Total Environment Assessment Model for Early Child Development

Spheres of
Influence:
The Family
of attachment to a primary caregiver, prior
research has shown that there are differences
in the physiological and functional developmental
outcomes of children reared longer
in orphanages, versus those who are adopted
early. These studies suggest that children who
are adopted early show much lower cortisol
levels and much fewer behavioral difficulties
than those children who remain in orphanages
for longer [3 4].
Beyond observational data, there has been
a randomized control trial study that demonstrated
an independent effect (over and above
nutritional supplementation) of stimulation
(as operationalized by mothers and children
playing with homemade toys) on perceptual
motor development outcomes among stunted
children [3]. Attachment is associated with
quality internal fantasy lives, flexibility and
complexity of play, and greater emotional
range [35]
Findings regarding the importance
of primary caregivers (and by extension,
families) for children, has led to the exploration
of the factors that facilitate healthy social
bonds and caregiving practices. All families
need some support to learn how to develop
and apply sensitivity and responsiveness in
their childcare practices. There are, however,
both biological and environmental factors
that can negatively impact on attachment.
These include low birth weight, malnutrition
and infections, poverty and its associations,
conflict and domestic violence, and mental
health problems such as maternal depression.
In these instances, external support for
families is particularly important.
family socioeconomic status
Family socioeconomic circumstances have
been a major area of study in this regard. What
is noteworthy here is that, though ‘poverty’
(as generally measured by some monetary
threshold) poses a significant barrier, healthy
bonding, caregiving, and ultimately ecd
outcomes, are not solely limited to those
falling below the threshold. Rather, degrees
of change in resources throughout the
socioeconomic spectrum results in degrees of
change in ecd.
This pattern of an incremental, linear
relationship between socioeconomic status
and human development in a population
is referred to as a socioeconomic gradient
(further explanation of socioeconomic status
(ses) gradients is provided later in this
chapter). Socioeconomic gradients suggest
strongly that, in contrast to strategies which
attend only to those below the poverty
threshold, a society-wide approach much be
applied in order to truly address the association
between socioeconomic conditions and
ecd, a point to which we return later.
Ample evidence suggests that family (ses)
is associated with a myriad of development
outcomes for children all across the world
[36-38]. In particular, there is a rich literature
on the tremendous influence of maternal
education on providing children with
stimulating and supportive, and nurturant
environments for children [39-42]. Further,
the literature suggests strongly that socioeconomic
gradients in early childhood replicate
themselves as socioeconomic gradients
throughout the human lifecourse [11].
A review of the outcomes associated with
family ses are extremely diverse, ranging
from increased probability of having low
birth-weight (itself associated with a host
of developmental difficulties later in life),
to risk of dental carries, to poorer cognitive
test scores, to difficulties with behavior
and socialization, and to increased odds of
disengagement from school [36, 43].
Social and economic resources are
significant for ecd and related outcomes for
several reasons. For instance, low levels of
education and literacy affect the knowledge
and skill-base of children’s caregivers; feeding
and breastfeeding practices (which in turn
affect childhood stunting and wasting or
obesity) vary by ses. From an environmental
perspective, there are two major reasons
that socioeconomic conditions matter. First,
children born poorer are more likely to be
exposed to conditions that are adverse for
development (e.g. crowded or slum living
conditions, unsafe neighborhoods, etc).
Second, studies have shown that poorer
children are also more likely to be affected
by adverse conditions, resulting in a ‘double
jeopardy’ of sorts [17].
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