Developmental trends in early childhood and their predictors from an Indian birth cohort
Abstract Background: Early childhood developmental pattern analyses not only project future cognition potential, but also identify potential risks for possible intervention. There is a paucity of literature evaluating developmental trends in the low and middle income country settings. Methods: Trends of early childhood development at 6, 15, 24 and 36 months of age and their predictors were explored in a longitudinal community-based birth cohort study in an urban slum in Vellore, South India. Development was assessed using the Bayley Scales of Infant and Toddler Development-III (BSID-III). Results: The birth cohort enrolled 251 children with 94%, 91% and 87% follow-up at 6, 24 and 36 months respectively. Child development domains of cognition, language, motor and social skills showed a significant decline in scores between 6 and 36 months of age. Cognition change was maximum augmented by higher socio-economic position (SEP) and nurturing home environment while stunting had the maximum negative impact. Higher maternal cognition, higher SEP, and caregiver responsivity positively contributed to language change over time, while higher maternal depression contributed negatively. An enriching home environment, growth parameters and blood iron status had high association with change in motor skills. Conclusions: A triple intervention plan to enhance home environment and nurturance, early childhood nutrient supplementation, and maternal education and well-being might prevent child developmental decline in high risk settings.