Cognitive development among young children in Cambodia: Implications for ECED programs

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Cognitive development among young children in
Cambodia Implications for ECED programs
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Outline

• 1. Previous research on cognitive delays
• 2. Impact Evaluation purpose and design
• 3. Descriptive Statistics
• 4. The TVIP
• 5. The Results Raw TVIP scores by age
• 6. Implications of results
• 7. Socioeconomic status and Raw TVIP scores
• 8. Nutrition and Raw TVIP scores
• 9. Implications for ECED programs

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1. Previous Research

• Previous research has indicated that cognitive
  delays are more likely to affect children from
  low-income countries because they are exposed to
  multiple risk factors, including
• lack of access to basic water and sanitation
  infrastructures,
• lack of access to quality health services
• inadequate nutritional inputs
• parents with low education levels and
• lack of access to quality daycare centers and
  preschools.
• Documenting cognitive delays in low-income
  countries is critical to design well-targeted
  effective and timely interventions

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2. Impact Evaluation Purpose and Design

• Purpose of the impact evaluation
• To assess the effectiveness and relative cost
  effectiveness of the three ECD interventions,
  namely the formal preschools, the community based
  preschool and the home based program.
• Data collection
• Baseline data collected from May, 2008 to Jan
  2009.
• The baseline data has been used to as an
  indicator of cognitive development in young
  children

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2. Impact Evaluation Purpose and Design

• The survey was conducted in some of the most
  disadvantaged areas in the country.
• All communities had a poverty rate exceeding 30.
  Given the national poverty rate was estimated at
  30.1 in 2007, this sample of children is poorer
  than the national average.
• The sample contains 4,072 children aged 36 to 59
  months in 141 communities across seven
  provinces.

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3. Descriptive Statistics
Basic Characteristics N Mean SD
Age (months) 4,072 47.0 6.8
Male 4,070 51.5
Urban 4,072 17.9
Caregiver Education 4,039 2.9 2.7
Caregiver without education 4,039 28.5
Stunted 4,011 47.6
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4. The TVIP

• The TVIP was used as an indicator of cognitive
  development
• Involves presenting each child with four pictures
  and asks them to correctly identify the picture
  corresponding to the vocabulary word presented.
  For example, the child could be presented with
  pictures of a dog, a glass, a piece of cake, and
  a fork and be asked to point to the glass.
• The test continues until the child makes six
  mistakes in eight consecutive responses and is
  scored according to the number of vocabulary
  words the child correctly identified.
• The TVIP is a version of the Peabody Picture
  Vocabulary test that was adapted for spanish
  children in low income-settings
• It was translated into Khmer and extensively
  piloted before it was used in Cambodia.

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5. The Results Raw TVIP scores by age
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6. Implications of results

• The data show that the are very large variations
  in cognitive development between children of the
  same age in each sample (even though children
  from the high end of the distribution are showing
  substantial signs of delay).
• Some children perform much better than their
  peers within each sample.
• I will now discuss the factors which cause this
  variation, thereby suggesting factors which
  contribute to improved cognitive development .

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7.Socioeconomic status and TVIP scores
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8. Nutrition and TVIP scores
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9. Implications for ECED programs

• The earlier the intervention the better.
• Socioeconomic status matters
• Strategies on how to prioritize children from
  very low income households in ECED programs
  should considered

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9. Implications for ECED programs

• ECED programs could be complemented with
  nutrition supplements
• Information on nutrition may not be sufficient to
  prevent or reverse stunting among young children.
• Research indicates that stunting typically occurs
  in the first two years of life.
• However, after the age of two, good nutrition
  continues to play an important role in a childs
  growth and development.