Abstract
The Developmental Study is part of a larger intervention on “saving of lives from drowning (SoLiD)” where children were enrolled either into crèches (daycare centers) or playpens to prevent drowning in rural Bangladesh. Sampling ~1000 children between the ages of 9–17 months, we compared problem-solving, communication, motor and personal-social outcomes assessed by the Ages and Stages Questionnaire in the two interventions. After controlling for variables such as home stimulation in multivariate regressions, children in crèches performed about a quarter of a standard deviation better in total scores (p < 0.10) and 0.45 standard deviations higher in fine motor skills (p < 0.05). Moreover, once the sample was stratified by length of exposure to the intervention, then children in crèches performed significantly better in a number of domains: those enrolled the longest (about 5 months) have higher fine motor (1.47, p < 0.01), gross motor (0.40, p < 0.05) and personal-social skills (0.95, p < 0.01) than children in playpens. In addition, children in crèches with the longer exposure (about 5 months) have significantly higher personal-social and problem-solving scores than those in crèches with minimum exposure. Enrollment in crèches of very young children may be positively associated with psychosocial scores after accounting for important confounding variables.
Highlights
Stimulation improves developmental outcomes among young children and these outcomes last over long periods [1,2,3]
The Saving of Lives from Drowning (SoLiD) project is one of the largest child drowning prevention projects undertaken in a low-and-middle-income countries (LMICs)
Children in crèches had better total ASQ scores and fine motor skills compared to children in the playpen controlling for relevant characteristics, and the longer that children spent in the crèche, the better they performed with respect to their total ASQ scores, gross motor, fine motor, and personal/social scores
Summary
Stimulation improves developmental outcomes among young children and these outcomes last over long periods [1,2,3]. Childhood education and care is a policy priority given the potential benefits that early cognitive and other stimulation can have on children’s problem-solving, communication, motor and personal-social outcomes, and the associated economic and social benefits that may arise at a population level [6] As such programs become more popular, their designs and contributions to cognitive and behavioral outcomes in varied settings are still uncertain. The Saving of Lives from Drowning (SoLiD) project is one of the largest child drowning prevention projects undertaken in a LMIC It aimed at enrolling around 80,000 children between 9–36 months in 51 unions (the local geographic administrative boundary) and 7 sub-districts in rural Bangladesh. The quality of execution of the SoLiD project was high, with fidelity to the initial design, and the outcomes on drowning have been promising [17,18]
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