Parental developmental screening with CARE: A pilot hybrid assessment and intervention with vulnerable families in Colombia.

Poverty and scarcity of resources make children in low-and-middle-income countries at risk of not reaching their developmental potential. Despite a near-universal interest in risk reduction, effective interventions like enhancing reading skills in parents to diminish developmental delay remain elusive for the great majority of vulnerable families. We undertook a efficacy study for parental use of a booklet called CARE for developmental screening of children between 36 to 60 months old (M = 44.0, SD = 7.5). All participants (N = 50), lived in vulnerable, low-income neighborhoods in Colombia. The study followed a pilot Quasi-Randomised Control Trial design (i.e., control group participants assigned based on non-random criteria) of parent training with a CARE intervention group compared to a control group. Data was analyzed using two-way ANCOVA for sociodemographic variables' interaction with follow-up results and one-way ANCOVA to evaluate the relations between the intervention and post-measurement of developmental delays and cautions and other language related-skills outcomes, while controlling for pre-measurements. These analyses indicated that the CARE booklet intervention enhanced children's developmental status and narrative skills (developmental screening delay items, F(1, 47) = 10.45, p = .002, partial η2 = .182; narrative devices scores, F(1, 17) = 4.87, p = .041, partial η2 = .223). Several limitations (e.g., sample size) and possible implications for the analysis of children's developmental potential are discussed and considered for future research, along with the effects of the COVID-19 pandemic on the closure of preschools and community care centers.

Agreement and Reliability of Parental Reports and Direct Screening of Developmental Outcomes in Toddlers at Risk.

Developmental screening is a practice that directly benefits vulnerable and low-income families and children when it is regular and frequently applied. A developmental screening tool administered by parents called CARE is tested. CARE contains a compilation of activities to report and enhance development at home. Hundred and fifty-seven families in Bogotá (Colombia) initially responded to a call to participate in developmental screening tools' validation and reliability study. All children (Average: 42.7 months old; SD: 9.4; Min: 24, Max: 58) were screened directly by trained applicants using a Spanish version of the Denver Developmental Screening test [i.e., the Haizea-Llevant (HLL) screening table]. After a first screening, 61 dyads were positive for follow-up and received a second HLL screening. Fifty-two out of 61 dyads use and returned CARE booklet after 1-month screening at home. The comparative analysis for parent reports using CARE and direct screening observation included (a) the effects of demographic variables on overall and agreement, (b) agreement and congruence between the CARE report classification and direct screening classification ("At risk" or "Not at risk"), (c) receiver operating characteristic analysis, (d) item-Level agreement for specific developmental domains, and (e) acceptability and feasibility analysis. Results and conclusions show the parental report using the CARE booklet as a reliable screening tool that has the potential to activate alerts for an early cognitive delay that reassure clinicians and families to further specialized and controlled developmental evaluations and act as a screen for the presence of such delay in four developmental dimensions.

Estructura evolutiva del cuidado, desarrollo socio-cognitivo y prácticas cotidianas / Evolutionary structure of care, socio-cognitive development and daily practices

El desarrollo infantil en el marco del ciclo vital puede resultar limitado si se eligen variables, además de la edad, que sólo se circunscriben a condiciones inevitables para la supervivencia. Este artículo presenta una definición amplia de desarrollo, va más allá del ciclo vital bajo el marco de una estructura evolutiva del cuidado y aporta evidencia de la importancia de considerar actividades cotidianas y contingentes. Para tal objetivo, además de una discusión conceptual previa sobre una estructura evolutiva del cuidado y desarrollo socio-cognitivo, se presentan algunos resultados del Programa Inicio Parejo de la Vida, realizado con un diseño de corte transversal y una muestra representativa poblacional de dos regiones de Colombia: 15 municipios de la zona Sabana Centro de Cundinamarca y cinco municipios de Boyacá. Se analizan los datos de 1177 duplas cuidadores principales-niños al responder encuestas sobre actividades de lectura, juego y otras más consideradas constitutivas e indispensables en la definición adoptada de desarrollo infantil y cuidado. Los resultados indican una relación significativa entre variables del cuidado y una observación del desarrollo de los niños y niñas entre 0 y 6 años (F(37, 229) = 26.27, p < .0001, R2 = .15). Se encuentra una situación adversa para el potencial del desarrollo individual para más del 80% de los participantes y se generan dos hipótesis a discutir y continuar en futuros estudios controlados: la desatención de la lectura diaria, el juego, la pintura y actividades deportivas entre otras, cómo interacciones entre cuidadores y niños, más otra como alternativa y dentro de los estudios de escases cognitiva (Scarcity) reportados en otros tópicos relacionados con la pobreza y sus efectos en el desarrollo.

Child development in the framework of the life-cycle may be limited if variables are chosen, in addition to age, and limited to inevitable conditions for survival. This article presents a broad definition of development, goes beyond the life-cycle framework and presents an evolutionary structure of care, providing evidence of the importance of considering daily and contingent activities. For this purpose, in addition to a previous conceptual discussion on an evolutionary structure of socio-cognitive care and development, some results of the Equal Start of Life Program (Inicio Parejo de la Vida in Spanish) was analyzed and carried out with a cross-sectional design and a representative population sample of two regions of Colombia: 15 municipalities in the Sabana Centro de Cundinamarca area and five municipalities in Boyacá. The data of 1177 primary caregiver-child pairs is analyzed when responding to surveys on reading, playing and other activities considered to be constitutive and indispensable in the adopted definition of child development and care. The results indicate a significant relationship between care variables and observation of the development of boys and girls between 0 and 6 years old (F(37, 229) = 26.27, p <.0001, R2 = .15). An adverse situation is found for the potential of individual development for more than 80% of the participants, and two hypotheses are generated to discuss and continue in future controlled studies: neglect of daily reading, play, painting and sports activities, among others. , how interactions between caregivers and children, plus another as an alternative and within the studies of cognitive scarcity (Scarcity) reported in other topics related to poverty and its effects on development.

Desarrollo socio-cognitivo en la primera infancia: los retos por cumplir en salud pública en la zona Sabana Centro y Boyacá / Socio-cognitive development in early childhood: the challenges to reach in public health at the area of Sabana Centro and Boyacá

RESUMEN Objetivo La necesidad de construir sistemas de salud pública que garanticen el desarrollo infantil integral, permite realizar una caracterización de los factores que favorecen o limitan el desarrollo integral de niñas y niños menores de seis años, para identificarlos como componentes necesarios a ser tenidos en cuenta en políticas públicas. Método Se realizó una encuesta a 1 177 madres o cuidadores de niños menores de seis años en 16 municipios de Cundinamarca y Boyacá, y se midió el respectivo desarrollo socio-cognitivo de los menores participantes con la tabla Haizea-Llevant y tareas relacionadas con el uso de sistemas de conocimiento intra-específicos. Resultados Mediante análisis estadísticos bivariados y multivariados se encontró que los factores que resultan significativos para atender a una propuesta de salud pública que busque el desarrollo integral de los niños menores de seis años son: las condiciones socio-económicas de los hogares, las complicaciones en el parto, la edad de inicio de alimentos sólidos, los tiempos de trabajo de las madres, la reglas sobre rutinas diarias y las prácticas de juego: lectura, pintura y actividades deportivas. Conclusiones Un sistema de salud que reconozca los resultados presentados, debería ofrecer atención especializada que procure el bienestar en la infancia y la niñez temprana, lo cual solo puede lograrse si las políticas de salud comienzan a considerar factores de orden doméstico y cotidiano que no pueden estar por fuera de políticas públicas, asegurando diversos niveles de intervención, impacto social y particular.(AU)

ABSTRACT Objective The need to build public health systems that ensure comprehensive child development enables a characterization of the factors that favor or restrict the integral development of children under the age of six. That is in order to identify them as necessary components to be taken into account in public policies. Method A survey was carried out with 1 177 mothers or family caregivers of children under six years old in 16 municipalities of Cundinamarca and Boyacá, and the respective socio-cognitive development of their own sons and daughters was measured with the Haizea-Llevant table and also tasks related to the use of core knowledge systems. Results Through bivariate and multivariate statistical analyzes, it was found that the factors that are significant to address a public health proposal that seeks the integral development of children under six years of age are: socio-economic conditions of households, complications in childbirth, the starting age of solid foods, mothers' working shifts, rules on daily routines and play practices such as reading, painting and sport activities. Conclusions A health system that acknowledges the results presented should offer specialized care that seeks welfare in childhood and early childhood, which can only be achieved if health policies begin to consider domestic and daily factors that cannot be excluded from public policies and it should guarantee different levels of intervention of social and particular impact.(AU)

[Socio-cognitive development in early childhood: the challenges to reach in public health at the area of Sabana Centro and Boyacá]. / Desarrollo socio-cognitivo en la primera infancia: los retos por cumplir en salud pública en la zona Sabana Centro y Boyacá.

OBJECTIVE: The need to build public health systems that ensure comprehensive child development enables a characterization of the factors that favor or restrict the integral development of children under the age of six. That is in order to identify them as necessary components to be taken into account in public policies. METHOD: A survey was carried out with 1 177 mothers or family caregivers of children under six years old in 16 municipalities of Cundinamarca and Boyacá, and the respective socio-cognitive development of their own sons and daughters was measured with the Haizea-Llevant table and also tasks related to the use of core knowledge systems. RESULTS: Through bivariate and multivariate statistical analyzes, it was found that the factors that are significant to address a public health proposal that seeks the integral development of children under six years of age are: socio-economic conditions of households, complications in childbirth, the starting age of solid foods, mothers' working shifts, rules on daily routines and play practices such as reading, painting and sport activities. CONCLUSIONS: A health system that acknowledges the results presented should offer specialized care that seeks welfare in childhood and early childhood, which can only be achieved if health policies begin to consider domestic and daily factors that cannot be excluded from public policies and it should guarantee different levels of intervention of social and particular impact.

OBJETIVO: La necesidad de construir sistemas de salud pública que garanticen el desarrollo infantil integral, permite realizar una caracterización de los factores que favorecen o limitan el desarrollo integral de niñas y niños menores de seis años, para identificarlos como componentes necesarios a ser tenidos en cuenta en políticas públicas. MÉTODO: Se realizó una encuesta a 1 177 madres o cuidadores de niños menores de seis años en 16 municipios de Cundinamarca y Boyacá, y se midió el respectivo desarrollo socio-cognitivo de los menores participantes con la tabla Haizea-Llevant y tareas relacionadas con el uso de sistemas de conocimiento intra-específicos. RESULTADOS: Mediante análisis estadísticos bivariados y multivariados se encontró que los factores que resultan significativos para atender a una propuesta de salud pública que busque el desarrollo integral de los niños menores de seis años son: las condiciones socio-económicas de los hogares, las complicaciones en el parto, la edad de inicio de alimentos sólidos, los tiempos de trabajo de las madres, la reglas sobre rutinas diarias y las prácticas de juego: lectura, pintura y actividades deportivas. CONCLUSIONES: Un sistema de salud que reconozca los resultados presentados, debería ofrecer atención especializada que procure el bienestar en la infancia y la niñez temprana, lo cual solo puede lograrse si las políticas de salud comienzan a considerar factores de orden doméstico y cotidiano que no pueden estar por fuera de políticas públicas, asegurando diversos niveles de intervención, impacto social y particular.

Una mirada a la caracterización de la primera infancia: contextos y métodos / An analysis of the characterization of early childhood: contexts and methods / Um olhar sobre a caracterização da primeira infância: contextos e métodos

Responde a una revisión de la literatura sobre experiencias de caracterización en la primera infancia. Tuvimos como objetivo identificar y describir metodologías para el diagnóstico situacional de la niñez temprana. Para esto consultamos bases de datos científicas, Google académico y páginas oficiales de las experiencias identificadas. Caracterización no lo encontramos como descriptor de búsqueda, por lo que se utilizaron términos equivalentes. Se hallaron trabajos que reportan la relación entre características socio-demográficas y los resultados de encuestas transversales, estudios epidemiológicos y evaluaciones del desarrollo infantil. Se resumen los contextos y métodos de cuatro experiencias de caracterización de la niñez y la adolescencia, donde se evidencia el uso complementario de técnicas de recolección de datos con el deseo de responder a una visión multidimensional del desarrollo.

A literature review on the characterization of early childhood was carried out to identify methods used to conduct a situational analysis of children under 6 years of age. Scientific databases, Google Scholar and research websites were searched. No term or scientific significance was found for ‘characterization’, so equivalent terms were used. National health and child welfare surveys, epidemiological studies of specific diseases and studies of child development assessment with neuro-psychological testing and its relationship with socio-demographic characteristics were identified. Four international situational analysis experiences of childhood and adolescence were found. Their contexts and methodologies are described.

Este trabalho corresponde a uma revisão da literatura sobre experiências de caracterização na primeira infância. Teve como objetivo identificar e descrever metodologias para o diagnóstico situacional da primeira infância. Para isto, foram consultadas bases de dados científicas, Google acadêmico e sites oficiais das experiências identificadas. A Caracterização não foi encontrada como descritor de enquetes transversais, estudos epidemiológicos e avaliações do desenvolvimento infantil. São resumidos em contextos e metodologias de quatro experiências de caracterização da infância e da adolescência, donde é evidenciado o uso complementário de técnicas de coleta de dados com a finalidade de responder a uma visão multidimensional do desenvolvimento.