Child Development, Child Developmental Delay, Community Health Workers, Low Income Population
Conditions
Brief summary
Building on an intervention for early child development from the SPARK Center in Boston, Socios En Salud (SES) pilot tested CASITA a community-based package to screen and treat young children (ages 1-3 years of age) diagnosed with neurodevelopment risk and delay in Carabayllo, Lima, Peru. Ministry of Health CHWs identified children with developmental delays within the clinics and community and delivered a structured early intervention that included parent coaching and social support. In order to test the hypothesis that CASITA improves early child development, caregiver, and home environment, dyads received either nutrition supplements alone, nutrition + CASITA early child development sessions individually, or CASITA in a group of 10 dyads.
Interventions
OTHERCASITA
Sponsors
Grand Challenges Canada
Harvard University
Boston Children's Hospital
Boston Medical Center
Partners in Health
Brigham and Women's Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Months to 24 Months
Healthy volunteers
Yes
Inclusion criteria
1. Age between 6 - 24 months of age; 2. Known primary caregiver (parent or legal guardian) living with child; 3. Living within the catchment area of the 6 Health Centers that comprise the study zone. 4. Screen positive for neurodevelopment delay (at risk or delayed in neurodevelopment based on Evaluation del Desarrollo Psicomotor (EEDP) assessment). 5. Be at risk by scoring \<45 on the Progress Out of Poverty Index.
Exclusion criteria
1. A known medical condition that would make the child unresponsive to early intervention; 2. Family anticipates moving within the next three months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in risk of delay, as measured by the EASQ | baseline, 3 months | The Ages and Stages Questionnaire (ASQ) is an internationally-validated instrument that can be used to assess change in developmental risk over time. Fernald et al incorporated additional observation-based assessments and the following modifications: 1) addition of child observation exercises to allow for validity check of parent responses (original ASQ questions), and 2) the incorporation of ASQ questions from the next highest age range. The Extended Ages and Stages Questionnaire (EASQ) was utilized as an assessment tool to allow us to better quantify degree of risk at baseline (based on quintiles of scores). By incorporating ASQ questions from the next two highest age ranges, scores will be continuous across the study period of three. The EASQ has been applied to children in four countries, including 2,845 children in Peru. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in global HOME score | baseline, 3 months | The Infant Toddler Home Observation Measurement of the Environment (HOME) evaluates parenting and home influences on child development. |
| Change in HOME subscore of parent responsivity | baseline, 3 months | This HOME subscore is defined in the manual as the extent to which the parent responds to the child's behavior including reinforcement for desired behavior and communication through words and actions. |
| Change in HOME subscore of parent involvement | baseline, 3 months | This HOME subscore is defined as parental acceptance of the child's behavior that is less than optimal and examines avoidance of undue restriction and punishment. |
Outcome results
None listed