factors and lifestyle confounders, and suggests that the context of screen use matters, not solely screen time, in children's cognitive development.

Introduction: Early childhood is a crucial period for the development and improvement of motor, cognitive, and social skills, which are fundamental for functional independence and adequate child development. However, prolonged and excessive exposure to digital technologies among children in this age group has become increasingly common, raising important questions about the possible negative effects that increased screen time can have on children's motor and cognitive development. Objectives: Investigate how excessive use of digital devices can negatively impact neuromotor development in early childhood. Methodology: This is an Integrative Literature Review, conducted in the PubMed, SciELO, and BVS databases, including articles published in the last 5 years. The selection of studies was carried out in three stages: screening of titles, reading of abstracts, and full reading of the selected articles. Results and discussion: The results indicate that exceeding one hour of screen time per day can cause impairments in children's motor, cognitive, and social development, in addition to increasing the risk for Developmental Coordination Disorder (DCD) and affecting improvements in communication and daily life skills. Final considerations: Prolonged use of screens in children under 6 years of age is related to motor, cognitive and social development, highlighting the importance of guiding parents and caregivers on the moderate use of electronic devices and encouraging activities that promote healthy child development.

Introduction: Early childhood is a crucial period for the development and improvement of motor, cognitive, and social skills, which are fundamental for functional independence and adequate child development. However, prolonged and excessive exposure to digital technologies among children in this age group has become increasingly common, raising important questions about the possible negative effects that increased screen time can have on children's motor and cognitive development. Objectives: Investigate how excessive use of digital devices can negatively impact neuromotor development in early childhood. Methodology: This is an Integrative Literature Review, conducted in the PubMed, SciELO, and BVS databases, including articles published in the last 5 years. The selection of studies was carried out in three stages: screening of titles, reading of abstracts, and full reading of the selected articles. Results and discussion: The results indicate that exceeding one hour of screen time per day can cause impairments in children's motor, cognitive, and social development, in addition to increasing the risk for Developmental Coordination Disorder (DCD) and affecting improvements in communication and daily life skills. Final considerations: Prolonged use of screens in children under 6 years of age is related to motor, cognitive and social development, highlighting the importance of guiding parents and caregivers on the moderate use of electronic devices and encouraging activities that promote healthy child development.