Abstract
Background and ObjectiveInfants and young children in low to middle-income countries are at risk for adverse neurodevelopment due to multiple risk factors. In this study, we sought to identify stimulation and learning opportunities, growth, and burden of respiratory infections and diarrhea as predictors for neurodevelopment.MethodsWe visited 422 North Indian children 6 to 30 months old weekly for six months. Childhood illnesses were assessed biweekly. At end study, we assessed neurodevelopment using the Ages and Stages Questionnaire 3rd ed. (ASQ-3) and gathered information on stimulation and learning opportunities. We identified predictors for ASQ-3 scores in multiple linear and logistic regression models.ResultsWe were able to explain 30.5% of the variation in the total ASQ-3 score by the identified predictors. When adjusting for child characteristics and annual family income, stimulation and learning opportunities explained most of the variation by 25.1%. Height for age (standardized beta: 0.12, p<.05) and weight for height z-scores (std. beta: 0.09, p<.05) were positively associated with the total ASQ-3 score, while number of days with diarrhea was negatively associated with these scores (std. beta: -0.13, p<0.01).ConclusionOur results support the importance of early child stimulation and general nutrition for child development. Our study also suggests that diarrhea is an additional risk factor for adverse neurodevelopment in vulnerable children.
Highlights
There is sound evidence that deficient care and inadequate stimulation are key risk factors for adverse neurodevelopment in children [1,2,3]
Infants and young children in low to middle-income countries are at risk for adverse neurodevelopment due to multiple risk factors
Height for age and weight for height z-scores were positively associated with the total ASQ-3 score, while number of days with diarrhea was negatively associated with these scores
Summary
There is sound evidence that deficient care and inadequate stimulation are key risk factors for adverse neurodevelopment in children [1,2,3]. Risk factors co-occur giving rise to cumulative effects on neurodevelopment [2,5,11,12]. Complex relationships among these risk factors make it challenging to determine their independent contribution. We have assessed developmental status and collected information on various risk and protective factors for adverse development such as socioeconomic status, child characteristics and stimulation and learning opportunities in a sample of 422 young North Indian children. Infants and young children in low to middle-income countries are at risk for adverse neurodevelopment due to multiple risk factors. We sought to identify stimulation and learning opportunities, growth, and burden of respiratory infections and diarrhea as predictors for neurodevelopment
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