Early child development—a winning combination

Abstract

4 years ago, a Lancet Series on child development reported that worldwide, more than 200 million children younger than 5 years were failing to reach their developmental potential. In today's issue a follow-up Series documents progress in reduction of risk factors for poor development, such as inadequate cognitive stimulation, intrauterine growth restriction, HIV infection, and societal violence. The poorest and most vulnerable children benefit most from interventions, such as preschool programmes, because risk factors accumulated over a child's short life produce greater inequality in educational achievements and development. The economic benefits of investment in child development are clear—a projected 25% per country uplift in preschool enrolment in 1 year would yield a return of US$10·6 billion, largely due to increased schooling. According to Maureen Black of the University of Maryland School of Medicine, USA, a winning combination is created when children in the crucial early years receive stimulation through parenting and educational support, in addition to health and nutrition. The Series papers show the challenges that remain in both research and implementation. Evidence is weaker for children younger than 3 years, for whom there are fewer programmes known to be effective. Scaling up of beneficial programmes requires committed funding, and ongoing monitoring to ensure access for the poorest. Even in the present economic climate, there is an incredible opportunity to act. Following the UN Secretary General's 2010 launch of the Global Strategy for Women's and Children's Health, there can be no sharper message to proponents of maternal and child health—that acting early in a child's life reaps the highest reward both for individuals and societies. “Many health programmes use child developmental indicators as a measure of success”, says Black, but most have not integrated early development interventions. Governments and agencies who fight daily to save children from neonatal illness and infectious diseases are urged to give them the opportunity to reach their full developmental potential. Early childhood development—global action is overdueIn 2007, The Lancet declared that early childhood development was a global challenge of the greatest urgency.1–4 4 years later, we have made progress, but still have far to go in making early childhood development the global priority it must be. Full-Text PDF Inequality in early childhood: risk and protective factors for early child developmentInequality between and within populations has origins in adverse early experiences. Developmental neuroscience shows how early biological and psychosocial experiences affect brain development. We previously identified inadequate cognitive stimulation, stunting, iodine deficiency, and iron-deficiency anaemia as key risks that prevent millions of young children from attaining their developmental potential. Recent research emphasises the importance of these risks, strengthens the evidence for other risk factors including intrauterine growth restriction, malaria, lead exposure, HIV infection, maternal depression, institutionalisation, and exposure to societal violence, and identifies protective factors such as breastfeeding and maternal education. Full-Text PDF Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countriesThis report is the second in a Series on early child development in low-income and middle-income countries and assesses the effectiveness of early child development interventions, such as parenting support and preschool enrolment. The evidence reviewed suggests that early child development can be improved through these interventions, with effects greater for programmes of higher quality and for the most vulnerable children. Other promising interventions for the promotion of early child development include children's educational media, interventions with children at high risk, and combining the promotion of early child development with conditional cash transfer programmes. Full-Text PDF