research study about child development

InBrief: The Science of Early Childhood Development

This brief is part of a series that summarizes essential scientific findings from Center publications.

Content in This Guide

Step 1: why is early childhood important.

: Brain Hero
: The Science of ECD (Video)
You Are Here: The Science of ECD (Text)

Step 2: How Does Early Child Development Happen?

: 3 Core Concepts in Early Development
: 8 Things to Remember about Child Development
: InBrief: The Science of Resilience

Step 3: What Can We Do to Support Child Development?

: From Best Practices to Breakthrough Impacts
: 3 Principles to Improve Outcomes

The science of early brain development can inform investments in early childhood. These basic concepts, established over decades of neuroscience and behavioral research, help illustrate why child development—particularly from birth to five years—is a foundation for a prosperous and sustainable society.

Brains are built over time, from the bottom up.

The basic architecture of the brain is constructed through an ongoing process that begins before birth and continues into adulthood. Early experiences affect the quality of that architecture by establishing either a sturdy or a fragile foundation for all of the learning, health and behavior that follow. In the first few years of life, more than 1 million new neural connections are formed every second . After this period of rapid proliferation, connections are reduced through a process called pruning, so that brain circuits become more efficient. Sensory pathways like those for basic vision and hearing are the first to develop, followed by early language skills and higher cognitive functions. Connections proliferate and prune in a prescribed order, with later, more complex brain circuits built upon earlier, simpler circuits.

In the proliferation and pruning process, simpler neural connections form first, followed by more complex circuits. The timing is genetic, but early experiences determine whether the circuits are strong or weak. Source: C.A. Nelson (2000). Credit: Center on the Developing Child

The interactive influences of genes and experience shape the developing brain.

Scientists now know a major ingredient in this developmental process is the “ serve and return ” relationship between children and their parents and other caregivers in the family or community. Young children naturally reach out for interaction through babbling, facial expressions, and gestures, and adults respond with the same kind of vocalizing and gesturing back at them. In the absence of such responses—or if the responses are unreliable or inappropriate—the brain’s architecture does not form as expected, which can lead to disparities in learning and behavior.

The brain’s capacity for change decreases with age.

The brain is most flexible, or “plastic,” early in life to accommodate a wide range of environments and interactions, but as the maturing brain becomes more specialized to assume more complex functions, it is less capable of reorganizing and adapting to new or unexpected challenges. For example, by the first year, the parts of the brain that differentiate sound are becoming specialized to the language the baby has been exposed to; at the same time, the brain is already starting to lose the ability to recognize different sounds found in other languages. Although the “windows” for language learning and other skills remain open, these brain circuits become increasingly difficult to alter over time. Early plasticity means it’s easier and more effective to influence a baby’s developing brain architecture than to rewire parts of its circuitry in the adult years.

Cognitive, emotional, and social capacities are inextricably intertwined throughout the life course.

The brain is a highly interrelated organ, and its multiple functions operate in a richly coordinated fashion. Emotional well-being and social competence provide a strong foundation for emerging cognitive abilities, and together they are the bricks and mortar that comprise the foundation of human development. The emotional and physical health, social skills, and cognitive-linguistic capacities that emerge in the early years are all important prerequisites for success in school and later in the workplace and community.

Toxic stress damages developing brain architecture, which can lead to lifelong problems in learning, behavior, and physical and mental health.

Scientists now know that chronic, unrelenting stress in early childhood, caused by extreme poverty, repeated abuse, or severe maternal depression, for example, can be toxic to the developing brain. While positive stress (moderate, short-lived physiological responses to uncomfortable experiences) is an important and necessary aspect of healthy development, toxic stress is the strong, unrelieved activation of the body’s stress management system. In the absence of the buffering protection of adult support, toxic stress becomes built into the body by processes that shape the architecture of the developing brain.

Brains subjected to toxic stress have underdeveloped neural connections in areas of the brain most important for successful learning and behavior in school and the workplace. Source: Radley et al (2004); Bock et al (2005). Credit: Center on the Developing Child.

Policy Implications

The basic principles of neuroscience indicate that early preventive intervention will be more efficient and produce more favorable outcomes than remediation later in life.
A balanced approach to emotional, social, cognitive, and language development will best prepare all children for success in school and later in the workplace and community.
Supportive relationships and positive learning experiences begin at home but can also be provided through a range of services with proven effectiveness factors. Babies’ brains require stable, caring, interactive relationships with adults — any way or any place they can be provided will benefit healthy brain development.
Science clearly demonstrates that, in situations where toxic stress is likely, intervening as early as possible is critical to achieving the best outcomes. For children experiencing toxic stress, specialized early interventions are needed to target the cause of the stress and protect the child from its consequences.

Suggested citation: Center on the Developing Child (2007). The Science of Early Childhood Development (InBrief). Retrieved from www.developingchild.harvard.edu .

Introduction

Nature of learning and play, categories of play, object play, physical, locomotor, or rough-and-tumble play, outdoor play, social or pretend play alone or with others, development of play, effects on brain structure and functioning, benefits of play, benefits to adults of playing with children, implications for preschool education, modern challenges, role of media in children’s play, barriers to play, role of pediatricians, conclusions, lead authors, contributor, committee on psychosocial aspects of child and family health, 2017–2018, council on communications and media, 2017–2018, the power of play: a pediatric role in enhancing development in young children.

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

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Michael Yogman , Andrew Garner , Jeffrey Hutchinson , Kathy Hirsh-Pasek , Roberta Michnick Golinkoff , COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH , COUNCIL ON COMMUNICATIONS AND MEDIA , Rebecca Baum , Thresia Gambon , Arthur Lavin , Gerri Mattson , Lawrence Wissow , David L. Hill , Nusheen Ameenuddin , Yolanda (Linda) Reid Chassiakos , Corinn Cross , Rhea Boyd , Robert Mendelson , Megan A. Moreno , MSEd , Jenny Radesky , Wendy Sue Swanson , MBE , Jeffrey Hutchinson , Justin Smith; The Power of Play: A Pediatric Role in Enhancing Development in Young Children. Pediatrics September 2018; 142 (3): e20182058. 10.1542/peds.2018-2058

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Children need to develop a variety of skill sets to optimize their development and manage toxic stress. Research demonstrates that developmentally appropriate play with parents and peers is a singular opportunity to promote the social-emotional, cognitive, language, and self-regulation skills that build executive function and a prosocial brain. Furthermore, play supports the formation of the safe, stable, and nurturing relationships with all caregivers that children need to thrive.

Play is not frivolous: it enhances brain structure and function and promotes executive function (ie, the process of learning, rather than the content), which allow us to pursue goals and ignore distractions.

When play and safe, stable, nurturing relationships are missing in a child’s life, toxic stress can disrupt the development of executive function and the learning of prosocial behavior; in the presence of childhood adversity, play becomes even more important. The mutual joy and shared communication and attunement (harmonious serve and return interactions) that parents and children can experience during play regulate the body’s stress response. This clinical report provides pediatric providers with the information they need to promote the benefits of play and and to write a prescription for play at well visits to complement reach out and read. At a time when early childhood programs are pressured to add more didactic components and less playful learning, pediatricians can play an important role in emphasizing the role of a balanced curriculum that includes the importance of playful learning for the promotion of healthy child development.

Since the publication of the American Academy of Pediatrics (AAP) Clinical Reports on the importance of play in 2007, 1 , 2 newer research has provided additional evidence of the critical importance of play in facilitating parent engagement; promoting safe, stable, and nurturing relationships; encouraging the development of numerous competencies, including executive functioning skills; and improving life course trajectories. 3 , – 5 An increasing societal focus on academic readiness (promulgated by the No Child Left Behind Act of 2001) has led to a focus on structured activities that are designed to promote academic results as early as preschool, with a corresponding decrease in playful learning. Social skills, which are part of playful learning, enable children to listen to directions, pay attention, solve disputes with words, and focus on tasks without constant supervision. 6 By contrast, a recent trial of an early mathematics intervention in preschool showed almost no gains in math achievement in later elementary school. 7 Despite criticism from early childhood experts, the 2003 Head Start Act reauthorization ended the program evaluation of social emotional skills and was focused almost exclusively on preliteracy and premath skills. 8 The AAP report on school readiness includes an emphasis on the importance of whole child readiness (including social–emotional, attentional, and cognitive skills). 9 Without that emphasis, children’s ability to pay attention and behave appropriately in the classroom is disadvantaged.

The definition of play is elusive. However, there is a growing consensus that it is an activity that is intrinsically motivated, entails active engagement, and results in joyful discovery. Play is voluntary and often has no extrinsic goals; it is fun and often spontaneous. Children are often seen actively engaged in and passionately engrossed in play; this builds executive functioning skills and contributes to school readiness (bored children will not learn well). 10 Play often creates an imaginative private reality, contains elements of make believe, and is nonliteral.

Depending on the culture of the adults in their world, children learn different skills through play. Sociodramatic play is when children act out the roles of adulthood from having observed the activities of their elders. Extensive studies of animal play suggest that the function of play is to build a prosocial brain that can interact effectively with others. 11

Play is fundamentally important for learning 21st century skills, such as problem solving, collaboration, and creativity, which require the executive functioning skills that are critical for adult success. The United Nations Convention on the Rights of the Child has enshrined the right to engage in play that is appropriate to the age of the child in Article 21. 12 In its 2012 exhibit “The Century of the Child: 1900–2000,” the Museum of Modern Art noted, “Play is to the 21st century what work was to industrialization. It demonstrates a way of knowing, doing, and creating value.” 13 Resnick 14 has described 4 guiding principles to support creative learning in children: projects, passion, peers, and play. Play is not just about having fun but about taking risks, experimenting, and testing boundaries. Pediatricians can be influential advocates by encouraging parents and child care providers to play with children and to allow children to have unstructured time to play as well as by encouraging educators to recognize playful learning as an important complement to didactic learning. Some studies 15 , – 18 note that the new information economy, as opposed to the older industrial 1, demands more innovation and less imitation, more creativity and less conformity. Research on children’s learning indicates that learning thrives when children are given some agency (control of their own actions) to play a role in their own learning. 19 The demands of today’s world require that the teaching methods of the past 2 centuries, such as memorization, be replaced by innovation, application, and transfer. 18

Bruner et al 20 stressed the fact that play is typically buffered from real-life consequences. Play is part of our evolutionary heritage, occurs in a wide spectrum of species, is fundamental to health, and gives us opportunities to practice and hone the skills needed to live in a complex world. 21 Although play is present in a large swath of species within the animal kingdom, from invertebrates (such as the octopus, lizard, turtle, and honey bee) to mammals (such as rats, monkeys, and humans), 22 social play is more prominent in animals with a large neocortex. 23 Studies of animal behavior suggests that play provides animals and humans with skills that will help them with survival and reproduction. 24 Locomotor skills learned through rough-and-tumble play enables escape from predators. However, animals play even when it puts them at risk of predation. 25 It is also suggested that play teaches young animals what they can and cannot do at times when they are relatively free from the survival pressures of adult life. 26 Play and learning are inextricably linked. 27 A Russian psychologist recognized that learning occurs when children actively engage in practical activities within a supportive social context. The accumulation of new knowledge is built on previous learning, but the acquisition of new skills is facilitated by social and often playful interactions. He was interested in what he called the “zone of proximal development,” which consists of mastering skills that a child could not do alone but could be developed with minimal assistance. 28 Within the zone of proximal development, the “how” of learning occurs through a reiterative process called scaffolding, in which new skills are built on previous skills and are facilitated by a supportive social environment. The construct of scaffolding has been extrapolated to younger children. Consider how a social smile at 6 to 8 weeks of age invites cooing conversations, which leads to the reciprocal dance of social communication even before language emerges, followed by social referencing (the reading of a parent’s face for nonverbal emotional content). The balance between facilitating unstructured playtime for children and encouraging adult scaffolding of play will vary depending on the competing needs in individual families, but the “serve-and-return” aspect of play requires caregiver engagement. 29

Early learning and play are fundamentally social activities 30 and fuel the development of language and thought. Early learning also combines playful discovery with the development of social–emotional skills. It has been demonstrated that children playing with toys act like scientists and learn by looking and listening to those around them. 15 , – 17 However, explicit instructions limit a child’s creativity; it is argued that we should let children learn through observation and active engagement rather than passive memorization or direct instruction. Preschool children do benefit from learning content, but programs have many more didactic components than they did 20 years ago. 31 Successful programs are those that encourage playful learning in which children are actively engaged in meaningful discovery. 32 To encourage learning, we need to talk to children, let them play, and let them watch what we do as we go about our everyday lives. These opportunities foster the development of executive functioning skills that are critically important for the development of 21st century skills, such as collaboration, problem solving, and creativity, according to the 2010 IBM’s Global CEO Study. 33

Play has been categorized in a variety of ways, each with its own developmental sequence. 32 , 34

This type of play occurs when an infant or child explores an object and learns about its properties. Object play progresses from early sensorimotor explorations, including the use of the mouth, to the use of symbolic objects (eg, when a child uses a banana as a telephone) for communication, language, and abstract thought.

This type of play progresses from pat-a-cake games in infants to the acquisition of foundational motor skills in toddlers 35 and the free play seen at school recess. The development of foundational motor skills in childhood is essential to promoting an active lifestyle and the prevention of obesity. 36 , – 39 Learning to cooperate and negotiate promotes critical social skills. Extrapolation from animal data suggests that guided competition in the guise of rough-and-tumble play allows all participants to occasionally win and learn how to lose graciously. 40 Rough-and-tumble play, which is akin to the play seen in animals, enables children to take risks in a relatively safe environment, which fosters the acquisition of skills needed for communication, negotiation, and emotional balance and encourages the development of emotional intelligence. It enables risk taking and encourages the development of empathy because children are guided not to inflict harm on others. 25 , 30 , 40 The United Kingdom has modified its guidelines on play, arguing that the culture has gone too far by leaching healthy risks out of childhood: new guidelines on play by the national commission state, “The goal is not to eliminate risk.” 41

Outdoor play provides the opportunity to improve sensory integration skills. 36 , 37 , 39 These activities involve the child as an active participant and address motor, cognitive, social, and linguistic domains. Viewed in this light, school recess becomes an essential part of a child’s day. 42 It is not surprising that countries that offer more recess to young children see greater academic success among the children as they mature. 42 , 43 Supporting and implementing recess not only sends a message that exercise is fundamentally important for physical health but likely brings together children from diverse backgrounds to develop friendships as they learn and grow. 42

This type of play occurs when children experiment with different social roles in a nonliteral fashion. Play with other children enables them to negotiate “the rules” and learn to cooperate. Play with adults often involves scaffolding, as when an adult rotates a puzzle to help the child place a piece. Smiling and vocal attunement, in which infants learn turn taking, is the earliest example of social play. Older children can develop games and activities through which they negotiate relationships and guidelines with other players. Dress up, make believe, and imaginary play encourage the use of more sophisticated language to communicate with playmates and develop common rule-bound scenarios (eg, “You be the teacher, and I will be the student”).

Play has also been grouped as self-directed versus adult guided. Self-directed play, or free play, is crucial to children’s exploration of the world and understanding of their preferences and interests. 19 , 32 , 44 Guided play retains the child agency, such that the child initiates the play, but it occurs either in a setting that an adult carefully constructs with a learning goal in mind (eg, a children’s museum exhibit or a Montessori task) or in an environment where adults supplement the child-led exploration with questions or comments that subtly guide the child toward a goal. Board games that have well-defined goals also fit into this category. 45 For example, if teachers want children to improve executive functioning skills (see the “Tools of the Mind” curriculum), 46 they could create drum-circle games, in which children coregulate their behavior. Familiar games such as “Simon Says” or “Head, Shoulders, Knees, and Toes” ask children to control their individual actions or impulses and have been shown to improve executive functioning skills. 47 Guided play has been defined as a child-led, joyful activity in which adults craft the environment to optimize learning. 4 , 48 This approach harkens back to Vygotsky 28 and the zone of proximal development, which represents the skills that children are unable to master on their own but are able to master in the context of a safe, stable, and nurturing relationship with an adult. The guidance and dialogue provided by the adult allow the child to master skills that would take longer to master alone and help children focus on the elements of the activity to guide learning. One way to think about guided play is as “constrained tinkering.” 14 , 48 This logic also characterizes Italy’s Emilio Reggio approach, which emphasizes the importance of teaching children to listen and look.

According to Vygotsky, 28 the most efficient learning occurs in a social context, where learning is scaffolded by the teacher into meaningful contexts that resonate with children’s active engagement and previous experiences. Scaffolding is a part of guided play; caregivers are needed to provide the appropriate amount of input and guidance for children to develop optimal skills.

How does play develop? Play progresses from social smiling to reciprocal serve-and-return interactions; the development of babbling; games, such as “peek-a-boo”; hopping, jumping, skipping, and running; and fantasy or rough-and-tumble play. The human infant is born immature compared with infants of other species, with substantial brain development occurring after birth. Infants are entirely dependent on parents to regulate sleep–wake rhythms, feeding cycles, and many social interactions. Play facilitates the progression from dependence to independence and from parental regulation to self-regulation. It promotes a sense of agency in the child. This evolution begins in the first 3 months of life, when parents (both mothers and fathers) interact reciprocally with their infants by reading their nonverbal cues in a responsive, contingent manner. 49 Caregiver–infant interaction is the earliest form of play, known as attunement, 50 but it is quickly followed by other activities that also involve the taking of turns. These serve-and-return behaviors promote self-regulation and impulse control in children and form a strong foundation for understanding their interaction with adults. The back-and-forth episodes also feed into the development of language.

Reciprocal games occur with both mothers and fathers 51 and often begin in earnest with the emergence of social smiles at 6 weeks of age. Parents mimic their infant’s “ooh” and “ah” in back-and-forth verbal games, which progress into conversations in which the parents utter pleasantries (“Oh, you had a good lunch!”), and the child responds by vocalizing back. Uncontrollable crying as a response to stress in a 1-year-old is replaced as the child reaches 2 to 3 years of age with the use of words to self-soothe, building on caregivers scaffolding their emotional responses. Already by 6 months of age, the introduction of solid foods requires the giving and receiving of reciprocal signals and communicative cues. During these activities, analyses of physiologic heart rate rhythms of infants with both their mothers and fathers have shown synchrony. 49 , 52

By 9 months of age, mutual regulation is manifested in the way infants use their parents for social referencing. 53 , 54 In the classic visual cliff experiment, it was demonstrated that an infant will crawl across a Plexiglas dropoff to explore if the mother encourages the infant but not if she frowns. Nonverbal communication slowly leads to formal verbal language skills through which emotions such as happiness, sadness, and anger are identified for the child via words. Uncontrollable crying in the 1-year-old then becomes whining in the 2-year-old and verbal requests for assistance in the 3-year-old as parents scaffold the child’s emotional responses and help him or her develop alternative, more adaptive behaviors. Repetitive games, such as peek-a-boo and “this little piggy,” offer children the joy of being able to predict what is about to happen, and these games also enhance the infants’ ability to solicit social stimulation.

By 12 months of age, a child’s experiences are helping to lay the foundation for the ongoing development of social skills. The expression of true joy and mastery on children’s faces when they take their first step is truly a magical moment that all parents remember. Infant memory, in Piagetian terms, develops as infants develop object permanence through visible and invisible displacements, such as repetitive games like peek-a-boo. With the advent of locomotor skills, rough-and-tumble play becomes increasingly available. During the second year, toddlers learn to explore their world, develop the beginnings of self-awareness, and use their parents as a home base (secure attachment), frequently checking to be sure that the world they are exploring is safe. 55 As children become independent, their ability to socially self-regulate becomes apparent: they can focus their attention and solve problems efficiently, they are less impulsive, and they can better manage the stress of strong emotions. 56 With increased executive functioning skills, they can begin to reflect on how they should respond to a situation rather than reacting impulsively. With the development of language and symbolic functioning, pretend play now becomes more prominent. 57 Fantasy play, dress up, and fort building now join the emotional and social repertoire of older children just as playground activities, tag, and hide and seek develop motor skills. In play, children are also solving problems and learning to focus attention, all of which promote the growth of executive functioning skills.

Play is not frivolous; it is brain building. Play has been shown to have both direct and indirect effects on brain structure and functioning. Play leads to changes at the molecular (epigenetic), cellular (neuronal connectivity), and behavioral levels (socioemotional and executive functioning skills) that promote learning and adaptive and/or prosocial behavior. Most of this research on brain structure and functioning has been done with rats and cannot be directly extrapolated to humans.

Jaak Panksepp, 11 a neuroscientist and psychologist who has extensively studied the neurologic basis of emotion in animals, suggests that play is 1 of 7 innate emotional systems in the midbrain. 58 Rats love rough-and-tumble play and produce a distinctive sound that Panksepp labeled “rat laughter.” 42 , 59 , – 64 When rats are young, play appears to initiate lasting changes in areas of the brain that are used for thinking and processing social interaction.

The dendritic length, complexity, and spine density of the medial prefrontal cortex (PFC) are refined by play. 64 , – 67 The brain-derived neurotrophic factor ( BDNF ) is a member of the neurotrophin family of growth factors that acts to support the survival of existing neurons and encourage the growth and differentiation of new neurons and synapses. It is known to be important for long-term memory and social learning. Play stimulates the production of BDNF in RNA in the amygdala, dorsolateral frontal cortex, hippocampus, and pons. 65 , 68 , – 70 Gene expression analyses indicate that the activities of approximately one-third of the 1200 genes in the frontal and posterior cortical regions were significantly modified by play within an hour after a 30-minute play session. 69 , 70 The gene that showed the largest effect was BDNF . Conversely, rat pup adversity, depression, and stress appear to result in the methylation and downregulation of the BDNF gene in the PFC. 71

Two hours per day of play with objects predicted changes in brain weight and efficiency in experimental animals. 11 , 66 Rats that were deprived of play as pups (kept in sparse cages devoid of toys) not only were less competent at problem solving later on (negotiating mazes) but the medial PFC of the play-deprived rats was significantly more immature, suggesting that play deprivation interfered with the process of synaptogenesis and pruning. 72 Rat pups that were isolated during peak play periods after birth (weeks 4 and 5) are much less socially active when they encounter other rats later in life. 73 , 74

Play-deprived rats also showed impaired problem-solving skills, suggesting that through play, animals learn to try new things and develop behavioral flexibility. 73 Socially reared rats with damage to their PFC mimic the social deficiencies of rats with intact brains but who were deprived of play as juveniles. 66 The absence of the play experience leads to anatomically measurable changes in the neurons of the PFC. By refining the functional organization of the PFC, play enhances the executive functioning skills derived from this part of the brain. 66 Whether these effects are specific to play deprivation or merely reflect the generic effect of a lack of stimulation requires further study. Rats that were raised in experimental toy-filled cages had bigger brains and thicker cerebral cortices and completed mazes more quickly. 67 , 75

Brain neurotransmitters, such as dopamine made by cells in the substantia nigra and ventral tegmentum, are also related to the reward quality of play: drugs that activate dopamine receptors increase play behavior in rats. 76

Play and stress are closely linked. High amounts of play are associated with low levels of cortisol, suggesting either that play reduces stress or that unstressed animals play more. 23 Play also activates norepinephrine, which facilitates learning at synapses and improves brain plasticity. Play, especially when accompanied by nurturing caregiving, may indirectly affect brain functioning by modulating or buffering adversity and by reducing toxic stress to levels that are more compatible with coping and resilience. 77 , 78

In human children, play usually enhances curiosity, which facilitates memory and learning. During states of high curiosity, functional MRI results showed enhanced activity in healthy humans in their early 20s in the midbrain and nucleus accumbens and functional connectivity to the hippocampus, which solidifies connections between intrinsic motivation and hippocampus-dependent learning. 79 Play helps children deal with stress, such as life transitions. When 3- to 4-year-old children who were anxious about entering preschool were randomly assigned to play with toys or peers for 15 minutes compared with listening to a teacher reading a story, the play group showed a twofold decrease in anxiety after the intervention. 24 , 80 In another study, preschool children with disruptive behavior who engaged with teachers in a yearlong 1-to-1 play session designed to foster warm, caring relationships (allowing children to lead, narrating the children’s behavior out loud, and discussing the children’s emotions as they played) showed reduced salivary cortisol stress levels during the day and improved behavior compared with children in the control group. 81 The notable exception is with increased stress experienced by children with autism spectrum disorders in new or social circumstances. 82 Animal studies suggest the role of play as a social buffer. Rats that were previously induced to be anxious became relaxed and calm after rough-and-tumble play with a nonanxious playful rat. 83 Extrapolating from these animal studies, one can suggest that play may serve as an effective buffer for toxic stress.

The benefits of play are extensive and well documented and include improvements in executive functioning, language, early math skills (numerosity and spatial concepts), social development, peer relations, physical development and health, and enhanced sense of agency. 13 , 32 , 56 , 57 , 84 , – 88 The opposite is also likely true; Panksepp 89 suggested that play deprivation is associated with the increasing prevalence of attention-deficit/hyperactivity disorder. 90

Executive functioning, which is described as the process of how we learn over the content of what we learn, is a core benefit of play and can be characterized by 3 dimensions: cognitive flexibility, inhibitory control, and working memory. Collectively, these dimensions allow for sustained attention, the filtering of distracting details, improved self-regulation and self-control, better problem solving, and mental flexibility. Executive functioning helps children switch gears and transition from drawing with crayons to getting dressed for school. The development of the PFC and executive functioning balances and moderates the impulsiveness, emotionality, and aggression of the amygdala. In the presence of childhood adversity, the role of play becomes even more important in that the mutual joy and shared attunement that parents and children can experience during play downregulates the body’s stress response. 91 , – 94 Hence, play may be an effective antidote to the changes in amygdala size, impulsivity, aggression, and uncontrolled emotion that result from significant childhood adversity and toxic stress. Future research is needed to clarify this association.

Opportunities for peer engagement through play cultivate the ability to negotiate. Peer play usually involves problem solving about the rules of the game, which requires negotiation and cooperation. Through these encounters, children learn to use more sophisticated language when playing with peers. 95 , 96

Play in a variety of forms (active physical play, pretend play, and play with traditional toys and shape sorters [rather than digital toys]) improves children’s skills. When children were given blocks to play with at home with minimal adult direction, preschool children showed improvements in language acquisition at a 6-month follow-up, particularly low-income children. The authors suggest that the benefits of Reach Out and Play may promote development just as Reach Out and Read does. 97 When playing with objects under minimal adult direction, preschool children named an average of 3 times as many nonstandard uses for an object compared with children who were given specific instructions. 98 In Jamaica, toddlers with growth retardation who were given weekly play sessions to improve mother–child interactions for 2 years were followed to adulthood and showed better educational attainment, less depression, and less violent behavior. 3

Children who were in active play for 1 hour per day were better able to think creatively and multitask. 22 Randomized trials of physical play in 7- to 9-year-olds revealed enhanced attentional inhibition, cognitive flexibility, and brain functioning that were indicative of enhanced executive control. 99 Play with traditional toys was associated with an increased quality and quantity of language compared with play with electronic toys, 100 particularly if the video toys did not encourage interaction. 101 Indeed, it has been shown that play with digital shape sorters rather than traditional shape sorters stunted the parent’s use of spatial language. 102 Pretend play encourages self-regulation because children must collaborate on the imaginary environment and agree about pretending and conforming to roles, which improves their ability to reason about hypothetical events. 56 , 57 , 103 , – 105 Social–emotional skills are increasingly viewed as related to academic and economic success. 106 Third-grade prosocial behavior correlated with eighth-grade reading and math better than with third-grade reading and math. 17 , 107

The health benefits of play involving physical activity are many. Exercise not only promotes healthy weight and cardiovascular fitness but also can enhance the efficacy of the immune, endocrine, and cardiovascular systems. 37 Outdoor playtime for children in Head Start programs has been associated with decreased BMI. 39 Physical activity is associated with decreases in concurrent depressive symptoms. 108 Play decreases stress, fatigue, injury, and depression and increases range of motion, agility, coordination, balance, and flexibility. 109 Children pay more attention to class lessons after free play at recess than they do after physical education programs, which are more structured. 43 Perhaps they are more active during free play.

Play also reflects and transmits cultural values. In fact, recess began in the United States as a way to socially integrate immigrant children. Parents in the United States encourage children to play with toys and/or objects alone, which is typical of communities that emphasize the development of independence. Conversely, in Japan, peer social play with dolls is encouraged, which is typical of cultures that emphasize interdependence. 110

Playing with children adds value not only for children but also for adult caregivers, who can reexperience or reawaken the joy of their own childhood and rejuvenate themselves. Through play and rereading their favorite childhood books, parents learn to see the world from their child’s perspective and are likely to communicate more effectively with their child, even appreciating and sharing their child’s sense of humor and individuality. Play enables children and adults to be passionately and totally immersed in an activity of their choice and to experience intense joy, much as athletes do when they are engaging in their optimal performance. Discovering their true passions is another critical strategy for helping both children and adults cope with adversity. One study documented that positive parenting activities, such as playing and shared reading, result in decreases in parental experiences of stress and enhancement in the parent–child relationship, and these effects mediate relations between the activities and social–emotional development. 111 , – 113

Most importantly, play is an opportunity for parents to engage with their children by observing and understanding nonverbal behavior in young infants, participating in serve-andreturn exchanges, or sharing the joy and witnessing the blossoming of the passions in each of their children.

Play not only provides opportunities for fostering children’s curiosity, 14 self-regulation skills, 46 language development, and imagination but also promotes the dyadic reciprocal interactions between children and parents, which is a crucial element of healthy relationships. 114 Through the buffering capacity of caregivers, play can serve as an antidote to toxic stress, allowing the physiologic stress response to return to baseline. 77 Adult success in later life can be related to the experience of childhood play that cultivated creativity, problem solving, teamwork, flexibility, and innovations. 18 , 52 , 115

Successful scaffolding (new skills built on previous skills facilitated by a supportive social environment) can be contrasted with interactions in which adults direct children’s play. It has been shown that if a caregiver instructs a child in how a toy works, the child is less likely to discover other attributes of the toy in contrast to a child being left to explore the toy without direct input. 38 , 116 , – 118 Adults who facilitate a child’s play without being intrusive can encourage the child’s independent exploration and learning.

Scaffolding play activities facilitated by adults enable children to work in groups: to share, negotiate, develop decision-making and problem-solving skills, and discover their own interests. Children learn to resolve conflicts and develop self-advocacy skills and their own sense of agency. The false dichotomy between play versus formal learning is now being challenged by educational reformers who acknowledge the value of playful learning or guided play, which captures the strengths of both approaches and may be essential to improving executive functioning. 18 , 19 , 34 , 119 Hirsh-Pasek et al 34 report a similar finding: children have been shown to discover causal mechanisms more quickly when they drive their learning as opposed to when adults display solutions for them.

Executive functioning skills are foundational for school readiness and academic success, mandating a frame shift with regard to early education. The goal today is to support interventions that cultivate a range of skills, such as executive functioning, in all children so that the children enter preschool and kindergarten curious and knowing how to learn. Kindergarten should provide children with an opportunity for playful collaboration and tinkering, 14 a different approach from the model that promotes more exclusive didactic learning at the expense of playful learning. The emerging alternative model is to prevent toxic stress and build resilience by developing executive functioning skills. Ideally, we want to protect the brain to enable it to learn new skills, and we want to focus on learning those skills that will be used to buffer the brain from any future adversity. 18 The Center on the Developing Child at Harvard University offers an online resource on play and executive functioning with specific activities suggested for parents and children ( http://developingchild.harvard.edu/wp-content/uploads/2015/05/Enhancing-and-Practicing-Executive-Function-Skills-with-Children-from-Infancy-to-Adolescence-1.pdf ). 120

Specific curricula have now been developed and tested in preschools to help children develop executive functioning skills. Many innovative programs are using either the Reggio Emilia philosophy or curricula such as Tools of the Mind (developed in California) 121 or Promoting Alternative Thinking Strategies–Preschool and/or Kindergarten. 122 Caregivers need to provide the appropriate amount of input and guidance for children to develop optimal problem-solving skills through guided play and scaffolding. Optimal learning can be depicted by a bell-shaped curve, which illustrates the optimal zone of arousal and stress for complex learning. 123

Scaffolding is extensively used to support skills such as buddy reading, in which children take turns being lips and ears and learn to read and listen to each other as an example of guided play. A growing body of research shows that this curriculum not only improves executive functioning skills but also shows improvement in brain functioning on functional MRI. 6 , 124 , – 126

Focusing on cultivating executive functioning and other skills through playful learning in these early years is an alternative and innovative way of thinking about early childhood education. Instead of focusing solely on academic skills, such as reciting the alphabet, early literacy, using flash cards, engaging with computer toys, and teaching to tests (which has been overemphasized to promote improved test results), cultivating the joy of learning through play is likely to better encourage long-term academic success. Collaboration, negotiation, conflict resolution, self-advocacy, decision-making, a sense of agency, creativity, leadership, and increased physical activity are just some of the skills and benefits children gain through play.

For many families, there are risks in the current focus only on achievement, after-school enrichment programs, increased homework, concerns about test performance, and college acceptance. The stressful effects of this approach often result in the later development of anxiety and depression and a lack of creativity. Parental guilt has led to competition over who can schedule more “enrichment opportunities” for their children. As a result, there is little time left in the day for children’s free play, for parental reading to children, or for family meal times. Many schools have cut recess, physical education, art, and music to focus on preparing children for tests. Unsafe local neighborhoods and playgrounds have led to nature deficit disorder for many children. 127 A national survey of 8950 preschool children and parents found that only 51% of children went outside to walk or play once per day with either parent. 128 In part, this may reflect the local environment: 94% of parents have expressed safety concerns about outdoor play, and access may be limited. Only 20% of homes are located within a half-mile of a park. 129 , 130 Cultural changes have also jeopardized the opportunities children have to play. From 1981 to 1997, children’s playtime decreased by 25%. Children 3 to 11 years of age have lost 12 hours per week of free time. Because of increased academic pressure, 30% of US kindergarten children no longer have recess. 42 , 129 An innovative program begun in Philadelphia is using cities (on everyday walks and in everyday neighborhoods) as opportunities for creating learning landscapes that provide opportunities for parents and children to spark conversation and playful learning. 131 , 132 For example, Ridge et al 132 have placed conversational prompts throughout supermarkets and laundromats to promote language and lights at bus stops to project designs on the ground, enabling children to play a game of hopscotch that is specifically designed to foster impulse control. By promoting the learning of social and emotional skills, the development of emotional intelligence, and the enjoyment of active learning, protected time for free play and guided play can be used to help children improve their social skills, literacy, and school readiness. Children can then enter school with a stronger foundation for attentional disposition based on the skills and attitudes that are critical for academic success and the long-term enjoyment of learning and love of school.

Media (eg, television, video games, and smartphone and tablet applications) use often encourages passivity and the consumption of others’ creativity rather than active learning and socially interactive play. Most importantly, immersion in electronic media takes away time from real play, either outdoors or indoors. Real learning happens better in person-to-person exchanges rather than machine-to-person interactions. Most parents are eager to do the right thing for their children. However, advertisers and the media can mislead parents about how to best support and encourage their children’s growth and development as well as creativity. Parent surveys have revealed that many parents see media and technology as the best way to help their children learn. 133 However, researchers contradict this. Researchers have compared preschoolers playing with blocks independently with preschoolers watching Baby Einstein tapes and have shown that the children playing with blocks independently developed better language and cognitive skills than their peers watching videos. 34 , 134 Although active engagement with age-appropriate media, especially if supported by cowatching or coplay with peers or parents, may have some benefits, 135 real-time social interactions remain superior to digital media for home learning. 136

It is important for parents to understand that media use often does not support their goals of encouraging curiosity and learning for their children. 137 , – 141 Despite research that reveals an association between television watching and a sedentary lifestyle and greater risks of obesity, the typical preschooler watches 4.5 hours of television per day, which displaces conversation with parents and the practice of joint attention (focus by the parent and child on a common object) as well as physical activity. For economically challenged families, competing pressures make it harder for parents to find the time to play with children. Encouraging outdoor exercise may be more difficult for such families given unsafe playgrounds. Easy access to electronic media can be difficult for parents to compete with.

In the 2015 symposium, 137 the AAP clarified recommendations acknowledging the ubiquity and transformation of media from primarily television to other modalities, including video chatting. In 2016, the AAP published 2 new policies on digital media affecting young children, school-aged children, and adolescents. These policies included recommendations for parents, pediatricians, and researchers to promote healthy media use. 139 , 140 The AAP has also launched a Family Media Use Plan to help parents and families create healthy guidelines for their children’s media use so as to avoid displacing activities such as active play, and guidelines can also be found on the HealthyChildren.org and Common Sense Media (commonsensemedia.org) Web sites.

There are barriers to encouraging play. Our culture is preoccupied with marketing products to young children. 142 Parents of young children who cannot afford expensive toys may feel left out. 143 Parents who can afford expensive toys and electronic devices may think that allowing their children unfettered access to these objects is healthy and promotes learning. The reality is that children’s creativity and play is enhanced by many inexpensive toys (eg, wooden spoons, blocks, balls, puzzles, crayons, boxes, and simple available household objects) and by parents who engage with their children by reading, watching, playing alongside their children, and talking with and listening to their children. It is parents’ and caregivers’ presence and attention that enrich children, not elaborate electronic gadgets. One-on-one play is a time-tested way of being fully present. Low-income families may have less time to play with their children while working long hours to provide for their families, but a warm caregiver or extended family as well as a dynamic community program can help support parents’ efforts. 144 The importance of playtime with children cannot be overemphasized to parents as well as schools and community organizations. Many children do not have safe places to play. 145 Neighborhood threats, such as violence, guns, drugs, and traffic, pose safety concerns in many neighborhoods, particularly low-income areas. Children in low-income, urban neighborhoods also may have less access to quality public spaces and recreational facilities in their communities. 145 Parents who feel that their neighborhoods are unsafe may also not permit their children to play outdoors or independently.

Public health professionals are increasingly partnering with other sectors, such as parks and recreation, public safety, and community development, to advocate for safe play environments in all communities. This includes efforts to reduce community violence, improve physical neighborhood infrastructure, and support planning and design decisions that foster safe, clean, and accessible public spaces.

Pediatricians can advocate for the importance of all forms of play as well as for the role of play in the development of executive functioning, emotional intelligence, and social skills ( Table 1 ). Pediatricians have a critical role to play in protecting the integrity of childhood by advocating for all children to have the opportunity to express their innate curiosity in the world and their great capacity for imagination. For children with special needs, it is especially important to create safe opportunities for play. A children’s museum may offer special mornings when it is open only to children with special needs. Extra staffing enables these children and their siblings to play in a safe environment because they may not be able to participate during crowded routine hours.

Recommendations From Pediatricians to Parents

Adapted from pathways.org ( https://pathways.org/wp-content/uploads/2019/07/PlayBrochure_English_LEGAL_FOR-PRINT_2022.pdf ).

The AAP recommends that pediatricians:

Encourage parents to observe and respond to the nonverbal behavior of infants during their first few months of life (eg, responding to their children’s emerging social smile) to help them better understand this unique form of communication. For example, encouraging parents to recognize their children’s emerging social smile and to respond with a smile of their own is a form of play that also teaches the infants a critical social–emotional skill: “You can get my attention and a smile from me anytime you want just by smiling yourself.” By encouraging parents to observe the behavior of their children, pediatricians create opportunities to engage parents in discussions that are nonjudgmental and free from criticism (because they are grounded in the parents’ own observations and interpretations of how to promote early learning);

Advocate for the protection of children’s unstructured playtime because of its numerous benefits, including the development of foundational motor skills that may have lifelong benefits for the prevention of obesity, hypertension, and type 2 diabetes;

Advocate with preschool educators to do the following: focus on playful rather than didactic learning by letting children take the lead and follow their own curiosity; put a premium on building social–emotional and executive functioning skills throughout the school year; and protect time for recess and physical activity;

Emphasize the importance of playful learning in preschool curricula for fostering stronger caregiver–infant relationships and promoting executive functioning skills. Communicating this message to policy makers, legislators, and educational administrators as well as the broader public is equally important; and

Just as pediatricians support Reach Out and Read, encourage playful learning for parents and infants by writing a “prescription for play” at every well-child visit in the first 2 years of life.

A recent randomized controlled trial of the Video Interaction Project (an enhancement of Reach Out and Read) has demonstrated that the promotion of reading and play during pediatric visits leads to enhancements in social–emotional development. 112 In today’s world, many parents do not appreciate the importance of free play or guided play with their children and have come to think of worksheets and other highly structured activities as play. 146 Although many parents feel that they do not have time to play with their children, pediatricians can help parents understand that playful learning moments are everywhere, and even daily chores alongside parents can be turned into playful opportunities, especially if the children are actively interacting with parents and imitating chores. Young children typically seek more attention from parents. 46 Active play stimulates children’s curiosity and helps them develop the physical and social skills needed for school and later life. 32

Cultural shifts, including less parent engagement because of parents working full-time, fewer safe places to play, and more digital distractions, have limited the opportunities for children to play. These factors may negatively affect school readiness, children’s healthy adjustment, and the development of important executive functioning skills;

Play is intrinsically motivated and leads to active engagement and joyful discovery. Although free play and recess need to remain integral aspects of a child’s day, the essential components of play can also be learned and adopted by parents, teachers, and other caregivers to promote healthy child development and enhance learning;

The optimal educational model for learning is for the teacher to engage the student in activities that promote skills within that child’s zone of proximal development, which is best accomplished through dialogue and guidance, not via drills and passive rote learning. There is a current debate, particularly about preschool curricula, between an emphasis on content and attempts to build skills by introducing seat work earlier versus seeking to encourage active engagement in learning through play. With our understanding of early brain development, we suggest that learning is better fueled by facilitating the child’s intrinsic motivation through play rather than extrinsic motivations, such as test scores;

An alternative model for learning is for teachers to develop a safe, stable, and nurturing relationship with the child to decrease stress, increase motivation, and ensure receptivity to activities that promote skills within each child’s zone of proximal development. The emphasis in this preventive and developmental model is to promote resilience in the presence of adversity by enhancing executive functioning skills with free play and guided play;

Play provides ample opportunities for adults to scaffold the foundational motor, social–emotional, language, executive functioning, math, and self-regulation skills needed to be successful in an increasingly complex and collaborative world. Play helps to build the skills required for our changing world; and

Play provides a singular opportunity to build the executive functioning that underlies adaptive behaviors at home; improve language and math skills in school; build the safe, stable, and nurturing relationships that buffer against toxic stress; and build social–emotional resilience.

For more information, see Kearney et al’s Using Joyful Activity To Build Resiliency in Children in Response to Toxic Stress . 147

American Academy of Pediatrics

brain-derived neurotrophic factor

prefrontal cortex

Dr Yogman prepared the first draft of this report and took the lead in reconciling the numerous edits, contributions, and suggestions from the other authors; Drs Garner, Hutchinson, Hirsh-Pasek, and Golinkoff made significant contributions to the manuscript by revising multiple drafts and responding to all reviewer concerns; and all authors approved the final manuscript as submitted.

The opinions and assertions expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Uniformed Services University or the Department of Defense.

FUNDING: No external funding.

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

Clinical reports from the American Academy of Pediatrics benefit from expertise and resources of liaisons and internal (AAP) and external reviewers. However, clinical reports from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations or government agencies that they represent.

The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

All clinical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

Michael Yogman, MD, FAAP

Andrew Garner, MD, PhD, FAAP

Jeffrey Hutchinson, MD, FAAP

Kathy Hirsh-Pasek, PhD

Roberta Golinkoff, PhD

Virginia Keane, MD, FAAP

Michael Yogman, MD, FAAP, Chairperson

Rebecca Baum, MD, FAAP

Thresia Gambon, MD, FAAP

Arthur Lavin, MD, FAAP

Gerri Mattson, MD, FAAP

Lawrence Wissow, MD, MPH, FAAP

Sharon Berry, PhD, LP – Society of Pediatric Psychology

Amy Starin, PhD, LCSW – National Association of Social Workers

Edward Christophersen, PhD, FAAP – Society of Pediatric Psychology

Norah Johnson, PhD, RN, CPNP-BC – National Association of Pediatric Nurse Practitioners

Abigail Schlesinger, MD – American Academy of Child and Adolescent Psychiatry

Karen S. Smith

David L Hill, MD, FAAP, Chairperson

Nusheen Ameenuddin, MD, MPH, FAAP

Yolanda (Linda) Reid Chassiakos, MD, FAAP

Corinn Cross, MD, FAAP

Rhea Boyd, MD, FAAP

Robert Mendelson, MD, FAAP

Megan A Moreno, MD, MSEd, MPH, FAAP

Jenny Radesky, MD, FAAP

Wendy Sue Swanson, MD, MBE, FAAP

Justin Smith, MD, FAAP

Kristopher Kaliebe, MD – American Academy of Child and Adolescent Psychiatry

Jennifer Pomeranz, JD, MPH – American Public Health Association Health Law Special Interest Group

Brian Wilcox, PhD – American Psychological Association

Thomas McPheron

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Theories of Child Development and Their Impact on Early Childhood Education and Care

Published: 29 October 2021
Volume 51 , pages 15–30, ( 2023 )

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Olivia N. Saracho ORCID: orcid.org/0000-0003-4108-7790 1

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Developmental theorists use their research to generate philosophies on children’s development. They organize and interpret data based on a scheme to develop their theory. A theory refers to a systematic statement of principles related to observed phenomena and their relationship to each other. A theory of child development looks at the children's growth and behavior and interprets it. It suggests elements in the child's genetic makeup and the environmental conditions that influence development and behavior and how these elements are related. Many developmental theories offer insights about how the performance of individuals is stimulated, sustained, directed, and encouraged. Psychologists have established several developmental theories. Many different competing theories exist, some dealing with only limited domains of development, and are continuously revised. This article describes the developmental theories and their founders who have had the greatest influence on the fields of child development, early childhood education, and care. The following sections discuss some influences on the individuals’ development, such as theories, theorists, theoretical conceptions, and specific principles. It focuses on five theories that have had the most impact: maturationist, constructivist, behavioral, psychoanalytic, and ecological. Each theory offers interpretations on the meaning of children's development and behavior. Although the theories are clustered collectively into schools of thought, they differ within each school.

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The author is grateful to Mary Jalongo for her expert editing and her keen eye for the smallest details.

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Saracho, O.N. Theories of Child Development and Their Impact on Early Childhood Education and Care. Early Childhood Educ J 51 , 15–30 (2023). https://doi.org/10.1007/s10643-021-01271-5

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The paper provides an overview of a German cohort study of newborns which includes a representative sample of about 3500 infants and their mothers. The aims, challenges, and solutions concerning the large-scale assessment of early child capacities and skills as well as the measurements of learning environments that impact early developmental progress are presented and discussed. First, a brief overview of the German regulations related to early child education and care (ECEC) and parental leave as well as the study design are outlined. Then, the assessments of domain-specific and domain-general cognitive and socio-emotional indicators of early child functioning and development are described and the assessments of structural, orientational, and process quality of the children’s learning environment at home and in child care are presented. Special attention is given to direct assessments and their reliability and validity; in addition, some selected results on social disparities are reported and the prospects of data analyses are discussed.

Early childhood and early child education are an important basis for later development, educational performance, and pathways as well as for lifelong learning and well-being. This important claim has been made repeatedly (Caspi et al. 2003 ; Noble et al. 2007 ), and even critical phases of development have been suggested (e.g., Mayberry et al. 2002 ). Nevertheless and despite the existence of quite a few longitudinal studies addressing this issue, empirical evidence concerning effective conditions, differential child progress, and how the early phases of life impact future development and prospects is still rare.

From an educational and political point of view, it is alarming that various studies have documented profound disparities in child development according to family background when children are merely 3 years of age (Brooks-Gunn and Duncan 1997 ; Dubowy et al. 2008 ; Hart and Risley 1995 , 1999 ; Weinert et al. 2010 ). Even in the first year of life, very early roots of social disparities have been demonstrated which increased substantially over the next few years (Halle et al. 2009 ). In addition, some studies show a high stability of interindividual differences and social disparities from age three onward across preschool (Weinert and Ebert 2013 ; Weinert et al. 2010 ) and school age (Law et al. 2014 ). Notably, the stability of individual differences in children’s test performance has been shown to be even more pronounced in educationally dependent domains of development, like language and factual knowledge, than in more domain-general and less culture-dependent facets of children’s cognitive functioning, as indicated by non-verbal intelligence test scores (Weinert et al. 2010 ).

Drawing on a bioecological model of development (Bronfenbrenner and Morris 2006 ), developmental progress and child education are influenced from early on by the interaction between (developing) child characteristics, skills, and competencies and the quality of structural and process characteristics of the learning environment at the child’s home (Bakermans-Kranenburg and van Ijzendoorn 2011 ; Bradley and Corwyn 2002 ; Ebert et al. 2013 ; Weinert et al. 2012 ) as well as in child care (Anders et al. 2013 ). Longitudinal studies shed light on these interactions and how they impact later development and education, which is of great importance for gaining a better understanding of the underlying processes and influential conditions. It is important to note that the form and organization of the various learning environments are affected by state regulations, which differ between countries, resulting in different support systems, offers and regulations for parents from child birth until her/his formal school enrolment (Waldfogel 2001 ).

Regulations in Germany

Maternity leave regulations in Germany prescribe a period of 14 weeks for maternity leave which is divided into two phases: 6 weeks before and 8 weeks after birth. Mothers receive maternity pay from public funds in addition to their employer’s contribution which amounts to 100 % of their former income. After this period, parents are offered various options for taking parental leave until the child’s third birthday. Specifically, parents may interrupt their employment to provide child care and are legally protected from dismissal during this 3-year period; parents also receive parental pay during their parental leave (substitution of income) amounting to two-thirds of her/his prior salary (ranging from € 300.- up to € 1800.-) for a maximum period of 14 months.

Governments also support families through child care policies. The German early child education and care (ECEC) system covers institutional care and education before and alongside elementary and secondary school. Since 1993 children from age of three onward have had a legal right to institutional child care which is primarily organized by local communities and welfare organizations providing care to mainly age-mixed groups at centers with varying opening hours (Linberg et al. 2013 ). However, during the last decade, there has been growing demand for ECEC for children under the age of three that led to the enactment of laws on the demand-driven expansion of child care (“Tagesbetreuungsausbaugesetz TAG”) and the expansion of child care infrastructure for infants and children (“Kinderförderungsgesetz KiföG”) in 2005 and 2008, respectively. Additionally, the legal right to institutional ECEC was expanded in 2013 to include 1-year-old children and political leaders from local, state, and federal levels agreed to provide enough places for 35 % of the children.

Accordingly, the actual use of child care for young children under the age of three has rapidly changed during recent years: Within 8 years (2005–2013), the child care rates for the under 3-year olds increased from 7 to 23 % in the Western states of Germany and from 36 to 47 % in the Eastern states, which have their own distinct tradition and infrastructure concerning early care and education (Kreyenfeld and Krapf 2016 ). In 2015, the nation-wide care rate amounted to 32.9 % with mean values of 28.2 % for the Western and 51.9 % for the Eastern states (Statistisches Bundesamt 2016 ).

However, despite rising rates of early education, a child’s family still is the first and often only environment for developmental processes during the first years of life. Thus, there is a substantial need for analyzing the decision mechanisms as well as the effects of the various options available for early child care.

To summarize, longitudinal studies that provide a basis for analyzing the conditions which significantly contribute to early developmental progress are of great importance for the individual child as well as for society. These studies produce relevant knowledge on how children’s abilities, skills, and competencies develop based on individual resources and conditions; how learning opportunities influence their development in different contexts; how disparities emerge early in life; and how all this impacts educational careers, lifelong learning, well-being, and participation in society.

The German National Educational Panel Study

(NEPS) Footnote 1 has been set up to substantially contribute to these issues (Blossfeld et al. 2011 ). The idea of a multicohort panel study was brought up by the German Federal Ministry of Education and Research (BMBF). A nation-wide interdisciplinary scientific network of researchers was established to develop this idea further and to prepare a proposal for a longitudinal representative large-scale educational study to investigate, monitor, and compare competence development and educational processes in Germany. In light of the specific challenges associated with sampling and measurement of early child characteristics, a newborn cohort study was not initially included in the main NEPS program, but was planned to be conducted as an associated add-on project. However, the study was incorporated into the NEPS study design on behalf of the international evaluation committee organized by the German Research Foundation (DFG) for two main reasons: the growing research on the importance of early child development and education and the rapid changes taking place in early child care, including new social policies being implemented in Germany (see above).

The NEPS is carried out by a network of excellence. It features a longitudinal multicohort sequence design and comprises more than 60,000 target persons as well as 40,000 context persons. In particular, the NEPS design encompasses six longitudinal panel studies conducted simultaneously, which cover a wide range of ages and educational stages. NEPS data are disseminated in a user-friendly way to the scientific community. According to the sensitivity of data, the access is given by a web download, a remote access solution, or on-site in a secure environment. All data are documented in English and are available for use by national and international researchers. In addition to providing substantial analyses of the data themself, it can be used as a benchmark for intervention research, international comparison, and for evaluating issues such as the differences and changes in the use of institutional child care.

At the moment, more than 1100 researchers from more than 700 projects are drawing on the NEPS data already published. The data are used for research in a variety of scientific disciplines and also for educational monitoring—especially, the indicator-based National Report for Education. In order to facilitate access to results for a wide range of professions interested in education—including policy, administration, and practice—scientific papers with important conclusions and empirical evidence are currently summarized by the Leibniz Institute for Educational Trajectories (LIfBi) for public communication and information beyond science and are distributed via the NEPS webpage. Moreover, results are regularly fed back to these groups by presentations and newsletters.

The present paper provides an overview of the NEPS newborn cohort study and its analytic potential. First, the design of the study will be presented with a special emphasis on the aims, challenges, and solutions for the assessment of child characteristics and learning environments. We will then report a few selected results (a) concerning the validity and reliability of the measures used and (b) on early social disparities.

Design of the newborn cohort study of the NEPS: a brief overview

Like all other cohort studies of the NEPS, the cohort study of newborns addresses five research perspectives (Blossfeld et al. 2011 ). Drawing on a theoretical framework, various domain-specific as well as domain-general indicators of early child capacities, characteristics, and developments are assessed as well as measures of structural and process characteristics of their (different) learning environments and their social, occupational, and educational family background. In addition, there is a special focus on families with a migration background, on educational decisions (e.g., concerning child care), and—especially in the newborn cohort study—on patterns of coparenting and child care arrangements. By combining direct observational measures, interview data, and questionnaires, the newborn cohort study allows for in-depth analyses of developmental progress and influential conditions that affect the development of educationally relevant competencies and the stability or changes of interindividual differences. Therefore, it provides insight into the mechanisms through which social disparities emerge, change, and impact children’s future prospects and returns to education.

Sampling strategy

To ensure a representative sample, a two-stage procedure was implemented: 84 German municipalities were used as primary sampling units, explicitly stratified according to three strata of urbanization (via the number of inhabitants; see Aßmann et al. 2015 ). Within these municipalities, addresses were sampled and divided into two birth tranches (infants born between February and April 2012 and between May and June 2012) in order to guarantee a small age range for the infant sample. Starting from a gross sample of about 8500 families, a total of about 3500 families (response rate 41 %) took part in the first assessment wave. In the second wave, the realized sample still included about 2850 families (panel stability 83 %).

Assessment waves and data collection

During the very early phases of child development, three successive assessment waves were carried out when children were on average 7 months (wave 1), 17 months (wave 2), and 26 months of age (wave 3). In the first and third wave video-taped observations and computer-assisted personal interviews (CAPI) were conducted at the family’s home for the entire sample. In the second wave, families were surveyed by computer-assisted telephone interviews (CATI), while video-taped observational measures at the child’s home were only assessed in half of the sample (subsample approx. 1500) in accordance with the study’s design. After wave 3 (i.e., from age two onward) children and their context persons were and will be surveyed every year. Data are collected by trained interviewers. Mothers are the primary respondents, as they can provide valid information about conditions and feelings during and after their pregnancy. Each assessment wave is preceded by a longitudinal pilot study, which runs 1 year before the main study is conducted, to test all instruments and procedures.

Measuring early child characteristics: aims, challenges, and solutions

The assessment of a child’s capacities, characteristics, and early development is pivotal for analyzing the effects of environmental conditions and the impact of early child development and education on later development, educational achievement, career, and life satisfaction or other outcomes and returns. In particular, measuring child characteristics is essential to the modeling of intra-individual progress and changes in interindividual differences, including the emergence of social disparities in various domains of development across childhood. At the same time, it is crucial for analyzing the mechanisms of change, the effects of learning environments and opportunities, and their interactions with the individual capacities and characteristics of the children, while taking the risk or protecting factors of the individual child and his/her environment into account, as well as for controlling for basic interindividual differences if necessary.

However, measuring early child characteristics is a major challenge for longitudinal studies, especially large-scale studies. This is due to various issues and questions, such as which aspects and indicators of early child development should be assessed, how should they be measured, and how can the standardization and validity of measurements be ensured in large-scale assessments of very young children.

Early child development: domain-specific challenges for the child

Developmental psychology has convincingly documented for a long time that neither the development of children nor the development of infants is a homogeneous endeavor. Since the time of Piaget’s ( 1970 ) overarching stage theory of development, it has been empirically demonstrated that development is domain-specific, i.e., demands, prerequisites, effective environmental stimulations differ according to the developmental domain under study (e.g., the acquisition of language, of mathematical competencies, of competencies in natural science, or of an intuitive psychology) (Karmiloff-Smith 1999 ). Even in infancy domain-specific precursors of e.g., mathematical and psychological knowledge and competencies are observable (Goswami 2008 ). Determining how educationally relevant competencies emerge from the interplay of these domain-specific precursors and domain-general basic capacities of the child (like basic reasoning abilities, speed of information processing, or executive functions including cognitive flexibility, inhibition, working memory) on the one hand and of the environmental conditions in the family and in child care on the other is an important issue to be addressed by educational studies. It is important to note that (interindividual differences in) basic capacities also change with age and environmental conditions, although not to the same extent as culture- and education-dependent competencies, and that stimulation of and progress in one developmental domain may enhance, hinder, or compensate for those in other domains.

General NEPS framework for assessing competencies

Within the NEPS, a general framework for assessing educationally relevant abilities and competencies has been developed (Weinert et al. 2011 ). Specifically, the assessments include (a) domain-general cognitive abilities/capacities captured by the constructs of “fluid intelligence” (Cattell 1971 ) or “cognitive mechanics” (Baltes et al. 2006 ); these refer to performance differences in speed of basic cognitive processes, the capacity of working memory, and the ability to apply deductive or analogical thinking in new situations (Brunner et al. 2014 ); (b) domain-specific cognitive competencies, e.g., language competencies, mathematical competencies, and natural science competencies are to be assessed longitudinally and as coherently as possible; and not least (c) meta-competencies, including self-regulation (in the cognitive, behavioral, and emotional domain) and socio-emotional competencies are to be measured (see Weinert et al. 2011 for an elaborated rational of the assessments).

Selecting and measuring relevant and predictive indicators of early child development: a challenge for research

As already mentioned, even in infancy and early childhood, there is no overall indicator for children’s capacities and development. Considering the fact that there are thousands of studies into infant competencies, the indicators have to be carefully selected—not least because of the limited study time and other constraints associated with large-scale assessments, especially those concerning infants and young children who cannot be tested in group settings and whose attentional capacities are still limited. Within the NEPS, the selection draws on the general framework outlined above, including domain-general basic capacities, domain-specific precursors and early roots of language and mathematics as well as indicators of socio-emotional development and early self-regulation.

However, deciding on how to measure these early child characteristics and developments is a major challenge for theoretically sound educational large-scale assessments. Just relying on parents’ reports is problematic since the parents’ judgements might be affected, for example, by their (different) knowledge of child development, by possible restrictions/differences in how they observe the child, and by their particular cultural and individual beliefs and biases. In addition, major aspects of domain-general and domain-specific cognitive functioning and development are not easily observable and need sophisticated assessment methods developed in infancy research.

If newborn cohort studies took direct measures into consideration in addition to interviews and questionnaires, they often relied on the Bayley Scales of Infant Development (Bayley 2006 ; Schlesiger et al. 2011 for a brief overview). However, the NEPS feasibility and pilot studies revealed that the standardized administration of test items (using an educationally sound selection of items) turned out to be highly error-prone for trained interviewers who are usually experts in administering interviews but not tests. In addition, the sensorimotor indicators of developmental status measured by the Bayley Scales have been shown to be rather instable across situations (Attig et al. 2015 ) and infancy (McCall et al. 1977 ) and were hardly predictive for later cognitive functioning (e.g., Fagan and Singer 1983 ). Therefore, an indicator of basic information processing abilities was introduced within the NEPS newborn cohort study which has predominantly been used in baby lab studies, namely, the children’s visual attention and speed of habituation within a habituation–dishabituation paradigm. Within this paradigm, the child’s visual attention and the decrease of her/his visual attention when being presented with a series of identical or categorically similar stimuli are used as indicators of the child’s ability to build up a cognitive representation of a stimulus or a stimulus category (Pahnke 2007 ; Sokolov 1990 ). In addition, a new stimulus (or a stimulus from a new category) is presented in the dishabituation phase of the paradigm and a new increase of the child’s visual attention is interpreted as a signal of her/his ability to distinguish stimuli or categories presented during the two phases of the paradigm and to show a preference toward new information. These measures have been shown to be highly predictive of later intelligence scores or other indicators of cognition and language (Bornstein and Sigman 1986 ; Fagan and Singer 1983 ; Kavšek 2004 ). Thus, this paradigm was used to assess early domain-general information processing/categorization abilities; it was also used to measure early precursors of numeracy and word learning (see Table 1 ). To assure standardization and reliability, pictures were presented on a computer screen and the child’s looking behavior (look at/away from the respective stimulus) was video-taped (as were all other direct measures) and coded afterward on a 30 frames per second basis. A third direct indicator of early child characteristics relevant to learning and education is her/his interactional behavior (cognitive, behavioral, and socio-emotional aspects) in mother–child interaction (see “ Assessment of mother–child interaction: direct measurement of the home-learning environment and of the child’s characteristics in mother–child interaction ” section). Table 1 summarizes the measurements of child characteristics and development assessed in the first three waves of the NEPS newborn cohort study.

In addition to direct assessment, mothers were asked (see Table 1 ) about the child’s skills and development as well as about the child’s health. The questions on the child’s skills and development cover items on cognition (e.g., means-end task and object categorization), communicative gesture (e.g., to draw someone’s attention, negation/headshaking), gross and fine motor skills (e.g., climbing up steps, stacking of toy blocks) as well as language (e.g., size of productive vocabulary, comprehension of short instructions). A short version of the Infant Behavior Questionnaire (IBQ-R, Gartstein and Rothbart 2003 ) was used to assess facets of the child’s temperament, specifically orienting/regulatory capacity (items like “if you sing or speak to <target child’s name>, how often does she/he calm down instantly?”) and negative affectivity (items like “when <target child’s name> can’t have what she/he wants, how often does she/he get angry?”) (Bayer et al. 2015 ). In wave 3, a German language checklist and, for bilingual children, an additional Turkish or Russian language checklist (versions of the well-known MacArthur Communicative Development Inventory (CDI); Fenson et al. 1993 ) was introduced.

Measuring learning environments: aims, challenges, and solutions

Likewise, measuring learning environments that impact child development is an important challenge for longitudinal large-scale educational studies. As suggested by bioecological theories (Bronfenbrenner and Morris 2006 ), it is not enough to just focus on the home-learning environment; the use and features of non-parental care and other learning environments like parent–child programs, which 55 % of the children in the newborn cohort study experience in their first year of life, should also be assessed. Moreover, it is not sufficient to only measure quantitative structural characteristics, since domain-general and domain-specific qualitative aspects have been shown to be especially important (e.g., Anders et al. 2012 ; Sylva et al. 2006 ); however, indispensable direct observational measurements are hard to obtain in large-scale studies. It is important to note that the meaningfulness of the specific features/aspects assessed for characterizing the different learning environments and the constraints of the measurements have a large impact on the validity of subsequent analyses and conclusions.

General framework of the NEPS

To deal with these issues coherently across cohorts, the measurement of important characteristics of learning environments draws on a general framework which subdivides three different dimensions: Structural quality , which refers to relatively persistent general conditions; orientational quality , like values, norms, and attitudes of an actor; and process quality , which refers to the interaction of the individual with her/his learning environment (Bäumer et al. 2011 ).

Selection and measurement of indicators

For the assessment of the process quality of the home-learning environment as the central learning environment in the very early years, the NEPS newborn cohort study relies on both interviews/questionnaires and direct observations (see below).

In addition, as approx. 24 % of the children of the newborns’ cohort sample were using supplementary non-parental care settings in wave 2, the dimensions specified above were also surveyed in these child care settings using self-administered drop-off questionnaires for center-based ECEC as well as for child minders. Because the NEPS has to rely on survey data, the validity of the quality of non-parental care settings gained from the questionnaire is tested by conducting a sub-study, which compares observational methods with the questionnaire used in the NEPS study. The questionnaire covers structural characteristics as well as process characteristics (see Table 2 for examples).

Besides external day care, the newborn cohort study of the NEPS places a strong emphasis on the home-learning environment—especially in very early childhood—as it is of central importance for later development (NICHD 1998 ). Large-scale longitudinal studies mostly focus on the structural aspects of the home-learning environment to account for variability in infants’ and toddlers’ cognitive and social skills (Halle et al. 2009 ; Hillemeier et al. 2009 ). However, process variables account for additional variance in both social and cognitive child outcomes and may even mediate the effect of structural characteristics (Flöter et al. 2013 ; NICHD 1998 ). Therefore, the assessment of the home-learning environment is not only limited to measuring structural aspects like sociodemographics, but also includes orientations (see Table 3 ); in particular, special emphasis is given to the assessment of processes . Mothers are asked about issues, such as joint activities and their language use at home and the quality of these interactions is also assessed by means of videotaping mother–child interactions during the first three assessment waves (see Table 3 ; “ Assessment of mother–child interaction: direct measurement of the home-learning environment and of the child’s characteristics in mother-child interaction ” section).

Assessment of mother–child interaction: direct measurement of the home-learning environment and of the child’s characteristics in mother–child interaction

On the one hand, the assessment of mother–child interactions as a dyadic process allows a deeper look into maternal interaction behavior as a crucial characteristic of the home-learning environment; on the other hand, it captures additional information about the relevant characteristics of the child.

The quality of maternal interaction behavior has been shown to impact a child’s language (Nozadi et al. 2013 ; Tamis-LeMonda et al. 2001 ), cognitive (NICHD 1998 ; Pearson et al. 2011 ), and socio-emotional development (Bigelow et al. 2010 ; Meins et al. 2001 ). High-quality maternal interaction behavior in very early childhood is mostly described as interaction behavior that provides the child with emotional support in terms of sensitivity, which is defined as a prompt, warm, and contingent reaction to the child’s needs and signals (Ainsworth et al. 1974 ). But stimulating interaction behavior in the sense of scaffolding behavior (Wood 1989 ) is also regarded as high-quality maternal behavior, even in early childhood.

However, maternal interaction behavior cannot be considered separately from the child’s behavior, as interaction is a dyadic process in which both partners’ behavior refers to each other in a reciprocal way. It is well acknowledged that children play an active role in the dyadic interaction process from the very beginning, initiating interactions (van den Bloom and Hoeksma 1994 ) and influencing their occurrence and appearance (Lloyd and Masur 2014 ). Additionally, the child’s temperament (e.g., fear, excitement, protesting, and crying) can become effective in an interaction (Mayer 2013 ).

Accordingly, the NEPS newborn cohort study assesses maternal as well as filial interaction behavior via observation. The mother–child interactions are videotaped in the family home and are rated afterward by trained coders. The interaction itself takes place in a semi-standardized play situation in which the mother and the child play with a standardized toy set (Sommer et al. 2016 ). The play situation is adapted to the different age-related requirements: In the first wave, the mother–child interaction is videotaped for 5 min in which toys from the NEPS toy set are provided. In waves 2 and 3, the mother and child are observed while carrying out a three-bag procedure in which the mother and child played for 10 min with toys from three different bags in a set order (NICHD 2005 ).

Maternal as well as filial interaction behavior is assessed using a macro analytic rating system whereby various interactional characteristics are evaluated on five-point-rating scales with qualitatively specified graduations ([EKIE]; Sommer and Mann 2015 ). The assessment of maternal behavior covers emotional supportive interaction behavior (like sensitivity to distress and non-distress, positive regard for the child, emotionality) and stimulating interaction behavior, including a common rating for language and play stimulation in the first two waves and differentiating language and mathematical stimulation in wave 3 when children were 2 years of age (see Table 3 ). The mother’s intrusiveness, detachment, and negative regard of the child were also rated. The coding of the child’s behavior and emotions focuses on the child’s mood, activity level, social interest in the mother, and sustained attention to objects.

Some selected results

NEPS data are disseminated among the scientific community for analysis and provide an important basis for substantive longitudinal and comparative research. In particular, the various measurements of child characteristics and the detailed measures of the home-learning environment, including the observation of mother–child interactions, enable in-depth analyses to be conducted. In the first section, the results on the reliability and validity of these direct measures and information on the underlying constructs are given, while the second section contains an analysis of early social disparities in the mother’s behavior and child’s development. In addition to using the data from the newborn cohort study (wave 1), Footnote 2 we also draw on the data obtained from the “ViVA project,” Footnote 3 which aims to validate the NEPS measures as one of its objectives.

Reliability and validity of measures of mother–child interaction

Assessing interactions in a large-scale assessment is challenging with regard to validity and reliability of the measurements and ratings. In the NEPS newborn cohort study, these challenges were solved quite successfully: Weighted inter-rater reliability ranged from 84 to 100 % and the ecologic validity of the observed maternal interaction behavior seems to be high, as the data from the ViVA project show that interaction behavior assessed in the semi-structured play situation is comparable to maternal interaction behavior in other situations, i.e., natural feeding and diapering situations (Friedman test comparing differences between interaction situations: χ 2 = 0.74, p = 0.69; Intra-Class-Correlations of maternal interaction behavior in different situations: ICC = 0.68, p < 0.001; n = 23–30; Vogel et al. 2015 ).

Assessing the quality of the mother’s interaction behavior is a core construct of the home-learning environment in the first waves of the newborn cohort study and focuses on socio-emotional aspects as well as on stimulation. Although the assessed indicators address different aspects of maternal interaction behavior, some of them are related to each other (see Table 4 ). It is worth noting that aspects, like intrusiveness, detachment, or negative regard, are not simply the negative end of the more or less pronounced positive dimensions.

From a theoretical point of view, high-quality interaction behavior includes both sensitivity and stimulation behavior. To test the assumption that a rather broad composite indicator of quality of interaction behavior is not only theoretically but also empirically meaningful, a confirmatory factor analysis was conducted (see Fig. 1 ). Items in the socio-emotional domain ( sensitivity to non - distress , Footnote 4 positive regard , and emotionality ) as well as stimulation loaded substantially on quality of interaction behavior (all standardized coefficients above 0.45). Positive regard (0.69) and stimulation (0.77) contributed the most to this factor. Internal consistency was high (Cronbach's α = 0.80).

Results from confirmatory factor analysis for the latent variable Q uality of interaction behavior (Linberg et al. 2016 ). N = 2190; Chi 2 (2) = 16.05, p < .000; RMSEA = 0.06; CFI = .99; based on all German-speaking mother–child interactions in wave 1

One should note, however, that this broad measure of the quality of interaction behavior is only slightly, albeit significantly, related to other aspects of the home-learning environment which were assessed via the parents interview: This includes issues, like the overall amount of joint activities with the child ( r = 0.13, p < 0.000) and special activities (joint picture book reading, r = 0.13, p < 0.000; joint construction play, r = 0.07, p < 0.000; and talking to the child, r = 0.07, p < 0.000).

Reliability and validity of measures of early child characteristics

Given the sample size and household setting, the available data on child characteristics provide a rather detailed insight into the early stages of development, especially with respect to early cognitive capacities and child temperament, which are both measured by multiple indicators. As expected, the first results revealed that these multiple assessment approaches refer to different facets of early child development.

The mother’s report on the child’s temperament deals with the reactions of the child to stressful situations and her/his susceptibility to calming related behavior. In line with previous evidence, this is hardly related to the indicators of child’s temperament, which were assessed in a fairly relaxed mother–child interaction situation ( r = 0.05, p < 0.05; Freund and Weinert 2015 ). At the same time, there is evidence supporting the validity and reliability of these measurements. In the ViVA validation study, the information from the questionnaire has been shown to represent the complete subscales of the IBQ-R from which the items were selected ( r = 0.51 for negative affectivity/0.70 for orienting/regulatory capacity, p < 0.01; Bayer et al. 2015 ). In addition, it is correlated with the children’s reactions to stress-inducing maternal behavior in a still-face-paradigm where the mother is instructed not to react to her child’s signals ( r = 0.34–0.43, p < 0.05; Freund and Weinert 2015 ).

Likewise this can be shown for the assessments of early cognitive capacities/competencies. In the ViVA study, the items on sensorimotor development (assessment of developmental status) were highly correlated with the complete cognition and motor subscales of the Bayley Scales, respectively ( r = 0.48–0.63, p < 0.01; Attig et al. 2015 ). Hence the data on sensorimotor development as well as the data on basic information processing abilities (habituation–dishabituation paradigm; 85 % of the videos codable; non-completion of child <1 %; inter-coder reliability in wave 1: κ = 0.91) both rely on scientifically well-established and successfully applied assessments. Nevertheless, they are hardly correlated with each other and thus seem to cover different aspects of early development ( r = 0.06/0.14, p < 0.05; Weinert et al. 2016 ).

Although the findings always have to be considered within the context in which the assessments were made (e.g., short version/time), the validity of the various measurements of child characteristics and maternal interaction behavior seems to be apparent.

Early roots of social disparities in child development

The data of the NEPS newborn cohort study allow for an analysis of early social disparities with respect to both early child characteristics and their mother’s interaction behavior. Analyses of data from the first assessment wave when children were 6–8 months of age are in accordance with a bioecological model of child development (Weinert et al. 2016 ). As hypothesized, the mother’s interaction behavior in the video-taped mother–child interaction situation varied significantly according to her educational background. With regard to the broad concept of quality of interaction behavior described above, the mother’s education accounted—even in these early phases of child development—for 4 % ( p < 0.001) of the variance within the German subgroup of participants. However, as expected we did not find substantial disparities in child characteristics in early childhood, like basic information processing abilities (habituation–dishabituation paradigm), developmental status (sensorimotor scale), or socio-emotional child characteristics coded during mother–child interaction. Interestingly, some early roots of social disparities were observed in child’s characteristics, such as sustained attention to objects and activity level in mother–child interaction. Notably, as predicted, mother–child interaction turned out to be a mutual endeavor: Interactional characteristics of the child (especially the child’s mood, her/his social interest, and continuing sustained attention to objects) and the child’s temperament (orienting/regulatory capacity) accounted for 29 % ( p < 0.001) of the differences in the overall quality of the mother’s interaction behavior, over and above the control variables (age, sex) and socio-economic conditions (equivalized family income, education of mother, living in partnership) (Weinert et al. 2016 ). Of course, it is still an open question whether the differences observed between children result from former or actual differences in the mother’s behavior or whether the differences in child characteristics and behavior are effective in eliciting their mother’s behavior. In fact, the interrelation between mother and child behavior may vary according to other factors, e.g., additional protective or risk factors (Freund et al. 2016 ). Future findings from the NEPS cohort study of newborns will contribute to explaining how social disparities (suspected at age two and beyond) emerge, how they change over time, which mechanisms contribute to their emergence, and how they impact future development and education.

Prospects and conclusions

Insights and conclusions from longitudinal studies and analyses on the conditions which influence early developmental progress, the emergence of disparities, and their impacts are relevant to educational facilities and social policy and thus to the individual child as well as to society. The present paper focused on the first waves of a large-scale German cohort study of newborns. The various measures will help to better understand the stabilities, changes, and effects of qualitative and quantitative characteristics that early learning environments and other influential conditions have. They also illustrate how the very early outcomes of infant development act as a basis for future development. The child’s development will be measured by testing the development of mathematical, language, and early natural science competencies. Domain-general cognitive abilities will also be assessed (i.e., non-verbal categorization, delay of gratification, verbal memory, and executive functions) along with indicators of socio-emotional development (subscales of the Strength and Difficulties Questionnaire (SDQ), Goodman 1997 ), temperament (subscales of the Children’s Behavior Questionnaire (CBQ), Rothbart et al. 2001 ), and personality (BigFive; short version of the Five Factor Questionnaire for Children (FFFK); Asendorpf and van Aken 2003 ). Learning environments will be measured by interviews and questionnaires which draw on the general framework described above and will be supplemented with assessments of different facets of parenting style. To ensure standardization and reduce administration errors, all tests are carried out on tablet computers in child-oriented, playful settings.

It is worth noting that the kindergarten cohort of the NEPS, which started in 2010, also assessed comparable measures from age five onward. Here a sample of about 3000 children (institutional sample from 279 ECEC centers and 720 groups) was included. Despite differences between cohort designs (e.g., individual vs. institutional sample; child assessments at the children’s home vs. in preschool; playful test administration with vs. without tablet computers; CAPI vs. CATI interviews of the parents) the two cohort studies allow for comparisons while at the same time being characterized by partially complementary strengths and weaknesses (e.g., more elaborate information on home-learning environment vs. on institutional characteristics; extensive assessment of early roots vs. extensive assessment of further development). Among other things, this allows for an in-depth analysis of the interrelation between variations as well as an analysis of the constancies and changes in learning environments and child development, and it also relays important information concerning relevant aspects of early education and how it impacts development, educational career, and future prospects.

A better understanding of the relevant factors and conditions influencing early child development and learning together with their impact on children’s future development, educational success, and well-being is of special importance for ECEC policy. Longitudinal studies are needed because they allow analyses of the mechanism and processes of change in these decisive variables. While in cross-sectional studies causal effects cannot be inferred, longitudinal studies—especially those that enable complex group-specific growth-curve modeling and the modeling of intra-individual change—combined with experimental and quasi-experimental comparisons not only contribute significantly to gaining deeper insights into developmental and educational processes and the conditions influencing them but can also answer important questions relevant to ECEC policy such as how does early compared to late entry to institutional care impact later development in various cognitive and non-cognitive domains? Is early institutional care especially valuable (and to what extent) for different subgroups of children/families (e.g., disadvantaged families, children/families with specific risk factors, children with a migration background, refugees, multilingual children, e.g., children learning German as an (early) second or third language)? What are the determinants of the quality of home-learning environment and its effects on child development and education? What are specific risk (or protective) factors and is it possible to compensate for (or to draw on) them?

Obviously, even longitudinal studies will not deliver straightforward conclusions for ECEC policy. However, they provide an important and essential basis for evidence-based policy by informing about relevant conditions of early child education and how they impact later development (e.g., successful future development, educational drawbacks or opportunities in the social, socio-emotional, and cognitive domain). In fact, it has been suggested that high-quality early education is of special importance from a psychological, an educational, a sociological, and an economic perspective and thus is of significant relevance not only to the individual but also to society as a whole (Heckman 2013 ; Sylva et al. 2011 ). NEPS data are especially helpful when it comes to gaining a better understanding of the development of competencies and decisive conditions over the life course—the samples are carefully drawn, the validity of data is high, and longitudinal data are available in a user-friendly form for analyses and even for international comparisons.

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Authors’ contributions

SW conceptualized and drafted the overall manuscript, sequence alignment, and revisions. In addition she cooperatively conceived the design and assessments of the studies, in particular the assessment of early child competencies, and the analyses of social disparities. AL especially drafted the part on the learning environments and the assessment of mother-child interaction; she conducted the data analyses on mother-child interaction and supported the analyses on ecologic validity of mother-child-interaction. MA contributed to the description of the overall design and did the analyses on early roots of social disparities. She is also involved in the conceptualization and coordination of data assessment of the infant cohort study. TL drafted the part on regulations in Germany and contributed to the description of the assessment of learning environments. He is also involved in the conceptualization of the assessment of this data. JDF did the analyses on the reliability and validity of measures of early child characteristics; he drafted this part and cooperatively planned and conducted the validation study. All authors were involved in the sequence alignment and revisions, and approved the final manuscript. All authors read and approved the final manuscript.

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Weinert, S., Linberg, A., Attig, M. et al. Analyzing early child development, influential conditions, and future impacts: prospects of a German newborn cohort study. ICEP 10 , 7 (2016). https://doi.org/10.1186/s40723-016-0022-6

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DOI : https://doi.org/10.1186/s40723-016-0022-6

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Population Study Article
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Published: 03 March 2021

Associations of media use and early childhood development: cross-sectional findings from the LIFE Child study

Clarissa Schwarzer 1 ,
Nico Grafe 1 ,
Andreas Hiemisch 1 , 2 ,
Wieland Kiess 1 , 2 &
Tanja Poulain 1 , 2

Pediatric Research volume 91 , pages 247–253 ( 2022 ) Cite this article

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Excessive media usage affects children’s health. This study investigated associations between children’s and mother’s media use, parent–child interactions, and early-childhood development outcomes.

Two hundred and ninety-six healthy 2–5-year-old preschoolers (52.4% male, mean age = 3.5 years) and 224 mothers from the LIFE Child cohort study were analyzed. Screen times and parent–child interactions were assessed using standardized parental questionnaires. Developmental skills were investigated using the standardized development test ET 6-6-R.

High screen times in children (>1 h/day) were significantly associated with lower percentile ranks in cognition ( b = −10.96, p < 0.01), language ( b = −12.88, p < 0.01), and social–emotional skills ( b = −7.80, p = 0.05). High screen times in mothers (>5 h/day) were significantly associated with high media use by children (OR = 3.86, p < 0.01). Higher parent–child interaction scores were significantly associated with better body motor ( b = 0.41, p = 0.05), cognition ( b = 0.57, p < 0.01), language ( b = 0.48, p = 0.02), and social–emotional outcomes ( b = 0.80, p < 0.01) in children.

Conclusions

Public health strategies should seek to educate caregivers as competent mediators for their children’s media habits, with focus on the need for children to have frequent parent–child interactions.

High media usage in children is related to poorer cognition, language, and social–emotional skills.

More frequent parent–child interactions are associated with better body motor, cognition, language, and social–emotional skills in children.

High level of media use in mothers is not directly related to children’s development outcomes but is directly related to high media usage of children.

Public health strategies should seek to raise media awareness and management in both parents and children.

Screen media exposure in the first 2 years of life and preschool cognitive development: a longitudinal study

Sudarat Supanitayanon, Pon Trairatvorakul & Weerasak Chonchaiya

Displacement of peer play by screen time: associations with toddler development

Diane L. Putnick, Mai-Han Trinh, … Edwina Yeung

A novel, composite measure of screen-based media use in young children (ScreenQ) and associations with parenting practices and cognitive abilities

John S. Hutton, Guixia Huang, … Richard F. Ittenbach

Introduction

Early childhood is a period in which children reach crucial developmental milestones. 1 Environmental factors may promote or hinder this sensitive process. Among these influencing factors, media exposure has been discussed with regard to its effect on early childhood development. 2 , 3 World Health Organization (WHO) guidelines suggest limiting young children’s screen time to a maximum of 1 h per day. 4 However, digital media have become ubiquitous in young children’s lives 5 and, on average, preschoolers spend >2 h per day using digital media. 6

Several previous studies have focused on the effects of excessive media exposure on children’s health. 7 , 8 , 9 , 10 Longitudinal studies have indicated that greater levels of screen time are not only associated with poorer physical health and obesity in later life 7 but also with lower psychological well-being and mental health issues in school-aged children and adolescents. 9 , 10 Furthermore, previous longitudinal studies have demonstrated that high media use by preschool-aged children is related to conduct problems, hyperactivity, and inattention later in life. 11 , 12 Importantly, longitudinal investigations have found high media exposure to be detrimental to early childhood development. 2 , 3 , 13 In particular, young children’s cognition and language outcomes have been shown to be affected by high media consumption 3 , 13 with toddlers and children from low socio-economic status (SES) families being especially vulnerable. 3 , 13 , 14 Among the possible explanations put forward is that screens displace opportunities for children to communicate, interact, play, and therefore to learn. 2 , 3 In contrast, other cross-sectional and longitudinal studies have found varied associations between preschooler’s and elementary-schooler’s media usage and development outcomes. 14 , 15 , 16 Specifically, a stimulating environment, 14 high-quality media content, 15 and parental co-viewing 16 have been identified as being beneficial for language and social–emotional outcomes in young children. In more recent literature, a meta-analysis has discussed touchscreen devices and interactive apps in terms of their potential for promoting early academic skills 17 and a cross-sectional investigation found associations between fine motor abilities and early touchscreen scrolling in toddlers. 18 In addition to the effects of children’s own media habits, previous cross-sectional and longitudinal studies have shown associations between parent’s media usage and behavioral problems in children <10 years of age. 19 , 20 Parental media usage has been shown to disrupt parent–child interactions, 21 with parents being slower, less attentive, and more passive in reacting to their children. 22 Moreover, previous cross-sectional studies have found that parents’ conceptions play an important part in mediating preschool-aged children’s media habits 23 , 24 and that parent–child interactions can moderate the relationship between high media exposure and young children’s executive functioning. 25

Given the rapidly changing nature of digital media, for the study discussed here, we decided to investigate not only the use of television by German preschoolers and their mothers but also that of other forms of screen-based media (e.g., mobile phone/smartphone, personal computer (PC)/laptop/tablet, and game consoles). While former studies relied on screening tests based on parental reports 2 or focused on single domains of childhood development, 3 , 13 , 14 we used a detailed, standardized development test to evaluate associations between children’s media use and multiple dimensions of childhood development. Furthermore, as little is known about the relationships between mothers’ overall media use and their children’s development outcomes, we investigated these associations too. Finally, we included parent–child interactions in our analysis as we were interested in comparing the way children and mothers’ media behavior related to development outcomes to the way activities based on parent–child interaction related to such outcomes and whether these associations were independent from or potentially moderated by each other. Based on a number of previous longitudinal studies, we hypothesized negative associations between high overall screen time in children and early childhood development outcomes. Accordingly, we hypothesized that high media usage by mothers is negatively associated with early childhood development outcomes. In contrast, we hypothesized positive associations between the frequency of parent–child interactions and children’s development outcomes.

Methods and measurements

Our research was conducted within the framework of the LIFE Child study, which is based at the Leipzig Research Center for Civilization Diseases at Leipzig University, Germany. 26 , 27 LIFE Child is a cohort study that follows healthy children from the prenatal period to early adulthood and seeks to investigate environmental and lifestyle influences on young people’s health and development. All healthy subjects between the ages of 2 and 5 years who performed a specific development test were included in this analysis. Children born prematurely before the end of the 37th week of pregnancy (<37 + 0) were excluded. In cases of siblings, we included only one, randomly selected child from each family. For children with multiple visits, we included only one, randomly selected visit in our analysis. Data were collected between July 2017 and August 2019. The final sample included 296 children (52.4% boys, mean age = 3.5 years) and 224 mothers. SES was assessed using the Winkler index, whereby values assigned to parental education, parental occupation, and household equivalent income are combined to give an index score between 3 and 21 inclusive, with higher scores indicating higher SES. 28 , 29 Using categories based on a representative German sample, 28 3% of our sample were placed in a low SES group (index score 3–8.4), 44% in a middle SES group (index score 8.5–15.4), and 53% in a high SES group (index score 15.5–21). Parents gave informed written consent before their children were included in the study. The study protocol was approved by the Ethics Committee of Leipzig University (Reg. No. 264-10-19042010), and the study was performed in accordance with the Declaration of Helsinki.

Media use of children and mothers

The researchers assessed the children and mother’s media use using standardized parental questionnaires. The questionnaires were designed by the authors by adapting a previous questionnaire, which was lifted from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). 30 The earlier version and its counterpart in the KiGGS study have been used in previous research, 10 , 11 , 31 as has the adapted version used in our study. 20 Parents were asked to report the time they and their children spend on average, on a daily basis, engaged with specific media devices. Leisure media usage was included, but media use at work and media not involving a screen (e.g., listening to music) were excluded. The questionnaires provided a range of possible answers from “not at all” to “>4 h per day”. The included devices were television/video/DVD (excluding computer screens), game console, computer/laptop/tablet with and without internet access, and mobile phone/smartphone with and without internet access.

Adapting the analysis method used in a previous study, 20 the answers were converted into durations (hours/day) as follows: “not at all” = 0, “approximately 30 min/day” = 0.5, “approximately 1–2 h/day” = 1.5, “approximately 3–4 h/day” = 3.5, “>4 h/day” = 5. Media usage with and without internet access was added together. We added weekday and weekend usage using the formula ((usage on weekdays × 5) + (usage at weekends × 2))/7. Total screen time included durations of television/video/DVD, game console, computer/laptop/tablet, and mobile phone use. We categorized the total screen times reported for children as “normal” or “high” based on the WHO recommendation that young children should not exceed 1 h of screen time over the course of a day. 4 We are not aware of any recommendations relating to total screen use by mothers. Therefore, the reported total screen times for mothers were categorized as “high” when they were greater than the average in the present sample. On this basis, a high reported total screen time for mothers was defined as >5 h/day. Hereafter, we will use the simplified terms of high screen time or high media usage when referring to high reported total screen time or high reported total media usage, respectively.

Parent–child interactions

Interaction between parents and children was assessed using a questionnaire answered by parents that we adapted from the German version of the questionnaire on preschool-aged children’s activities in the family (Roßbach, H. G. & Leal, T. B., Mütterfragebogen zu kindlichen Aktivitäten im Kontext des Familiensettings (AKFRA). Deutsche Fassung des Questionnaire on Preschool-Aged Children’s Activities in the Family, 1993, unpublished manuscript). It covers 11 types of activity involving interaction between the child and all caregivers that belong to the child’s household: telling/reading a story, singing, movement-based play, drawing, building-based play, doing a jigsaw, ball play, role play, language play, number play, and talking about problems. The reported frequency for each activity was converted into a score, as follows: “once/month” = 1, “every 2 weeks” = 2, “once/week” = 3, “more often than once/week” = 4, “daily” = 5. The scores for each activity type were added to obtain an overall interaction score (max = 55). In our sample, Cronbach’s alpha was 0.76, indicating that the internal consistency of the questionnaire was satisfactory.

Early childhood development

Early childhood development was assessed using the general development test “ET 6-6-R”, whose full German title translates as “Development Test 6 Months to 6 Years - Revision”. 32 This standardized development test for infants, toddlers, and preschoolers aims to establish a differentiated developmental status and to detect developmental disorders or delays. The tasks used in the ET 6-6-R are based on “boundary stones,” i.e. skills targets that 90–95% of a normative, culturally similar population of children can be expected to have acquired by a certain age. 33 The boundary stones themselves relate to established milestones of early childhood development. Body motor, hand motor, cognition, language, and social–emotional skills are evaluated, and the results converted into percentile ranks relative to a standardization sample. The ET 6-6-R comprises 79 parental questions and 166 tasks, with different requirements set for 13 age ranges, with the skills tested in older children building progressively on those tested in younger children. To ensure consistency in the test conditions, precise instructions are given on the setting, the task itself, and how it is to be evaluated. 34 The ET 6-6-R has been also evaluated in terms of additional quality criteria. Specifically, in previous studies, it has been compared to the Bayley Scales of Infant Development BSID II, the SETK-2 language development test, 35 and the WPSSI-IV intelligence test for preschoolers. 36 These evaluations indicated significant intercorrelations within the ET 6-6-R as well as intercorrelations between the ET 6-6-R and the other tests, demonstrating a satisfactory level of internal and external validity. Moreover, language and cognition outcomes assessed by means of the ET 6-6-R were found to be reliable in predicting children’s intelligence quotients. 36

Data analysis

We performed our data analysis using R, version 3.5.3, 37 using linear or logistic regression models to analyze associations between children’s media use, mothers’ media use, and parent–child interaction scores, and using linear regression models to investigate associations between these parameters and early childhood development outcomes. The percentile ranks in the single domains of development were included as outcome variables and children’s media use, mothers’ media use, and parent–child interaction scores were included as exposure variables. First, we calculated separate models for each exposure variable. Exposure variables that showed significant associations with at least one outcome variable were included together in the same model (multiple analyses) to test whether the associations were independent from one another. Furthermore, we investigated interactions between these exposure variables to examine whether the association between one pair of variables was moderated by another variable (moderator analysis).

All models were adjusted for the control variables of child age, child sex, and family SES and were evaluated for interactions with these control variables. We decided that interactions would be included in the final model if they satisfied certain preconditions with regard to significance ( p < 0.05) and preservation of model quality (variance inflation factor <5). However, none of the interactions reached significance or limited the quality of the model by causing severe variance inflation. As such, the associations can be assumed not to differ depending on child age, sex, or SES. Strengths of association were described using non-standardized regression coefficients ( b ) or odds ratios (OR). The significance level was set to α = 0.05.

Description of the study sample

Children’s media use, mothers’ media use, parent–child interaction scores, and the early childhood development percentiles are summarized in Table 1 . The mean total screen time for the children was 0.75 h/day (SD = 0.70) with “high” screen times (≥1 h/day) reported for 24% of children. The mean total media use among mothers was 4.25 h/day (SD = 2.72) with “high” use of digital screens (>5 h/day) reported for 27% of mothers. The most common form of media use by children was watching television (0.55 h/day, SD = 0.56), whereas other digital devices were used rarely. The media device used most heavily by mothers was the mobile phone (1.63 h/day, SD = 1.40).

The mean parent–child interaction score was 40.49 (SD = 7.17) indicating that each of the 11 activities involving both parents and children occurred on average more than once a week. The most common of these shared activities was telling/reading a story, which on average took place on a daily basis, followed by singing, moving-based play, building-based play, role play, and drawing, which on average took place more than once a week. Ball play, talking about problems, doing a jigsaw, and language play were reported as taking place once a week. The least frequent of the shared activities was number play, which on average took place once every 2 weeks.

Importantly, mothers with high media use were four times more likely than the other mothers to have children with high media use (OR = 3.86, 95% confidence interval (CI) 1.80 to 8.26, p < 0.01). In contrast, high screen times among mothers showed no significant association with the reported amount of parent–child interactions ( b = −0.53, 95% CI −2.75 to 1.69, p = 0.64). Furthermore, high media use by children was not significantly associated with the amount of reported parent–child interactions ( b = −1.60, 95% CI −3.65 to 0.45, p = 0.13).

Associations between children’s media use and early childhood development outcomes

High screen times in children (>1 h/day) were significantly associated with lower percentile ranks in cognition ( b = −10.96, 95% CI −18.69 to −3.24, p < 0.01), language ( b = −12.88, 95% CI −20.19 to −5.57, p < 0.01), and social–emotional skills ( b = −7.80, 95% CI −15.45 to −0.14, p = 0.05). In contrast, there were no significant associations between high media use by children and body motor ( p = 0.40) or hand motor skills ( p = 0.61). Figure 1 shows the children’s estimated percentile ranks by media use level (normal or high). By way of example, children with high media usage (>1 h/day) were estimated to score 10.96 points lower on the cognition scale and 12.88 points lower on the language scale than children with normal media usage.

For children, high media use was defined as >1 h/day and included TV, PC/laptop/tablet, mobile phone, and game console use. Asterisk (*) indicates the level of significance 0.05.

Because high screen times in children (>1 h/day) were significantly associated with lower cognition, language, and social-emotional outcomes, we calculated separate models for usage of different types of media device. Since no specific guidelines exist for how long each media device should be used, we categorized reported TV usage times >0.5 h/day as high. For usage involving a games console, mobile phone, or PC/laptop/tablet, we compared users with non-users, i.e., usage >0 h/day was considered high. The distributions of normal versus high media usage times for the single media devices are presented in Supplementary Table S1 . Supplementary Table S2 shows associations with the development outcomes cognition, language, and social–emotional skills. Most importantly, high TV screen time (>0.5 h/day) was significantly associated with lower cognition ( b = −11.25, 95% CI −18.33 to −4.17, p < 0.01), and language outcomes ( b = −7.28, 95% CI −14.09 to −0.47, p = 0.04), whereas high usage times (>0 h/day) involving a game console, mobile phone, or PC/tablet/laptop showed no significant associations with cognition, language, and social–emotional skills.

Associations between mothers’ media use and early childhood development outcomes

High screen times among mothers (>5 h/day) showed no significant associations with percentile ranks in body motor ( p = 0.81), hand motor ( p = 0.35), cognition ( p = 0.27), language ( p = 0.14), or social–emotional skills ( p = 0.97). Figure 2 displays the estimated percentile ranks of children by mother’s media use level (normal or high).

For mothers, high media use was defined as >5 h/day and included TV, PC/laptop/tablet, mobile phone, and game console usage.

Associations between parent–child interactions and early childhood development outcomes

Each additional point on the parent–child interaction score was associated with an increase of 0.41 percentile ranks on the body motor scale (95% CI 0.01–0.82, p = 0.05), an increase of 0.57 percentile ranks on the cognition scale (95% CI 0.14–1.00, p < 0.01), an increase of 0.48 percentile ranks on the language scale (95% CI 0.07–0.90, p = 0.02), and an increase of 0.80 percentile ranks on the social–emotional scale (95% CI 0.38–1.22, p < 0.01). For example, for children with a relatively low interaction score of 30 (indicating that each of the eleven activities involving parents and children occurred almost once a week), the estimated score on the cognition scale was 39.52 points, in contrast to children with a relatively high interaction score of 50 (indicating that each of the 11 activities involving parents and children occurred almost daily), who scored 50.94 points on the cognition scale. There were no significant associations between parent–child interaction scores and hand motor skills ( p = 0.80). Associations between early childhood development outcomes and, variously, children’s media use, mothers’ media use, and parent–child interaction scores are summarized in Table 2 .

Associations between children’s media use, parent–child interaction scores, and early childhood development outcomes (multiple and moderator analysis)

As high media use by children and parent–child interaction scores were associated with child development in at least one domain, we included these parameters in multiple regression analyses (multiple analysis) and investigated whether associations between a particular parameter and developmental outcomes were moderated by another parameter (moderator analysis). In the multiple analysis, negative associations between high screen time in children and their development outcomes remained significant for cognition skills ( b = −10.13, 95% CI −17.83 to −2.44, p = 0.01), and language skills ( b = −12.20, 95% CI −19.50 to −4.90, p < 0.01). The negative associations between high screen time in children and their social–emotional skills did not remain significant ( b = −6.57, 95% CI −14.10 to 0.97, p = 0.09) after controlling for parent–child interactions. The positive associations between parent–child interactions and early childhood development outcomes remained significant for body motor skills ( b = 0.43, 95% CI 0.03 to 0.84, p = 0.04), cognition skills ( b = 0.52, 95% CI 0.09 to 0.95, p = 0.02), language skills ( b = 0.42, 95% CI 0.02 to 0.83, p = 0.04), and social–emotional skills (0.77, 95% CI 0.35 to 1.19, p < 0.01) after controlling for high media use by children. The moderator analysis revealed no significant interactions between children’s media use and parent–child interactions in relation to body motor skills ( b = −0.03, 95% CI −0.93 to 0.88, p = 0.96), cognition skills ( b = −0.13, 95% CI −1.09 to 0.82, p = 0.78), language skills ( b = −0.61, 95% CI −1.52 to 0.30, p = 0.19), and social–emotional skills ( b = −0.43, 95% CI −1.37 to 0.51, p = 0.37).

Principal findings

In our present study, German preschoolers on average spent approximately 45 min each day engaged with digital media. As such, the average screen time was within the WHO’s recommended limit for preschoolers of a maximum of 1 h/day media exposure. 4 However, 24% of children exceeded the recommended level. In line with our hypothesis, high media use by children was related to poorer cognition, language, and social–emotional development outcomes. A more detailed analyses revealed that especially high TV usage in children was associated with poorer cognitive and language development outcomes. In contrast, high media use by mothers (>5 h/day) was not directly related to early childhood development outcomes but was significantly associated with high media use in children. Increasing parent–child interactions were associated with better body motor, cognition, language, and social–emotional outcomes in children.

Associations of media use, parent–child interactions, and early childhood development

Consistent with previous studies, our findings suggest adverse effects of high media exposure on cognition, language, and social–emotional skills in children. 2 , 3 , 13 Possible reasons for this are that high media usage displaces children’s opportunities to communicate, interact, and play and that related conduct problems, such as hyperactivity and inattention, 11 , 12 reduce children’s ability to learn. Looking at the usage of different media devices, we can attribute negative associations between high media usage in children and their cognition and language outcomes primarily to high TV screen time, there being little use of other media devices. In 2–5-year-old children, TV is still the most used medium. The fact that we did not find associations between the use of other media devices and development outcomes might be explained by the infrequent use (rather than insignificance) of these media devices. Moreover, multiple and moderator analyses revealed that negative associations between high media usage in children and cognition and language skills were independent from and did not differ depending on the frequency of parent–child interactions. Unlike the findings of prior studies, 25 these results suggest that parent–child interactions may not serve to moderate the effects of high media usage with respect to children’s developmental outcomes. In contrast, our findings do support the idea that screen-based media usage offers suboptimal stimulation for cognitive and linguistic development, 38 with this appearing to be independent of the effects of stimulating forms of parent–child interaction. In our sample, body and hand motor skills were not affected by high screen times in children. Possible reasons are that children remain physically active despite their high media usage and increasingly use mobile devices with interactive apps that can be carried around easily. 18 Overall, our findings indicate that exposing children to >1 h of digital media interferes with sensitive development processes during infancy.

Previous studies have suggested that parental distraction by media devices could have detrimental effects on parent–child interaction. 19 , 20 , 21 , 22 In our analysis, high media use in mothers was not associated with less frequent parent–child interactions nor with poorer development outcomes in children. However, the questionnaire used did not assess the media use of mothers in the presence of the child or during shared activities. As they stand, these findings imply that media use by mothers does not displace shared activities with their children and does not directly affect development outcomes in children. Nevertheless, mothers who exhibited high levels of daily digital media use were more likely to have children with high screen times. Therefore, mothers should be aware that, in addition to their perception of media use, 22 , 23 their personal media habits operate as mediators for their children’s media use. Finally, we observed positive associations between parent–child interaction scores and body motor, cognition, language, and social–emotional outcomes in the children. These were independent from the children’s level of media use. This implies that shared activities involving parents and children stimulate and protect sensitive development processes in children.

Strengths and weaknesses

The strengths of our study include the fact that it offers an up-to-date assessment of young children’s media use, mothers’ media use, and parent–child interactions. Furthermore, the ET 6-6-R belongs to the newest generation of development tests for German speaking countries and addresses language and cognition outcomes, which are reliable predictors for children’s intelligence quotients. 36

The limitations include the fact that it relies on reports of media usage based on maternal perceptions and is thus susceptible to self-presentation biases. Furthermore, the type of media content and the context in which media devices were used (in co-use with a caregiver or alone) were not evaluated. The categories of “high” and “normal” media exposure in mothers were based on observations in this study, since we are not aware of any available guidelines on media consumption for mothers. Moreover, the parent–child interaction questionnaire did not assess durations or quality of interactions and identify the person(s) the activity was shared with (mother or father). Finally, the sample was shifted to higher levels of SES and is not representative of German families.

Implications and future research

Given the high number of children exceeding the recommended limits of 1 h of media use per day and the adverse effects of high media consumption on children’s development, the scope of educational campaigns and public health strategies should include the question of media awareness and management in both parents and children. In doing so, policymakers, health care professionals, and educators need to consider strategies for encouraging appropriate, guided media use with adequate safeguards in family and preschool-education settings. Therefore, the focus should not only be on implementing rigid daily limits on screen time but also on the communal, interactive use of high-quality media content. 14 , 16 Most importantly, education is needed for caregivers, in order that they become competent mediators for their children’s media habits, with sufficient focus on the need for children to have frequent parent–child interactions.

Further investigations should examine the long-term effects of digital media on childhood development, with a focus on protective factors such as parental mediation and co-use and the potential impacts of interactive touchscreen devices in young children.

Our findings suggest that >1 h of daily media usage in preschoolers is associated with poorer cognition, language, and social–emotional skills, whereas parent–child interactions are related to better body motor, cognition, language, and social–emotional skills in children. Moreover, our study indicates that high levels of media use in mothers is not directly related to children’s development outcomes but is directly related to high media usage of children.

With regards to the international trend that has seen young children become increasingly involved with the digital world, caregivers need to be sensitized and educated as mediators and role models for their children’s media habits. As part of this process, caregivers will be required to moderate their own media habits, with a view to offering their children more in the way of parent–child interactions.

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Acknowledgements

This publication was supported by LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig. LIFE receives funding from the European Union via the European Social Fund (ESF) and the European Regional Development Fund (ERDF) and from the Free State of Saxony within the framework of the excellence initiative. C.S. received a doctoral scholarship from the Faculty of Medicine at the Leipzig University.

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Clarissa Schwarzer, Nico Grafe, Andreas Hiemisch, Wieland Kiess & Tanja Poulain

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C.S., N.G., W.K., and T.P. contributed substantially to conception and design, acquisition of data, and/or analysis and interpretation of data. C.S. prepared the original draft and N.G., A.H., W.K., and T.P. revised it critically for important intellectual content. All authors gave final approval of this version to be published.

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Schwarzer, C., Grafe, N., Hiemisch, A. et al. Associations of media use and early childhood development: cross-sectional findings from the LIFE Child study. Pediatr Res 91 , 247–253 (2022). https://doi.org/10.1038/s41390-021-01433-6

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The HEALthy Brain and Child Development Study

The brain develops rapidly during pregnancy, through early childhood, and into adolescence, supporting a child’s cognitive and emotional development. This rapid growth also represents a highly vulnerable time where a variety of environmental exposures can have a large and enduring impact. Environmental exposures during pregnancy and infancy are also likely to have a significant impact on early brain development and long-term health outcomes.

For example, substance use during pregnancy, throughout breastfeeding, and while parenting has the potential to profoundly affect a child’s development in a variety of ways. The alarming increase in opioid use during pregnancy and the sharp rise in babies born with neonatal abstinence syndrome over the past decades show the urgent need to better understand the complex ways in which exposure to substances during pregnancy affects child health outcomes . 1

Other environmental factors also concern scientists, such as exposure to toxins, structural racism, SARS-CoV-2 and pandemic-related stress, as well as access to healthcare. Research suggests these may influence child development, including brain growth and physical development. 2-5 However, the scarcity of research on normal brain development from birth through adolescence from a large, diverse group of children has limited researchers’ ability to better understand how disruptions and experiences during early periods of growth impact individual development.

To better understand how these factors, alone and in combination, interact with genetics and other biological influences to affect a child’s mental and physical health over time, NIH is conducting the HEALthy Brain and Child Development (HBCD) Study .

What is the HBCD study?

The HEALthy Brain and Child Development (HBCD) Study is a large longitudinal study that will enroll around 7,500 pregnant volunteers from 25 research sites across the United States. The study will collect information about participants during pregnancy, at birth, and through early childhood. While most of the participants are expected to be recruited from the general population of pregnant people, a subset will include those whose babies were exposed during pregnancy or infancy to prescription and illicit opioids, cannabis (marijuana), stimulants, alcohol, and tobacco/nicotine; as well as participants from comparable environments who did not use substances during pregnancy. The HBCD Study is part of the National Institutes of Health (NIH) HEAL (Helping to End Addiction Long-term SM ) Initiative , launched in April 2018 to investigate evidence-based ways to end the national opioid overdose crisis .

Why is it important to study brain development?

The brain undergoes rapid development prenatally, through early childhood and into adolescence. This rapid growth also represents a highly vulnerable period where a variety of biological and environmental factors can have a large and enduring impact. 6-12 The HBCD study will allow scientists to better understand the complex interplay of biological and environmental factors that shape growing brains at the earliest stages.

What information will researchers collect?

Like the NIH’s Adolescent Brain Cognitive Development (ABCD) study , which is following more than 10,000 pre-adolescents through young adulthood, HBCD will collect a wide array of variables to chart the children’s development. Information collection will start in pregnancy, including a pregnant participant’s health history. Over the children’s first decade of life, scientists will collect data from regular, noninvasive medical imaging of their brains, as well as medical history; family history; biospecimens; and information on social, emotional, and cognitive development.

The study will also collect information related to COVID-19. For example, researchers at Oklahoma State University for Health Sciences conducted a feasibility study to assess the ability of pregnant people and new parents (both with and without histories of substance use disorders) to access treatment and mental health services during the COVID-19 crisis. Researchers at 17 HBCD sites across the country have been examining COVID-19’s impact on birth outcomes, parenting stress, and early childhood developmental milestones.

What can we learn from the HBCD study?

The HBCD study aims to help researchers:

Better understand how the brain develops during pregnancy, infancy, and childhood.
Discern how early exposure to opioids and other substances, including alcohol, tobacco, and cannabis, may affect development.
Study how other environmental factors, including socioeconomic status, neighborhood safety, and family stability affect early development.
Investigate the impact of traumatic events on brain development, including those resulting from the COVID-19 pandemic, parental loss, neglect, housing or food insecurity.
Uncover risks for substance use, mental disorders, and other behavioral and developmental problems that emerge during childhood and adolescence, and protective factors that promote resilience and healthy development.
Explore how interventions and services provided to pregnant participants, such as substance use disorder treatment or social/economic support, may help protect children from the adverse effects of exposure to drugs or other environmental stressors.
Develop, improve, and validate brain imaging technologies for infants. These include magnetic resonance imaging (MRI) scans looking at the brain’s structure, and newer methods that assess brain function and the connections between brain regions that are important for optimal brain functioning.

How is the study funded?

The HBCD study is funded as a partnership between the NIH HEAL Initiative SM and 11 NIH Institutes, Centers, and Offices with an interest in understanding brain and child development.

These are:

National Institute on Drug Abuse (NIDA)
National Institute of Mental Health (NIMH)
National Institute of Neurological Disorders and Stroke (NINDS)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
National Institute of Environmental Health Sciences (NIEHS)
National Institute on Minority Health and Health Disparities (NIMHD)
Environmental influences on Child Health Outcomes (ECHO) Program
Office of Behavioral and Social Sciences Research (OBSSR)
Office of Research on Women’s Health (ORWH)

New Study Informs Research on Child Development and Learning in Conflict-Affected Areas

A new analysis of existing research by Global TIES for Children, a research center supported by the NYU Abu Dhabi Research Institute and NYU New York, offers insights for developing more impactful studies and programs.

To provide effective aid to children who live in areas of conflict it is necessary to understand precisely how they have been impacted by the crises around them. One area of importance is the effect of conflict and trauma on a child’s development and education.

In a new research article, Global TIES for Children researchers J. Lawrence Aber , Carly Tubbs Dolan, Ha Yeon Kim, and Lindsay Brown, present a review of opportunities and challenges they have encountered in designing and conducting rigorous research that advances our understanding of this effect. Global TIES for Children, an international research center based at NYU Abu Dhabi and NYU New York, generates evidence to support the most effective humanitarian and development aid to promote children’s academic and socio-emotional learning.

This review focuses on their efforts to test the effectiveness of educational programming that incorporates skill-targeted social and emotional learning (SEL) programs. SEL programs are designed to help participants apply knowledge and skills towards managing their stress and feelings, establishing positive relationships, achieving goals, and making responsible decisions.

The results of the paper titled, Children's Learning and Development in Conflict- and Crisis- Affected Countries: Building a Science for Action , published in the Cambridge University Press journal Development and Psychopathology, indicated positive impacts of remedial education and social and emotional learning programs on academic skills, and presented key themes to be addressed when designing future refugee education programming and related research.

Aber and colleagues note the importance of long-term partnerships between researchers, practitioners, policymakers, and donors to provide higher quality evidence for decision making about programs and policies. Additionally, context-relevant measures and research methods are needed to enable the study of under-resourced, crisis-affected communities.

The researchers also argue for a global research effort on building cumulative and revisable developmental science that is based on the children’s lived experience in their own culture and context and grounded in ethical principles and practical goals.

The paper’s findings will also guide the development of effective research that can better study various communities and conditions.

“It is our hope that the findings of this paper can spark a conversation about how best to assess and meet the needs of children in conflict-affected areas, and can allow for the development of more effective aid programs,” said Aber.

Building on a research-practice partnership that started in 2010, Global TIES for Children and the International Rescue Committee have collaborated to marry innovative educational program delivery and rigorous research. Global TIES for Children NYU Global TIES for Children is an international research center embedded within NYU’s Institute of Human Development and Social Change (IHDSC) and supported by the NYU Abu Dhabi Research Institute and NYU New York. Established in 2014, Global TIES for Children was developed to lead efforts in generating rigorous evidence to support the best and most effective humanitarian and development aid. To date, Global TIES for Children has secured a position at the front lines of advances in methods and measures for assessing child development and for understanding variation in program impacts at multiple levels in low-income and crisis-affected contexts.

About NYU Abu Dhabi NYU Abu Dhabi is the first comprehensive liberal arts and science campus in the Middle East to be operated abroad by a major American research university. NYU Abu Dhabi has integrated a highly-selective liberal arts, engineering and science curriculum with a world center for advanced research and scholarship enabling its students to succeed in an increasingly interdependent world and advance cooperation and progress on humanity’s shared challenges. NYU Abu Dhabi’s high-achieving students have come from more than 115 nations and speak over 115 languages. Together, NYU's campuses in New York, Abu Dhabi, and Shanghai form the backbone of a unique global university, giving faculty and students opportunities to experience varied learning environments and immersion in other cultures at one or more of the numerous study-abroad sites NYU maintains on six continents.

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Children’s zero-sum perceptions (4-9 years) This study examines whether children are capable of making zero-sum judgements, and if they perceive exchanges involving various resources and social constructs (such as love, power, toys) as zero-sum. Parents and children will join the study via Zoom.

Meaninglessness (4-9 years) This study examines children’s higher order capabilities, specifically if they are sensitive to a lack of meaning, or “meaninglessness” in various activities. Parents and children will join the study via Zoom.

Evaluating Social Contribution (4-9 years) This study assesses children’s social evaluations of social contributions, to understand whether children are sensitive to and value making bigger social impacts, beyond the family. Parents and children will join the study via Zoom.

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Social Network Survey (6 months – 5 years) We are interested in children’s social networks before and during the COVID-19 pandemic to track how the people children interact with changes over time! We are looking for parents to fill out a short online questionnaire and survey that should take less than 30 mins to complete.

Hi Stranger (17-19 months) This study is investigating how toddlers interact with strangers over virtual formats such as videos. We are interested in whether toddlers will engage with a stranger over the computer and whether we can systematically measure how much they engage with a stranger. You can access the study on our partnership website with MIT called Lookit.

VPEEG (8-11 months) In this study, we are investigating how babies’ brain activity changes according to the language people speak. To measure babies’ brain activity, they wear an EEG hat that records their brain waves. This is a passive, baby-friendly method used to record brain activity. This is an in-person study and will involve a one-time visit to our lab in Hyde Park, Chicago.

ManyBabies (18-22 months) This study is interested in what toddler’s understand about what others know, and how that may influence others’ behavior. To measure your child’s understanding of what others know, we use an eye-tracker that uses cameras to record where your child is looking as they watch brief movies of animated animals. This is an in-person study and will involve a one-time visit to our lab in Hyde Park, Chicago.

Share with Me (15-17 months) In this study, we are interested in how information about whether two people are friends will influence children’s expectations of whether people will share things equally. Our future goals are to examine how relationship or friendship information about two distributors might change children’s expectations of equality. You can access the study on our partnership website with MIT called Lookit.

The Social Kids Lab Online

The Social Kids Lab Online is a collaboration between two research groups: Development of Social Cognition ( DSC ) Lab led by Professor Katherine D. Kinzler and the Developmental Investigations of Behavior and Strategy ( DIBS ) Labs led by Professor Alex Shaw.

Our studies currently focus on many different social ideas that develop during childhood. When your child participates, they will most likely do two or three short study games that investigate a variety of topics. Each study game is designed to be entertaining and fun for kids, similar to something they might read or see at school.

Our study topics currently include how children think about:

Leadership Kinship Perspective-taking Role models Social values Reputation Fairness, morality, and decision making Resource distribution Voting procedures Rules and rule-making Technology and robots Judgments based on language characteristics and Group communication

The study games typically involve seeing pictures of people, hearing different stories, and answering questions about what they think. We show our study materials through screen-sharing, and the researcher on the video call is usually a PhD student or undergraduate research assistant.

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More Screen Time Means Less Parent-Child Talk, Study Finds

By Emily Baumgaertner

According to new research, “technoference” is real.

Toddlers who are exposed to more screen time have fewer conversations with their parents or caregivers by an array of measures. They say less, hear less and have fewer back-and-forth exchanges with adults compared with children who spend less time in front of screens.

Those findings, published on Monday in the journal JAMA Pediatrics , make up one of the first sets of longitudinal evidence to confirm an intuitive reality: Screens are not just linked to higher rates of obesity, depression and hyperactivity among children; they also curb face-to-face interactions at home — with long-term implications that could be worrisome.

Some Background: What interrupts household chatter?

Researchers have long known that growing up in a language-rich environment is vital for early language development. More language exposure early in life is associated with social development , higher I.Q.s and even better brain function.

Given the value of such exposure, researchers in Australia were eager to investigate potential factors within the home environment that could be interrupting opportunities for parents to interact verbally with their children. Previous studies on the impact of technology mostly examined a parent’s use of a mobile device, rather than a child’s use of screens, and relied on self-reported measures of screen time rather than automated monitoring.

What Researchers Found: Every minute counts.

The new study, led by Mary E. Brushe , a researcher at the Telethon Kids Institute at the University of Western Australia, gathered data from 220 families across South Australia, Western Australia and Queensland with children who were born in 2017. Once every six months until they turned 3, the children wore T-shirts or vests that held small digital language processors that automatically tracked their exposure to certain types of electronic noise as well as language spoken by the child, the parent or another adult.

The researchers were particularly interested in three measures of language: words spoken by an adult, child vocalizations and turns in the conversation. They modeled each measure separately and adjusted the results for age, sex and other factors, such as the mother’s education level and the number of children at home.

Researchers found that at almost all ages, increased screen time squelched conversation. When the children were 18 months old, each additional minute of screen time was associated with 1.3 fewer child vocalizations, for example, and when they were 2 years old, an additional minute was associated with 0.4 fewer turns in conversation.

The strongest negative associations emerged when the children were 3 years old — and were exposed to an average of 2 hours 52 minutes of screen time daily. At this age, just one additional minute of screen time was associated with 6.6 fewer adult words, 4.9 fewer child vocalizations and 1.1 fewer turns in conversation.

What Happens Next: A look at “co-viewing.”

Lynn Perry, as associate professor of psychology at the University of Miami who was not involved in the study, said she was impressed by the way the study employed an objective measuring tool to demonstrate associations that “had previously only been assumed.”

Dr. Perry, who studies language and social interaction among preschool children, said experts in the field should next investigate how media designed to be viewed by parents and children together “might allow for more conversational turn-taking and bypass some of the negatives of screen time.”

Sarah Kucker, an expert in language development and digital media at Southern Methodist University in Dallas who was also not involved in the study, called the analysis “impressive” but emphasized that understanding the nuances of how and when media is used in a larger and more diverse population is “a critical next step.”

“Media is not going away,” Dr. Kucker said, “but paying attention to how and when media is used may be a good future avenue.”

Emily Baumgaertner is a national health reporter for The Times, focusing on public health issues that primarily affect vulnerable communities. More about Emily Baumgaertner

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Study eases concern at antipsychotics use in pregnancy

The use of antipsychotics during pregnancy isn't linked to childhood neurodevelopmental disorders or learning difficulties, UNSW Sydney-led study shows -- giving assurance to those concerned about continuing their medications during pregnancy.

Antipsychotics -- a branch of medication designed to treat schizophrenia and bipolar disorder -- are important tools for mental health care management. They work by blocking the effect of dopamine, which can help reduce psychotic symptoms such as hallucinations or delusions.

These versatile medications are also widely used for other mental health conditions and developmental disorders, like anxiety, depression, autism spectrum disorder, and insomnia.

But many women and pregnant people using these medications may feel concerned about the potential risks they pose to their unborn baby.

A new international study led by UNSW Sydney, published today in eClinicalMedicine , tracked the long-term risk of a child developing neurodevelopmental disorders and learning difficulties after being exposed to antipsychotics in the womb.

The findings show there's little to no increased risk of the exposure leading to intellectual disability, poor academic performance in maths and language, or learning, speech and language disorders.

"The findings are really reassuring for both women managing these psychiatric conditions during pregnancy and their providers," says Dr Claudia Bruno, a pharmacoepidemiologist based at UNSW's School of Population Health and lead author of the study.

"There's no increased risk when taking the medication during pregnancy, not only for the specific neurodevelopmental disorders that we looked at, but also ADHD and autism as shown in our team's previous studies."

This research is the most comprehensive study on antipsychotics and neurodevelopmental outcomes to date: it pulls together nationwide data from Denmark, Finland, Iceland, Norway, and Sweden into a large sample size of 213,302 children born to mothers with a diagnosed psychiatric condition, 5.5 per cent (11,626) of which were prenatally exposed to antipsychotics.

These five Nordic countries all have similar health and education systems and keep detailed data on birth records, filled prescriptions, and diagnoses from inpatient and outpatient specialist care, as well as antenatal care. The researchers teamed these data with results from the children's first standardised national school test (similar to Australia's NAPLAN tests), which happens between the ages of 8-10.

"It's reassuring that everything points to the same 'no major indication' of increased risks overall," says Scientia Associate Professor Helga Zoega, senior author of the study and pharmacoepidemiologist, also based at UNSW's School of Population Health.

"The study builds on our team's previous work that looked at birth outcomes, including serious congenital malformations, where we've seen similar null results.

"I think it's important to get excited about null results because this is essential information for the management of serious mental health conditions in pregnancy. It's as equally important as finding an increased risk of outcomes."

A gap that big health data is trying to fix

While this study is part of a growing body of research about medication safety in pregnancy, there's still a lot left in this field to discover, says A/Prof. Zoega.

"This is a hugely understudied area," she says. "Unfortunately, we know way too little about medication safety during pregnancy."

One of the reasons so little is known about medicines and pregnancy is that it's simply not feasible -- or in many cases, ethical -- to conduct randomised clinical trials on pregnant women. The potential risks of testing or withholding treatment to the unborn child and mother or pregnant person is often too great.

That's where harnessing big data can step in -- although the research isn't as simple as looking at the raw data alone.

For example, women treated with antipsychotics during pregnancy were more likely to smoke, have higher BMIs, lower education levels, to be older (35 years or more) and use other medications during pregnancy compared to women who didn't take antipsychotics during pregnancy -- all of which are risk factors that can potentially impact birth outcomes.

These circumstances -- called 'confounding factors' -- are accounted for in observational research using careful study design and complex adjusted risk models to make sure the results show the impact of the medication alone.

"These types of studies are methodologically tricky, and can take a long time to do," says A/Prof. Zoega. "This study has been in the making for almost 10 years now.

"We already know these women are dealing with psychiatric conditions, and by genetic default, their children would be more likely to have psychiatric or neurodevelopmental outcomes. But we're focused on the risks and benefits of the medication treatment in pregnancy, so we use methods to make the comparison groups as similar as possible."

The researchers also strengthened their findings by slicing up the data to take a closer look at whether individual medications, trimesters of exposure, and siblings carried higher risk levels.

While one antipsychotic, chlorpromazine, showed potential increased links to language and speech delays, these findings were based on small sample sizes of 8-15 children, so more research is needed to investigate this potential link.

Other than this anomaly, the results supported the finding that there was little to no increased risk of children prenatally exposed to antipsychotics developing neurodevelopmental disorders or learning difficulties.

Looking ahead

Dr Bruno is currently involved in two related studies on prenatal medication use and pregnancy outcomes. One explores if there is a relationship between the use of antiseizure medications during pregnancy and child school performance, and the other examines whether taking ADHD medication use and discontinuation during pregnancy on child health outcomes.

But she sees many avenues for future research to build on this work, including harnessing more Australian big health data.

"There's so much to learn about medication safety in pregnancy," says Dr Bruno. "These women are typically excluded from clinical trials, so there's a real lack of data or evidence.

"While these results are highly generalisable to women in Australia, we now have real-world linked Australian data that can start contributing to large-scale international studies like this one which we're very excited for."

A/Prof. Zoega co-leads an international research collaboration called International Pregnancy Drug Safety Study (InPreSS), which investigates the safety of medication in pregnancy. She says there's plenty to do in this space.

"Antipsychotics are only one class of medications, and we already know that up to 80 per cent of women use at least one prescription medicine during pregnancy. Most often, there's little or no guidance on safety.

"There are so many unanswered questions that there's enough for a lifetime of research."

Pregnancy and Childbirth
Mental Health Research
Teen Health
Diseases and Conditions
Mental Health
Child Development
Educational Psychology
Nutrition and pregnancy
Miscarriage
Sleep disorder
Sex education
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Story Source:

Materials provided by University of New South Wales . Note: Content may be edited for style and length.

Journal Reference :

Claudia Bruno, Carolyn E. Cesta, Vidar Hjellvik, Sinna Pilgaard Ulrichsen, Marte-Helene Bjørk, Buket Öztürk Esen, Malcolm B. Gillies, Mika Gissler, Alys Havard, Øystein Karlstad, Maarit K. Leinonen, Mette Nørgaard, Sallie-Anne Pearson, Johan Reutfors, Kari Furu, Jacqueline M. Cohen, Helga Zoega. Antipsychotic use during pregnancy and risk of specific neurodevelopmental disorders and learning difficulties in children: a multinational cohort study . eClinicalMedicine , 2024; 102531 DOI: 10.1016/j.eclinm.2024.102531

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Screen time robs average toddler of hearing 1,000 words spoken by adult a day, study finds

Research into 220 Australian families over two years concludes exposure to television, phone and other screens hinders young children’s language skills

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The average toddler is missing out on hearing more than 1,000 words spoken by an adult each day due to screen time, setting back their language skills, a first-of-its kind study has found.

The research, published on Tuesday in the Journal of the American Medical Association (Jama) Pediatrics, tracked 220 Australian families over two years to measure the relationship between family screen use and children’s language environment.

Families recorded all the audio around their child using advanced speech recognition technology over a 16-hour period on an average day at home. They repeated this process every six months between the ages of 12 and 36 months.

The lead researcher, Dr Mary Brushe from the Telethon Kids Institute, said: “The technology we use is essentially like a Fitbit, but instead of counting the number of steps, this device counts the number of words spoken by, to and around the child.”

The device also picked up electronic noise, which the researchers analysed to calculate screen time.

The researchers found young children’s exposure to screens including TVs and phones was interfering with their language opportunities, with the association most pronounced at three years of age.

For every extra minute of screen time, the three-year-olds in the study were hearing seven fewer words, speaking five fewer words themselves and engaging in one less conversation.

The study found the average three-year-old in the study was exposed to two hours and 52 minutes of screen time a day. Researchers estimated this led to those children being exposed to 1,139 fewer adult words, 843 fewer child words and 194 fewer conversations.

Because the study couldn’t capture parents’ silent phone use, including reading emails, texting or quietly scrolling through websites or social media, Brushe said they might have underestimated how much screen usage is affecting children.

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A language-rich home environment was critical in supporting infants and toddlers’ language development, Brushe said. While some educational children’s shows were designed to help children’s language skills, very young kids in the age group of the study could struggle to translate television shows into their own life, she said.

This study did not differentiate between whether children were watching high- or low-quality screen content.

Previous research in the area had relied on parents self-reporting their own and their child’s screen time, and only studied short periods of time.

“To our knowledge, no studies conducted since the rapid uptake of mobile phones and tablets have actually tracked children’s screen time and their early language experiences over an extended period of time,” Brushe said.

Prof Angela Morgan, the leader of the speech and language group at the Murdoch Children’s Research Institute, which was not involved in the study, said: “To my knowledge it’s the most robust examination of looking at screen time and interactions between parents and children that we’ve had available.

“For all children, the biggest opportunities for language learning are of course in those first few years of life … we know that early predictors do predict your later language outcomes, so it is really important that they’ve been looking at this question in the early years.”

Amber Flohm, the vice-president of the NSW Teachers Federation, said members who taught in early education and primary school had said how children were affected significantly by the increased amount of time spent on screen.

Flohm said teachers had noted language skills going backwards, both in conversation between children themselves and teachers and in reading and writing skills. The pandemic exacerbated the situation, but teachers had noted the trends around the increased used of screen time “at least the last five or six years pre-Covid”, she said.

The research in the study was carried out between 2018 and 2021, with some families undertaking their 30- or 36-month recording day early in the pandemic. However, researchers said participants’ average screen times did not appear to have increased substantially compared with those who completed their recordings prior to the pandemic.

Due to the advanced speech recognition technology only being able to code for English, only English-speaking households were part of the study.

Australia news

Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management

Sudheer kumar muppalla.

1 Pediatrics, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND

Sravya Vuppalapati

2 General Practice, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND

Apeksha Reddy Pulliahgaru

3 Pediatric Medicine, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND

Himabindu Sreenivasulu

4 General Medicine, PES (People's Education Society) Institute of Medical Sciences and Research, Kuppam, IND

Children's heavy reliance on screen media has raised serious public health issues since it might harm their cognitive, linguistic, and social-emotional growth. This study examines the effects of screen time on many developmental domains and covers management and limitation techniques for kids' screen usage. Screen media has a wide range of cognitive consequences, with both beneficial and detrimental effects noted. Screens can improve education and learning; however, too much time spent in front of a screen and multitasking with other media has been related to worse executive functioning and academic performance. As screen time reduces the amount and quality of interactions between children and their caregivers, it can also have an impact on language development. Contextual elements like co-viewing and topic appropriateness are key in determining how language development is impacted. Additionally, excessive screen usage has detrimental effects on social and emotional growth, including a rise in the likelihood of obesity, sleep disorders, and mental health conditions including depression and anxiety. It can obstruct the ability to interpret emotions, fuel aggressive conduct, and harm one's psychological health in general. Setting boundaries, utilizing parental controls, and demonstrating good screen behavior are all techniques that parents may use to manage children's screen usage. We can reduce the possible negative impacts of excessive screen time and promote children's healthy development and well-being by increasing knowledge and encouraging alternative activities that stimulate development.

Introduction and background

New technologies, such as mobile and interactive screen media, are now ingrained in a young child's daily life. Children today are "digital natives," having been born into an ever-changing digital ecosystem augmented by mobile media. The age at which kids engage with media on a regular basis has fallen from four years in 1970 to four months in the present day [ 1 ]. Electronic devices have revolutionized learning, communication, and information dissemination, but recent research indicates that screen media use may have serious adverse effects on children's health over the long term, making this a pressing public health concern [ 2 ]. It has raised the likelihood that children will become obese, experience behavioral problems, sleep irregularities, poor academic performance, etc. [ 1 - 3 ].

This article delves into the profound effects of excessive screen time on children's cognitive, language, and social-emotional development, while also exploring the crucial strategies and responsibilities that parents and schools can undertake to effectively manage and diminish screen time in young individuals.

Impact on development

Cognitive Development

Screen media use may have both beneficial and detrimental effects on a kid’s cognitive results. Media devices with screens have the potential to improve education and learning [ 2 ]. For instance, research has suggested that electronic books and learning-to-read applications may improve young children's early reading skills and creative thinking capacities [ 2 , 4 , 5 ]. However, studies have also demonstrated the negative effects of screen media use on a number of cognitive areas such as executive functioning, sensorimotor development, and academic outcomes [ 2 , 6 ]. Media multitasking was found to have a negative impact on executive functioning in teenagers, notably on working memory, inhibition, and the capacity to switch between tasks [ 2 , 7 ].

The Quebec Longitudinal Study of Child Development cohort study found a long-lasting connection between early screen media exposure and cognitive abilities, with each one-hour increase in TV exposure at two years of age corresponding to a 7% unit decrease in participation in class and a 6% unit decrease in math proficiency in the fourth grade [ 8 ]. A Spanish research study discovered a negative correlation between the use of screen media and academic achievement, indicating that increased screen time was associated with lower academic performance. Similarly, a study conducted in the United States found a significant link between higher levels of media multitasking and lower scores on standardized tests measuring academic performance in mathematics and English [ 9 ].

However, adverse executive and academic outcomes may be confounded by the poorer attention and focus from multitasking behaviors rather than solely from screen media overuse, and more research is necessary to tease out this relationship. Language development has received the majority of emphasis in studies on screen usage and cognitive development in young children, whereas other cognitive development domains including executive skills have received less attention [ 10 ]. Thus, there are significant, albeit indirect, effects of screen media use on cognitive development in children [ 2 ].

Language Development

The early years of childhood are crucial for acquiring language skills and children develop various aspects of language, including vocabulary and phonology [ 11 ]. These skills are acquired through interactions with adults [ 11 ]. Numerous studies have highlighted the significance of human interaction, particularly the frequency and quality of exchanges between adults and children, in the development of language skills [ 12 ]. However, there is a growing concern that screen time diminishes the quantity and quality of interactions between children and their parents, resulting in fewer chances for the child to practice and develop their language abilities [ 11 ]. The relationship between screen time and speech and language development is complex, and there are multiple factors that should be taken into account [ 13 ]. The impact of screen viewing is predominantly influenced by contextual factors rather than the sheer amount of time spent watching [ 14 ]. The context encompasses several aspects, such as the behavior exhibited by adult caregivers during screen time, the appropriateness of the content for the child's age, and the level of interactivity provided by the screen [ 14 ]. Increasing the amount of screen time at an early age has negative effects on language development [ 13 ]. However, beginning screen time at a later age has some potential benefits [ 13 ]. The characteristics of videos, their content, and co-viewing also play a role in influencing language development [ 13 ]. However, other studies have reported negative effects on speech, language, motor skills, cognitive development, and social development [ 13 ].

Adults should be aware of the impact of background television when children are present [ 13 ]. Studies have shown that increased exposure to background television can have adverse effects on children's language usage, executive functioning, and cognition in children under the age of five [ 13 ]. Excessive television viewing can also potentially affect language development and reading abilities at a young age [ 13 ].

A few studies show a positive correlation between children's screen time when co-viewed with a parent and their expressive lexical, phonological, and overall language abilities [ 11 ]. Studies have indicated that compared to children who view screens for ≤1 hour per day, those who engage in two or more hours per day, or three or more hours per day, are more likely to experience behavioral problems and have poorer vocabulary acquisition [ 15 ]. These findings suggest the importance of monitoring and regulating screen time for young children to mitigate potential adverse effects on their development and behavior [ 15 ].

While it is true that screens have become ubiquitous in homes and are increasingly integrated into school systems, it is crucial to educate caregivers of children under the age of three years about the potential risks associated with prolonged screen exposure in inappropriate contexts [ 14 ]. The current findings suggest that future research should investigate the screen time patterns of the entire family and explore the cumulative impact of both children's and parents' total screen time on language skills, specifically focusing on lexical skills [ 11 ]. In addition to providing guidance, it is crucial to offer families alternative options to media use that promote positive development, such as parent-child play activities [ 16 ]. These alternatives should be made available in pediatric practices and early childhood centers to support families in creating enriching and interactive experiences with their children [ 16 ].

Social-Emotional Development

In recent years, the concept of screen time has become more complex, with a wide range of electronic devices available worldwide [ 17 ]. The advancement of technology in recent years has led to increased screen-based technology usage among young people, coinciding with a decrease in their engagement with nature and impacting their mental health and overall well-being [ 18 ]. Research has shown negative associations between screen time, particularly television viewing, and the development of physical and cognitive abilities. Additionally, screen time has been linked to obesity, sleep problems, depression, and anxiety [ 17 ]. The specific physiological mechanisms underlying the adverse health outcomes related to screen time, as well as the relative contributions of different types of screens and media content to these outcomes, are still not fully understood [ 17 ]. However, studies in very young children indicate that screen usage is an independent risk factor for reduced psychological well-being. One study shows that increased TV exposure between six and 18 months of age was associated with emotional reactivity, aggression, and externalizing behaviors [ 17 ]. Few studies indicate that higher screen time at the age of four years is associated with lower levels of emotional understanding at the age of six years. It also reveals that having a television in a child's bedroom at the age of six years predicts lower levels of emotional understanding at eight years [ 19 ]. Gaming was associated with lower levels of emotional understanding in boys but not in girls. This suggests that different types of screen activities may have distinct effects on the emotional development of children based on their gender [ 19 ].

Computer use and video gaming, but not television viewing, were shown to be connected with more severe depressive symptoms when looking at the effects of various types of screens. Video gaming, in particular, is correlated with the severity of anxiety [ 17 ]. These findings align with other studies showing a cumulative impact of high screen time on symptoms, with more pronounced effects emerging during early adolescence and beyond [ 17 ]. Screen time-induced poor sleep, nighttime use of digital devices, and dependency on mobile phones have been associated with depressive symptoms [ 20 ]. Sleep issues, excessive screen time, and exposure to content that is violent and fast-paced trigger dopamine and reward pathways in the brain, all of which have been associated with attention-deficit/hyperactivity disorder (ADHD)-related behavior [ 20 ]. Early and persistent exposure to violent content raises the chance of engaging in antisocial behavior [ 20 ]. Psychoneurological effects of addictive screen time use include a decrease in social coping skills and the development of craving behaviors resembling substance dependence [ 20 ]. Structural changes in the brain related to cognitive control and emotional regulation have been observed in individuals with addictive digital media behavior [ 20 ].

It is worth noting that screens can also have positive educational and informational benefits [ 17 ]. For example, many schools are effectively using blogs as educational tools to improve written English, and the Internet provides access to health resources, including information on sexually transmitted infections and mental health [ 17 ]. Starting around the age of two years, high-quality television programs that are designed for specific educational purposes can serve as an additional means for early language and literacy development in children [ 21 ]. Such programs can also support cognitive development, promote positive racial attitudes, and encourage imaginative play [ 21 ]. High-quality content can enhance social and language skills for all children aged two years and older, particularly for those who are living in poverty or facing other disadvantages [ 21 ]. The presence of smartphones blurs the boundaries between work and home life, making timing unpredictable, and frequently requiring emotional investment to respond to them [ 21 ]. These findings emphasize the potential negative consequences of excessive screen exposure during early childhood, particularly when screens are present in a child's personal space, such as their bedroom [ 19 ]. This study emphasizes the significance of face-to-face interaction, especially with primary caregivers, in promoting the development of social-emotional competence in young children [ 19 ]. Further research is needed to investigate the mechanisms underlying the connection between screen time and developmental vulnerabilities [ 22 ].

Strategies for managing and reducing screen time in children

Strong evidence shows that parents' awareness-raising and other straightforward actions may significantly lower children's screen time [ 23 ]. Early excessive screen-watching habits seem to follow throughout time and tend to cluster with other harmful lifestyle behaviors including a poor diet and lack of sleep [ 24 ]. The amount of time spent watching television and other forms of screen time among teens decreased only when the intervention included specific elements or activities aimed at reducing it [ 25 ]. Possible additions to interventions include the use of an electronic monitoring device to restrict screen time (which allows users to set time limits for TV, digital versatile disc (DVD), computer, or video game use), the TV Turn-off Challenge (a campaign to turn off the TV for a specified number of days), the conditional use of screens on physical activity, or education via mass or small media (such as newsletters, brochures, or billboards) [ 26 ]. Birth kits distributed to moms by maternity wards should contain information regarding newborns and toddlers seeing screens [ 23 ]. Health visitors should provide new parents with advice and be aware of medical evidence [ 23 ]. Schools should take a stand on how much time kids spend using screens both inside and outside of the classroom and let students and parents know about it [ 23 ].

Role of Parents in Managing Screen Time

Parents sometimes used screen time as a reward but also believed digital technology would have a negative impact on their child’s behavior, social skills, sleep, and physical activity [ 27 ]. Parents have the chance to implement behavioral control in the home as the primary caretakers, frequently through observation and rule-setting [ 27 ]. In fact, treatments designed to enhance common parenting techniques at home have proved effective in raising a child's desirable behavior [ 27 ]. In line with this viewpoint, some research indicates that parents' usage of restrictions regarding the use of technology such as television, cellphones, tablets, and computers is linked to children spending less time on screens (such as television, video games, and computer/internet use) [ 28 ]. Parental controls, which are frequently present in the form of extra settings and password safeguards for different technical devices (such as televisions, laptops, cellphones, etc.), may offer a viable answer to parenting challenges around children's screen time [ 27 ].

The Centers for Disease Control and Prevention (CDC) and other organizations/studies have indicated that parental restrictions on screen time and the absence of screens in bedrooms both significantly lower screen time [ 29 , 30 ]. Ideal discretionary screen time limits are 0.5-1 hour/day for three to seven-year-olds, one hour for 7-12-year-olds, 1.5 hours for 12-15-year-olds, and two hours for 16+-year-olds. Role modeling is also another crucial element. The amount of screen time parents and kids watch is closely associated; kids who live in homes where watching TV is encouraged (e.g., meals eaten in front of the TV and the TV is on when the child gets home from school) are more likely to engage in binge-watching themselves. If parents watch television for more than four hours every day, their sons and daughters will, respectively, have a 10.5-fold and a three-fold increased likelihood of doing the same [ 31 ].

Conclusions

Excessive screen media usage in children can have both positive and negative impacts on their development. Regarding cognitive development, screens have the potential to enhance education and learning. However, studies have shown that excessive screen time and media multitasking can negatively affect executive functioning, sensorimotor development, and academic outcomes. Early screen exposure has been associated with lower cognitive abilities and academic performance in later years. Language development is also affected by screen time, as it diminishes the quantity and quality of interactions between children and caregivers. Contextual factors such as co-viewing and appropriateness of content play a role in determining the impact on language development. Excessive screen usage can also lead to problems in social-emotional development, including obesity, sleep disturbances, depression, and anxiety. It can impair emotional comprehension, promote aggressive behavior, and hinder social and emotional competence.

Parents play a crucial role in managing and reducing screen time by raising awareness, setting boundaries, and providing behavioral controls. Parental limitations and the absence of screens in bedrooms have been found to significantly reduce screen usage. Parents should also set an example by managing their own screen time. Overall, it is important for caregivers, educators, and healthcare professionals to understand the potential risks of excessive screen usage and implement strategies to promote healthy development in children, including alternative activities that foster cognitive, linguistic, and social-emotional skills.

The authors have declared that no competing interests exist.

Empathy in Action: Tross Family Boosts Progressive Aphasia Research

This story was published in the March 2024 issue of The Philanthropis t, a newsletter for supporters and friends of Northwestern University Feinberg School of Medicine. Read the past issues here .

March 15, 2024

For Beth and Nathan Tross, philanthropy supporting neurological disorders such as primary progressive aphasia research is personal.

Beth Tross, a former Montessori preschool teacher in Highland Park, Illinois, was diagnosed with primary progressive aphasia, or PPA, in 2019. The news was devastating; PPA is a rare dementia syndrome that affects a person’s command of language. People with PPA may experience difficulties with word finding, word usage, word order, word comprehension, or spelling. Mrs. Tross already had a long history with epilepsy, which she was diagnosed with as a teenager.

“It’s extraordinarily frustrating,” said her husband, Nate. “When she’s doing speech therapy, you know, she might know what the animal [on a flashcard] is, but she can’t say what it is.”

The Trosses have long supported philanthropic efforts to study epilepsy, especially in children, at their alma mater, the University of Iowa. But in the years since Beth came under the care of Borna Bonakdarpour, MD , at the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease at Northwestern University Feinberg School of Medicine, they have included Dr. Bonakdarpour’s aphasia research in their philanthropic portfolio.

“He’s terrific,” Mr. Tross said of Dr. Bonakdarpour. “He is willing to cast a wide net across other branches of neurology and disciplines to help the patient. He is very empathetic, very understanding, very encouraging, and always very positive. He’s the whole package.”

The Trosses’ giving has earned them membership in The Founders Society at the medical school and the Northwestern University Leadership Circle.

New Applications for Brain Stimulation

Dr. Bonakdarpour, who is an associate professor of Neurology (Behavioral Neurology), is spearheading a pilot project studying the effects of transcranial direct current stimulation, or tDCS, on progressive language impairment. The study combines state-of-the-art speech therapies for word retrieval and grammar disorders with high definition tDCS.

TDCS is a non-invasive brain stimulation technique in which electrode pads are attached to a patient’s scalp and a low-level current, usually 2–4 milliamperes, is dispensed in order to activate brain cells in a target region. Historically, the technique has been used to treat patients with neurological disorders including epilepsy, Parkinson’s disease, and multiple sclerosis, and has only begun to be explored as a treatment for progressive language disorders in recent years.

The seed funding provided by the Trosses enabled a group of investigators including neuroscientists, speech pathologists, and a biomedical engineer to launch the study in a matter of months, Dr. Bonakdarpour said. Without their support, it might have taken much longer to get off the ground.

“The synergy between the Tross family and our enthusiastic team of researchers worked wonderfully,” he said. “Results from our preliminary data will enable us to prove the feasibility of this approach and to apply for larger grants to be able to help individuals with PPA.”

Mr. Tross said he hopes the study will lead to better outcomes for future patients.

“If there is funding that's needed to advance the knowledge or to move the ball, even an inch, to help figure out how to help the patient suffering from aphasia, we’re willing to do it in whatever means we can,” he said.

The scientists are optimistic about outcomes from the project, as they expect to see improvement in word retrieval and sentence production that is greater in the group who receive the tDCS, Dr. Bonakdarpour said. They also expect to see underlying language network reorganization as measured by functional MRI.

"Beth and Nate's support of this pilot project enables us to study a truly novel method of treating aphasia,” Dr. Bonakdarpour said. “These are exciting times for PPA research, and it couldn't be done without generous philanthropy from donors like the Trosses."

For more information about supporting these efforts, please contact Jordan Sund at [email protected] or 312-503-2706 .

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4 Child Development and Early Learning
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InBrief: The Science of Early Childhood Development

Content in This Guide

Step 2: How Does Early Child Development Happen?

Step 3: What Can We Do to Support Child Development?

Brains are built over time, from the bottom up.

The interactive influences of genes and experience shape the developing brain.

The brain’s capacity for change decreases with age.

Cognitive, emotional, and social capacities are inextricably intertwined throughout the life course.

Toxic stress damages developing brain architecture, which can lead to lifelong problems in learning, behavior, and physical and mental health.

Policy Implications

Related Topics: toxic stress , brain architecture , serve and return

Introduction

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Theories of Child Development and Their Impact on Early Childhood Education and Care

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Analyzing early child development, influential conditions, and future impacts: prospects of a German newborn cohort study

Regulations in Germany

The German National Educational Panel Study

Design of the newborn cohort study of the NEPS: a brief overview

Sampling strategy

Assessment waves and data collection

Measuring early child characteristics: aims, challenges, and solutions

Early child development: domain-specific challenges for the child

General NEPS framework for assessing competencies

Selecting and measuring relevant and predictive indicators of early child development: a challenge for research

Measuring learning environments: aims, challenges, and solutions

General framework of the NEPS

Selection and measurement of indicators

Assessment of mother–child interaction: direct measurement of the home-learning environment and of the child’s characteristics in mother–child interaction

Some selected results

Reliability and validity of measures of mother–child interaction

Reliability and validity of measures of early child characteristics

Early roots of social disparities in child development

Prospects and conclusions

Authors’ contributions

Competing interests

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Child Development Research

Children’s Mental, Emotional, and Behavioral Health

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Associations of media use and early childhood development: cross-sectional findings from the LIFE Child study

Conclusions

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Screen media exposure in the first 2 years of life and preschool cognitive development: a longitudinal study

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A novel, composite measure of screen-based media use in young children (ScreenQ) and associations with parenting practices and cognitive abilities

Introduction

Methods and measurements

Media use of children and mothers

Parent–child interactions

Early childhood development

Data analysis

Description of the study sample

Associations between children’s media use and early childhood development outcomes

Associations between mothers’ media use and early childhood development outcomes

Associations between parent–child interactions and early childhood development outcomes

Associations between children’s media use, parent–child interaction scores, and early childhood development outcomes (multiple and moderator analysis)

Principal findings

Associations of media use, parent–child interactions, and early childhood development

Strengths and weaknesses

Implications and future research

Acknowledgements

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