Mother-child Interaction Research Articles

An examination of mothers’ self-efficacy and their interaction with their children aged 60-72 months

The present study has the aim of examining the parental self-efficacy of mothers in terms different variables, establishing the correlation between parenting and the general self-efficacy levels of mothers and to identify the characteristics of their interactions with their children in the context of their self-efficacy. Explanatory sequential design, a mixed method, was used in this study. For the quantitative part, 251 mothers with children who are 60-72 months was involved in. The sample for the qualitative part was formed of volunteers out of the said sample and consists of 20 mothers with 20 children in total; in this group of mothers, the self-efficacy levels were determined as low (n=10) or high (n=10). The data were collected through a set of forms, namely the “Demographic Information Form”, “General Self-Efficacy Scale”, “Berkeley Parenting Self-Efficacy Scale Revised”, and “Mother-Child Interaction Games Video Records”. Statistical analyzes revealed that the total scores of mothers' self-efficacy did not differ according to their educational status and social support from their spouses, but showed a significant difference according to the gender of their children, in favor of mothers with girls. Additionally, it was found that mothers' general self-efficacy levels and parenting self-efficacy were positively related. Mothers having low parenting self-efficacy levels exhibit more behaviors gravitating towards a “focusing on success” first and foremost, followed by “sensitivity” and “play interaction”. Mothers with high parenting self-efficacy, on the other hand, exhibited behaviors towards the theme of "sensitivity" the most, unlike mothers with low self-efficacy in games. However, the frequency of behavior for the themes of "achievement orientation" and "game interaction" was also found to be high.

Mothers' experiences: A missing puzzle piece in caring for children with autism spectrum disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social relationships, communication, and restricted and repetitive behavioral patterns [1]. In recent years, epidemiological studies have shown a rapid increase in the prevalence of ASD. According to the report from the Center for Disease Control and Prevention in the United States, the prevalence was estimated to be 1 in 59 individuals in 2014 and 1 in 54 individuals in 2016 among 8-year-old children [2]. ASD is a complex developmental condition that is accompanied by persistent challenges in social interaction, speech, and nonverbal communication, significantly affecting mother-child interactions [3]. One of the most significant concerns for mothers of these children is how to care for them. The exact cause of this disorder remains largely unknown, and lack of awareness about autism often leads to delayed recognition of the child's difficulties by families [4]. As a result, the golden time for early intervention may be missed, and life in society becomes more challenging for both these children and their caregivers. Additionally, these children require care and support from their families and community institutions from birth throughout their growth and development, making caregiving a stressful process for mothers. Therefore, caring for these children necessitates the adoption of specialized caregiving and parenting approaches [5, 6]. The literature review indicates that the majority of studies conducted in the field of caring for children with autism have primarily been quantitative studies with a traditional intervention approach, focusing on the effectiveness of cognitive-behavioral therapy play therapy, storytelling therapy, supportive counseling, psychotherapy, and teaching coping skills [7-9]. While quantitative research methods have their benefits in many areas, they alone cannot provide a comprehensive examination of the deep dimensions of the phenomenon from the perspective of individuals' first-hand experiences [10].

The effectiveness of the use of a technology toolkit on activities and mother-child interactions: children with complex care needs

Purpose Meaningful interactions with significant others are crucial for children’s well-being, including those with severe to profound intellectual and multiple disabilities. This study aimed to gain more insight into the potential of an ICT-Toolkit in enhancing or contributing to the interaction between parents and their children with complex care needs. Methods A multiple case study with an AB experimental design was conducted. Four mother-child dyads were observed during eight two-and-a-half-hour home visits. Children between 6 and 16 years with severe to profound intellectual and multiple disabilities were included. A participatory research observation approach was used. Results Using the ICT-Toolkit compared to the baseline phase stimulated a decrease in the repetitive activities of two of the four dyads. Overall, the activity repertoire of the children and the length of time being engaged in individual activities increased, and the activities together increased in three of the dyads. There were more turn-taking interactions; the children took more initiative to engage their mother in their activity, and the children exhibited more affection when engaging with the ICT-Toolkit items. Three mothers followed their children more in their play, and all mothers were more verbally and physically active in instructing and/or motivating their children. Discussion All mothers noticed their child’s “new” behaviour when interacting with an ICT-Toolkit item. The mothers followed the child’s lead when engaged with the ICT-Toolkit. The ICT-Toolkit’s added effect may be due to the predictability, uncomplicated and highly perceivable stimuli it provides with minimal effort and maximum effect.

The Quality of Mother-Child Feeding Interactions Predicts Psychopathological Symptoms in Offspring and Mothers Seven Years Later: A Longitudinal Study on the General Population.

The increased risk of internalizing and externalizing symptoms in children has been observed in the presence of maternal psychopathology. This study aimed to investigate a potential pathway involving the quality of early interactions between mothers and their children. A sample of 150 mother-child dyads underwent assessment when the children were 3 years old and around the age of 10. Video recordings of feeding exchanges between mothers and children were analyzed to evaluate the quality of mother-child interactions. Maternal psychopathology and child internalizing and externalizing symptoms were measured through self-report and report-form measures completed by mothers. The quality of mother-child feeding interactions at three years of age significantly differentiated (p < 0.001), eight years later, between mothers at high and low psychopathological risk and between children exhibiting clinical and subclinical internalizing symptoms. Clinically relevant child symptoms were notably more prevalent when the mother-child interaction quality at three years of age was maladaptive, particularly in the context of concurrent high maternal psychopathological risk. The study findings underscore the importance of focusing on the early quality of mother-child feeding interactions to identify potential situations of maternal and child clinical risk for the development of psychopathological symptoms and to guide preemptive measures and policies.

Predictors of executive function among 2 year olds from a Thai birth cohort

Executive function (EF) is a critical skill for academic achievement. Research on the psychosocial and environmental predictors of EF, particularly among Southeast Asian, agricultural, and low income/rural populations, is limited. Our longitudinal study explored the influence of agricultural environmental, psychosocial, and temperamental factors on children’s emerging EF. Three-hundred and nine farm worker women were recruited during the first trimester of pregnancy. We evaluated the effects of prenatal insecticide exposure and psychosocial factors on “cool” (i.e., cognitive: A-not-B task, looking version) and “hot” EF (i.e., affective, response inhibition) measures of emerging EF. Maternal urine samples were collected monthly during pregnancy, composited, and analyzed for dialkylphosphate (DAP) metabolites of organophosphate insecticides. Psychosocial factors included socioeconomic status, maternal psychological factors, and quality of mother-child behavioral interactions. Backward stepwise regressions evaluated predictors of children’s EF at 12 (N = 288), 18 (N = 277) and 24 (N = 280) months of age. We observed different predictive models for cool EF, as measured by A-not-B task, vs. hot EF, as measured by response inhibition tasks. Report of housing quality as a surrogate for income was a significant predictor of emerging EF. However, these variables had opposite effects for cool vs. hot EF. More financial resources predicted better cool EF performance but poorer hot EF performance. Qualitative findings indicate that homes with fewer resources were in tribal areas where children must remain close to an adult for safety reasons. This finding suggests that challenging physical environments (e.g., an elevated bamboo home with no electricity or running water), may contribute to development of higher levels of response inhibition through parental socialization methods that emphasize compliance. Children who tended to show more arousal and excitability, and joy reactivity as young infants in the laboratory setting had better cognitive performance. In contrast, maternal emotional availability was a significant predictor of hot EF. As expected, increased maternal exposure to pesticides during pregnancy was associated with worse cognitive performance but was not associated with inhibitory control. Identifying risk factors contributing to the differential developmental pathways of cool and hot EF will inform prevention strategies to promote healthy development in this and other unstudied rural, low income Southeast Asian farming communities.

A longitudinal study of families created using egg donation: Family functioning at age 5.

Findings are reported from Phase 2 of a longitudinal study of family functioning in heterosexual-couple families with 5 year olds conceived using identity-release egg donation. Seventy-two egg donation families were compared to 50 in vitro fertilization (IVF) families (ethnicity: 93% White British) using standardized observational, interview, and questionnaire measures. There were no differences between family types in the quality of mother-child or father-child interaction, apart from lower structuring by fathers in egg donation families. Egg donation mothers and fathers reported higher levels of parenting stress and lower levels of confidence and competence than their IVF counterparts. Egg donation mothers reported lower social support and couple relationship quality, greater anger toward their child, and perceived their child as more angry and less happy, compared to IVF mothers. Egg donation fathers showed greater criticism and anger toward their child, less joy in parenting, and were less satisfied with the support they received, than IVF fathers. Children in egg donation families showed higher levels of externalizing problems than IVF children as rated by mothers, fathers, and teachers, whereas they were rated as having higher levels of internalizing problems by teachers only. Externalizing problems were predicted by mothers' lower initial social support, steeper increases in parenting stress and greater concurrent criticism, whereas internalizing problems were associated with poorer initial couple relationship quality as rated by mothers. Both were predicted by fewer gains in reflective functioning. There was a moderation effect such that parenting stress was a stronger predictor of externalizing problems for egg donation than IVF families. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Being an Infant in a Pandemic: Influences of the COVID-19 Pandemic on Infants, Toddlers and Their Mothers in a Clinical Population.

The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child's sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants' regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group.

Explaining mental health and quality of mother-child interaction with attention deficit-hyperactivity based on parenting styles

Explaining mental health and quality of mother-child interaction with attention deficit-hyperactivity based on parenting styles

The Effect of Employed Mothers’ Work-Family Balance on a Child’s Smartphone Overdependence: The Mediating Effect of Mother-Child Interaction Activities

Objectives: This research investigates how mother-child interactions mediate the effect of employed mothers' work-family balance on their children's excessive smartphone use. The study aims to provide insights for developing support for working mothers and their children.Methods: A questionnaire was distributed to employed mothers with children in kindergartens and daycare centers in Seoul and Gyeonggi, yielding 221 valid responses. SPSS 26.0 and Mplus 7.4 were used for analysis, including frequency analysis, descriptive statistics, confirmatory factor analysis, and a mixed structural equation model, with significance at α = .05 and a 95% confidence interval.Results: The study found that a positive work-family balance enhances mother-child interaction, which in turn reduces children's smartphone overdependence. Conversely, work-family conflict increases this dependence, but is mitigated by mother-child interaction. The study delineates the relationships among work-family balance, interaction, and smartphone dependence in children.Conclusion: The interaction between working mothers and their children significantly influences children's smartphone overdependence. Thus, it's crucial to support employed mothers through educational strategies and programs promoting quality interactions with children, balancing work and family roles.

Autistic Children's Irritability During Social Communication Assessments.

Accurate measurement of autistic children's social communication is critical for assessing skills, setting intervention goals, evaluating change over time, determining service eligibility, and determining classroom placement. There are various types of assessments, some of which use specific tasks to elicit social communication. Structured tasks may frustrate children, inadvertently elicit irritability, and have a cascading effect on their ability to communicate. To date, no studies have evaluated how differing types of social communication assessments may exacerbate children's irritability and impact assessment scores. We examined the extent to which (a) social communication assessment type (structured vs. naturalistic) impacts autistic children's irritability and (b) child irritability is associated with social communication scores. Autistic toddlers (n = 114, Mage = 33.09 months, SD = 6.15) completed the Communication and Symbolic Behavior Scales (CSBS; structured) and a 10-min play-based mother-child interaction (MCX; naturalistic). Child irritability was scored on both assessments using a global rating scale of 0-15. Child irritability during the CSBS was significantly higher than during the MCX (V = 4892, p < .001, r = .68). Higher irritability was associated with lower CSBS social communication scores (B = -0.05, p = .03), but not MCX scores (B = 0.04, p = .13; Theil's F = 6.92, p = .009). Our findings suggest that the CSBS may pose unique challenges for autistic children, as it led to higher rates of irritability and negatively affected children's social communication scores. Evaluating the association between assessment type and irritability supports the complete characterization of autistic children's experience during assessments and clinicians in obtaining a more representative measure of social communication.

Maternal depressive symptoms and child language development: Exploring potential pathways through observed and self-reported mother-child verbal interactions

Abstract Maternal depressive symptoms (MDS) in the postnatal period may impact children’s later development through poorer quality parent-child interactions. The current study tested a specific pathway from MDS (child age 9 months) to child receptive vocabulary (4 ½ years) through both self-reported and observed parent-child verbal interactions (at both 2 and 4 ½ years). Participants (n = 4,432) were part of a large, diverse, contemporary pre-birth national cohort study: Growing Up in New Zealand. Results indicated a direct association between greater MDS at 9 months and poorer receptive vocabulary at age 4 ½ years. There was support for an indirect pathway through self-reported parent-child verbal interactions at 2 years and through observed parent-child verbal interactions at 4 ½ years. A moderated mediation effect was also found: the indirect effect of MDS on child vocabulary through observed verbal interaction was supported for families living in areas of greater socioeconomic deprivation. Overall, findings support the potential role of parent-child verbal interactions as a mechanism for the influence of MDS on later child language development. This pathway may be particularly important for families experiencing socioeconomic adversity, suggesting that effective and appropriate supportive parenting interventions be preferentially targeted to reduce inequities in child language outcomes.

Psychometric soundness and predictive factors of the NCAST Parent-Child Interaction Teaching Scale in urban Chinese population.

Quality of parent-child interaction in early childhood functions as a critical indicator of nurturing care and is strongly associated with short-term and long-term development (health, cognition, language, social emotion, well-being, etc.). NCAST PCI Teaching Scale (PCI-TS), a video-based assessment regarded as a gold standard to measure PCI, has been widely used worldwide. However, its psychometric soundness among the urban Chinese population is unclear. This study assesses the PCI-TS's reliability and validity and explores predictive factors among urban Chinese parent-child dyads. PCI-TS was adopted to code mother-child interaction among urban Chinese dyads recruited during the children's regular health checks in local maternal and child health centres. Reliability was evaluated by internal consistency (Cronbach'α coefficient) and test-retest reliability (Pearson correlation) with an average interval of 18 days. Score distribution of each subscale and total scale were compared with NCAST Database and Canadian community sample by single sample t-test. Criteria-related validity was conducted by Infant-Toddler Home Observation Measurement of the Environment (Pearson correlation). Predictive factors was performed by multiple linear regression. Four hundred and twenty-nine eligible mother-child dyads were included for data analysis among the 466 recruited samples. Four qualified local paediatricians accomplished video coding with an average agreement of 86%. The PCI-TS has strong reliability among the Chinese population with the Cronbach'α coefficients of the Caregiver-Infant total score, Caregiver total and Infant total scores of 0.81, 0.81 and 0.74, respectively; an acceptable test-retest reliability (r = 0.73, p < 0.01); and moderate correlation with IT-HOME, ranging from 0.53 to 0.62. Child age, birth weight, maternal education, full-time housewife, living with grandparent(s) and living space were predictive factors on PCI-TS in the Chinese population. PCI-TS showed good psychometric properties for measuring mother-child interactions among urban Chinese dyads, offering clinicians and researchers a practical tool to evaluate PCI objectively. Child age, maternal education and living space were beneficial factors, while full-time mothers and living with grandparent(s) were risk factors.

Factors Influencing The Social-Emotional Development of Children And Adolescents: A Study Systematic Literature Review

Adolescence brings about major changes that are intertwined in all domains of development, not only in the physical dimension but also in social-emotional development. This study aims to analyze the factors that influence the social-emotional development of children and adolescents. This study used a systematic literature review method. The analysis used was the Preferred Reporting Item for Systematic Review and Meta-Analytic (PRISMA) method. After scanning titles, abstracts and inclusion criteria, 575 journals were analyzed. Some findings were excluded because they did not meet the criteria, so the number of journals included in the discussion totaled 38 articles. The results showed that factors influencing socio-emotional development were grouped into six factors, namely socio-economic characteristics, mother-child interactions, risky behavior and device use, parental psychological conditions, attachment and parenting, and school learning programs. Suggestions that can be given are improving the psychological well-being of mothers, maintaining and increasing positive interactions between mothers and adolescents, parents have attachment and conduct positive parenting, adolescents have the ability to recognize and manage emotions.

Mother-Child Interactive Science Practices: Improving Mothers' Scientific Literacy and Children's Scientific Creativity

The aim of this study is to improve mothers' scientific literacy and children's scientific creativity through science practices based on mother-child interaction. For this purpose, a training program based on mother-child interaction and including scientific experiments and activities that can be done at home and at school was prepared. The study was designed in a quasi-experimental design within the framework of quantitative research methodology. The participants were 62 mothers and their children (62 children) who had primary school 4th-grade level children in a public primary school. The data of the study, which lasted 6 months during the 2021-2022 academic year, were collected with the Scientific Literacy Test and the Scientific Creativity Test. The results obtained from the study indicate that the science practices training program based on mother-child interaction increased the scientific literacy level of mothers. In addition, it was concluded that mother-child interactive activities were more effective in children's scientific creativity dimensions such as scientific imagination, creative experimental ability, and creative scientific product design skill. Also, it was determined that the children of mothers with high levels of scientific literacy showed higher success in all sub-dimensions of scientific creativity compared to their controls. Keywords: Mother training program, mother-child interaction, scientific literacy, scientific creativity in primary school.

Concurrent and lagged physiological synchrony during mother–child interaction and their relationship to positive affect in 8- to 10-year-old children

Mother–child interaction has been characterized by a fine-tuning of behavior and physiological activity. Yet, little is known about the dynamics of mother–child physiological synchrony during early school age and their associations to positive affect. To investigate these processes, 42 mother–child dyads, with children aged 8 to 10 years, played an interactive game while their interbeat intervals (IBI) and respiratory sinus arrhythmia (RSA) were measured simultaneously. IBI/RSA synchrony was calculated using cross-correlations of the IBI/RSA second-by-second time series for lags − 3 to + 3 seconds. Mother’s and child’s individual and shared positive affect were microcoded. During the interactive tasks, IBI and RSA synchrony significantly increased compared to control conditions. RSA and affect synchrony were significantly stronger for negative compared to positive lags indicating a stronger child leads/mother follows covariation. Further, dyad’s IBI and RSA synchrony were significantly associated to mother’s and child’s individual positive affect. Our data suggest that in low-risk community samples, mothers may respond to their children’s positive affect by matching their own affect and physiology. Investigating these temporally precise, concurrent and lagged synchrony processes may open up new avenues for understanding the ways in which parent–child interactions contribute to child developmental outcomes.

Development of the Culturally Affirming and Responsive Experiences (CARE) Measure: Observing Responsiveness and Ethnic-Racial Cultural Socialization in Mother-Child Interactions.

The existing literature on the importance of maternal responsiveness and the growing body of literature supporting early ethnic-racial cultural socialization highlight the need for an observational measure of how they co-occur during mother-child interactions. This study presents the development and initial validation of the Culturally Affirming and Responsive Experiences (CARE) measure, an observational measure of the presence and quality of responsiveness and ethnic-racial cultural socialization within early mother-child interactions. Pilot study results with 103 racially and ethnically diverse mother-child dyads demonstrated initial reliability and validity of the CARE measure. Implications of applying the CARE measure to early mother-child interactions to assess quality of responsiveness and ethnic-racial cultural socializations are discussed.

Behavioral and neural measures of infant responsivity increase with maternal multisensory input in non-irritable infants.

Parents often use sensory stimulation during early-life interactions with infants. These interactions, including gazing, rocking, or singing, scaffold child development. Previous studies have examined infant neural processing during highly controlled sensory stimulus presentation paradigms. In this study, we investigated infant behavioral and neural responsiveness during a mother-child social interaction during which the mother provided infant stimulation with a progressive increase in the number of sensory modalities. We prospectively collected and analyzed video-coded behavioral interactions and electroencephalogram (EEG) frontal asymmetry (FAS) from infants (n=60) at 2-4 months born at ≥34weeks gestation. As the number of sensory modalities progressively increased during the interaction, infant behaviors of emotional connection in facial expressiveness, sensitivity to mother, and vocal communication increased significantly. Conversely, infant FAS for the entire cohort did not change significantly. However, when we accounted for infant irritability, both video-coded behaviors and EEG FAS markers of infant responsiveness increased across the interaction in the non-irritable infants. The non-irritable infants (49%) demonstrated positive FAS, indicating readiness to engage with, rather than to withdraw from, multisensory but not unisensory interactions with their mothers. These results suggest that multisensory input from mothers is associated with greater infant neural approach state and highlight the importance of infant behavioral state during neural measures of infant responsiveness.

Conflict and negotiation with preschoolers during family meals.

Family meals provide opportunities to observe a variety of social exchanges. This study examined the occurrence of conflict and negotiation during the understudied context of family meals, examining both mother-child and father-child interactions with children aged 3-5 (n = 65). We investigated differences in parents' sensitivity and children's affect based on the occurrence of conflict and negotiation. Results indicated conflict was common with both parents, but particularly with mothers. Negotiation occurred less often: half of the time with mothers and a third of the time with fathers. Mothers were less sensitive and children more negative when mother-child conflict occurred; mothers were more sensitive when father-child conflict occurred. Fathers were more responsive when father-child conflict occurred, but more intrusive when both mother-child and father-child conflict occurred. Mother-child negotiation was associated with responsive mothers; mothers were less negative when mother-child negotiation occurred in the absence of father-child negotiation. Findings provide a deeper understanding of family interactions between young children and parents during family meals. These interactional processes may be an essential ingredient to better understand how family meals affect young children's health and well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Hyperscanning Studies on Interbrain Synchrony and Child Development: A Narrative Review.

Social interactions between parents and children are closely linked with children's development, and interbrain synchrony has been shown to be a neural marker of social interaction. However, to truly capture the essence of social interactions through interbrain synchrony, it is necessary to simultaneously discuss the parental and child brains and adequately record neurological signals during parent-child interactions in interactive tasks. In the current review, we have reviewed three main contents. First, we discuss the correlation between parent-child interbrain synchrony and the development of cognitive (e.g., emotion regulation, attention, and learning) and behavioral abilities (e.g., cooperation, problem-solving) in children. Second, we examine the different neural mechanisms of interbrain synchrony in mother-child and father-child interactions, aiming to highlight the separate roles of mother and father in child development. Last, we have integrated four methods to enhance interbrain synchrony, including communication patterns, nonverbal behavior, music, and multichannel stimulation. A significant correlation exists between parent-child interbrain synchrony and the development of children's cognitive and behavioral abilities. This summary may be useful for expanding researchers' and practitioners' understanding of the ways in which parenting and the parent-child relationship shape children' cognitive and behavioral abilities.

A trial of nurturing care among children who are HIV-exposed and uninfected in eSwatini.

Children who are HIV-exposed and uninfected (CHEU) are a growing population at potential risk of poor neurocognitive development. We tested a nurturing care intervention on children's neurocognitive development and maternal depressive symptoms (primary) with mediation through caregiving activities (secondary). This study was conducted among six intervention and nine comparison antenatal-care/prevention of vertical transmission (ANC/PVT) HIV clinics in eSwatini. We enrolled pregnant women and measured infant development at 9 and 18 months. mothers2mothers (m2m) designed and implemented the clinic-home-community-based intervention. We measured infants' neurodevelopment, maternal depressive symptoms and caregiving activities with the Mullen Scales of Early Learning (MSEL), Edinburgh Postnatal Depression Scale, HOME Inventory and Family Care Indicators. We fitted linear mixed effects regression models with clinic random effects to compare intervention versus comparison arms, and generalised structural equation models to evaluate mediation, adjusting for confounders. Mother-infant pairs (n = 429) participated between January 2016 through May 2018. Socio-demographic characteristics were balanced between arms except for higher rates of peri-urban versus rural residence and single versus married mothers in the comparison group. The 18 month retention was 82% (180/220) intervention, 79% (166/209) comparison arm, with 25 infant deaths. Intervention MSEL scores were significantly, and modestly, higher in receptive language (55.7 [95% CI 54.6, 56.9] vs. 53.7 [95% CI 52.6, 54.8]), expressive language (42.5 [95% CI 41.6, 39.8] vs. 40.8 [95% CI 39.8, 41.7]) and composite MSEL (85.4 [95% CI 83.7, 84.5] vs. 82.7 [95% CI 81.0, 84.5]), with no difference in maternal depressive symptoms or in observations of mother-child interactions. Intervention book-sharing scores were higher (0.63 vs. 0.41) and mediated the effect on MSEL scores (indirect effect, p-values ≤ 0.024). The direct effects on visual reception and expressive language scores were significantly higher in the intervention compared to the comparison arm (coefficients 1.93 [95% CI 0.26, 3.60] and 1.66 [95% CI 0.51, 2.79, respectively]). Nurturing care interventions can be integrated into ANC/PVT clinic-home-community programmes. The intervention, mediated through interactive caregiving activities, increased language development scores among CHEU. Partnering with a local team, m2m, to design and implement a culturally relevant intervention illustrates the ability to impact parent-child play and learning activities that are associated with children's neurodevelopment.