Objective. Daily methadone maintenance is the standard of care for opiate dependency during pregnancy. Previous research has indicated that single-dose maternal methadone administration significantly ...suppresses fetal neurobehaviours. The purpose of this study was to determine if split-dosing would have less impact on fetal neurobehaviour than single-dose administration.
Methods. Forty methadone-maintained women were evaluated at peak and trough maternal methadone levels on single- and split-dosing schedules. Monitoring sessions occurred at 36- and 37-weeks gestation in a counterbalanced study design. Fetal measures included heart rate, variability, accelerations, motor activity and fetal movement-heart rate coupling (FM-FHR). Maternal measures included heart period, variability, skin conductance, respiration and vagal tone. Repeated measure analysis of variance was used to evaluate within-subject changes between split- and single-dosing regimens.
Results. All fetal neurobehavioural parameters were suppressed by maternal methadone administration, regardless of dosing regimen. Fetal parameters at peak were significantly lower during single versus split methadone administration. FM-FHR coupling was less suppressed from trough to peak during split-dosing versus single-dosing. Maternal physiologic parameters were generally unaffected by dosing condition.
Conclusion. Split-dosed fetuses displayed less neurobehavioural suppression from trough to peak maternal methadone levels as compared with single-dosed fetuses. Split-dosing may be beneficial for methadone-maintained pregnant women.
Parental warmth, responsiveness, and stimulation are associated with positive child development, but it is unclear how parenting quality in early versus later developmental periods contributes to ...disparities in child cognitive and socioemotional development in low- and middle-income countries (LMIC). This longitudinal study examines the association between early childhood development and parenting quality (low, moderate, high) during infancy and prekindergarten developmental periods.. Parenting quality was defined using scales for “warmth and responsivity”, quantity of “stimulating parenting practices”, and “variety of learning materials” in the home environment, measured using the HOME Inventory in infancy and the Family Care Indicators (FCI) in the prekindergarten period. Child development was assessed in infancy using the Extended Ages and Stages Questionnaire (EASQ) and ASQ Socioemotional scale, and during prekindergarten with the McCarthy Scales of Children’s Abilities. The study sample included 603 children from poor, rural communities in Mexico who were assessed at 4 to 18 months of age and again at 3 to 5 years of age. The association between parenting quality and child development was examined for differences between indigenous and non-indigenous communities and controlled for child and family demographic characteristics (child age and sex, parent’s educational attainment, and household wealth and crowding). Parenting quality during infancy and prekindergarten were both independently and significantly associated with later child development. However, parenting quality in infancy was no longer significantly associated with later child development after controlling for the effects of child development in infancy. Parental warmth and responsiveness and the availability of learning materials in the home in infancy were significant predictors of child development at 3 to 5 years of age, but parental stimulating practices were not. Conversely, during the prekindergarten period, parental stimulating practices were significant predictors of child development, while the variety of learning materials in the home was not. There were no differences in the association between parenting and child development between indigenous and non-indigenous communities. This study advances the understanding of parenting quality in the early childhood period in LMIC, and among indigenous populations in Mexico.
Big Sisters Jakiela, Pamela; Ozier, Owen; Fernald, Lia C ...
IDEAS Working Paper Series from RePEc,
01/2020
Paper
Open access
This paper models household investments in young children when parents and older siblings share caregiving responsibilities and when investments by older siblings contribute to young children's human ...capital accumulation. To test the predictions of the model, the paper estimates the impact of having one older sister (as opposed to one older brother) on early childhood development in a sample of rural Kenyan households with otherwise similar family structures. Older sibling gender is not related to household structure, subsequent birth spacing, or other observable characteristics, so the presence of an older girl (as opposed to an older boy) is treated as plausibly exogenous. Having an older sister rather than an older brother improves younger siblings' vocabulary and fine motor skills by more than 0.1 standard deviations. Viewed through the lens of the model, the empirical pattern shown here suggests that: (i) older siblings' investments in young children contribute to their human capital accumulation, and (ii) households perceive lower returns to investing in older girls than in older boys.
Worldwide, 250 million children under five (43 percent) are not meeting their developmental potential because they lack adequate nutrition and cognitive stimulation in early childhood. Several parent ...support programs have shown significant benefits for children's development, but the programs are often expensive and resource intensive. The objective of this study was to test several variants of a potentially scalable, cost-effective intervention to increase cognitive stimulation by parents and improve emergent literacy skills in children. The intervention was a modified dialogic reading training program that used culturally and linguistically appropriate books adapted for a low-literacy population. The study used a cluster randomized controlled trial with four intervention arms and one control arm in a sample of caregivers (n = 357) and their 24- to 83- month-old children ages 24 to 83 months (n = 510) in rural Kenya. The first treatment group received storybooks, while the other treatment arms received storybooks paired with varying quantities of modified dialogic reading training for parents. The main effects of each arm of the trial were examined, and tests of heterogeneity were conducted to examine differential effects among children of illiterate versus literate caregivers. Parent training paired with the provision of culturally appropriate children?s books increased reading frequency and improved the quality of caregiver-child reading interactions among preschool-age children. Treatments involving training improved storybook-specific expressive vocabulary. The children of illiterate caregivers benefited at least as much as the children of literate caregivers. For some outcomes, the effects were comparable; for other outcomes, there were differentially larger effects for children of illiterate caregivers.
In many low- and middle-income countries, young children learn a mother tongue or indigenous language at home before entering the formal education system where they will need to understand and speaka ...country's official language(s). Thus, assessments of children before school age, conducted in a nation's official language, may not fully reflect a child's development, underscoring the importance of test translation and adaptation. To examine differences in vocabulary development by language of assessment, this study adapted and validated instruments to measure developmental outcomes, including expressive and receptive vocabulary. This study assessed 505 children ages 2 to 6 in rural communities in Western Kenya with comparable vocabulary tests in three languages: Luo (the local language or mother tongue), Swahili, and English (official languages) at two time points, five to six weeks apart, between September 2015 and October 2016. Younger children responded to the expressive vocabulary measure exclusively in Luo much more frequently than did older children: 44?59 percent of those ages 2 to 4, compared to 20?21 percent of those ages 5 to 6. Baseline receptive vocabulary scores in Luo and Swahili were strongly associated with receptive vocabulary in English at follow-up, even after controlling for English vocabulary at baseline: a multivariate regression of follow-up English vocabulary on standardized measures of receptive vocabulary in all three languages yields an estimate, for Luo, of ? = 0.26, SE = 0.05, p
PDF
