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Early Childhood Development: A Paradigm Shift From Developmental Screening and Surveillance to Parent Intervention
Sharmila Banerjee Mukherjee1, Satinder Aneja2, Suvasini Sharma2
1Department of Pediatrics, Lady Hardinge Medical College, New Delhi Correspondence to: Dr Sharmila B Mukherjee, Department of Pediatrics, Lady Hardinge Medical College, New Delhi. theshormi@gmail.com.
Insights
Many children in low- and middle-income countries face developmental delays. Nurturing care interventions involving parents show promise for improving early childhood development (ECD) outcomes more effectively than traditional screening methods.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- A significant number of children under five in low- and middle-income countries (LMICs) do not reach their developmental potential.
- Current methods for identifying developmental delay, such as screening and surveillance, have limitations in LMICs, with few tools meeting established suitability criteria.
Purpose of the Study:
- To evaluate the feasibility of existing developmental screening tools in the Indian context.
- To explore alternative, more effective strategies for enhancing early childhood development (ECD) in LMICs, focusing on parental involvement and the nurturing care framework.
Main Methods:
- Reviewed suitability criteria for developmental screening tools in LMICs.
- Identified two potentially suitable tools for the Indian context: the International guide for monitoring child development and the Monitoring child development in the integrated management of childhood illnesses context.
- Discussed the evidence supporting parent intervention programs and the nurturing care framework.
Main Results:
- Existing universal developmental screening programs are not currently feasible in LMICs.
- Parent intervention programs demonstrate a significant positive impact on early childhood development (ECD) outcomes.
- The nurturing care framework, comprising health, nutrition, responsive caregiving, early learning, and safety, offers a comprehensive approach to enhancing ECD.
Conclusions:
- A paradigm shift towards incorporating nurturing care-based preventive, supportive, and promotive healthcare services with active parental involvement is recommended.
- This approach may offer a more effective, sustainable, and impactful strategy for improving early childhood development (ECD) in resource-limited settings.
- Focusing on nurturing care and parental engagement presents a promising avenue for addressing developmental challenges in young children in LMICs.
Abstract:
A large proportion of children under the age of five years who do not attain their expected developmental potential belong to low- and middle-income countries (LMICs). The strategies used for identifying children with high risk for developmental delay/disorders include developmental screening, surveillance, and monitoring. Suitability criteria for developmental screening tools in LMICs have been established, but few tools meet all the benchmarks. Based on these, the authors identified two tools that may be considered suitable in the Indian context; the International guide for monitoring child development and the Monitoring child development in the integrated management of childhood illnesses context. However, implementing and sustaining a universal developmental screening program using these is not feasible in the present circumstances. There is emerging evidence that parent intervention programs have significant impact on outcomes related to early childhood development (ECD). The nurturing care framework encompasses five strategies known to enhance ECD in young children even in the presence of adversities; good health, adequate nutrition, responsive caregiving, opportunities for early learning and safety and security. This article discusses the paradigm shift to incorporation of nurturing care-based preventive, supportive and promotive health care services in office practice with active parental involvement. This may prove to be a better option with a more positive, long lasting and quicker impact on ECD.
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