Reaching expert consensus on training different cadres in delivering early childhood development: technical report

The Sustainable Development Goals (SDGs) signal a greater focus on inter-sectoral, collaborative approaches to ensuring that all human beings can fulfil their potential in dignity and equality. This is reflected in the current global concern with promotion of holistic, community-based programmes to support early childhood development and wellbeing ? widely referred to as ?early childhood development? (ECD). Within this context, the study reported here sought to achieve consensus among 14 global experts on training needs for three groups of personnel (?cadres?) involved in delivery of early childhood development (ECD) programmes. The three cadre groups, identified via a comprehensive review of literature on current issues in the provision of ECD, comprise delivery of education, health and community-based early childhood interventions across a diverse range of low resource settings. The study responds to a gap in knowledge on training needs for ECD cadres, associated with a serious dearth of human resources to support provision of ECD services. Key challenges reported here, based on comprehensive review of available literature, include: 1. A long-running, severe global shortage in availability of cadres to support delivery of ECD programmes. 2. To date, delivery of key health and education interventions principally in siloes, with limited integration and practitioners/professionals/para-professionals widely employed in vertical programmes. 3. Low professional and social status of many ECD cadres, due to a lack of systematic recognition and support. This has resulted in large numbers of cadres with undefined career paths, and high rates of turnover / attrition2. In response, expert consensus points to the following potential strategies for enhancing provision of ECD cadres training and professional development: 1. Development of coherent systems to support ECD training and professional development. a. Findings indicate consensus around commonalities among and distinctions between essential skills and knowledge required for education professionals, health professionals and non-certified para-professional groups. These insights could provide a basis for establishing coherent, joined-up professional pathways and support systems for development of ECD cadres. b. Consensus around the respective roles of these three cadres is reflected in the distinct training needs outlined for each group. There is consensus that, while noncertified para-professionals require programme-specific training to facilitate delivery of particular tasks, certified education and health professionals require training in more advanced skills such as problem-solving and flexibility. Exposure to a range of different programmes and approaches is required for certified professionals, to facilitate informed decision making around programme development and adapting / responding to local contextual needs. These distinctions could provide a basis for establishing clarity in respective roles for ECD cadres with regard to programme delivery. c. Consensus around training needs across cadre groups is indicated, in particular the need for on-going mentoring and supervision. While there is acknowledgment among experts about complexities associated with provision of on-going support, consensus around this component of training was strongest among all aspects surveyed. This reflects widespread concern among participating experts, as well as within the literature, that short-term training for ECD cadres must be followed up with opportunities for continuing professional development and systematic support, to facilitate sustained effective practice. 2. Within systems for ECD cadres training, a strong focus on the importance of contextually grounded programmes, materials / resources and strategies for implementation. a. There is strong consensus that ECD cadres training should be contextually-grounded to ensure responsive, effective provision. Training should be based on and promote careful consideration of a range of factors that shape provision of ECD, including but not restricted to, policy, budgets, available resources, local values, beliefs and practices. 3. Adoption of the concept of nurturing care as an underpinning principle for provision of ECD cadres training. a. Delphi findings indicate consensus around essential dispositions, or attitudes, required to support caring, respectful, responsive and trustful interactions with children, caregivers and communities. They also indicate that all cadres require knowledge and skills in promoting early stimulation; child-centred learning and development; effective communication and collaboration; problem solving, and reflective practice. These strategies are outlined in the proposed framework provided below, which identifies unique roles / training needs for different cadre groups, as well as opportunities for enhancing integration across ECD cadres training systems. 3 Experts suggest that these ?dispositions?, which are essential for effective provision, should be viewed as malleable. Training should work / be designed to promote, model and strengthen these characteristics

Assessing children’s implicit attitudes using the Affect Misattribution Procedure

In the current research we examined whether the Affect Misattribution Procedure (AMP; Payne et al., 2005) could be successfully adapted as an implicit measure of children’s attitudes. We tested this possibility in three studies with 5 to 10 year old children. In Study 1 we found evidence that children misattribute affect elicited by attitudinally positive (e.g., cute animals) and negative (e.g., aggressive animals) primes to neutral stimuli (inkblots). In Study 2, we found that, as expected, children’s responses following flower and insect primes were moderated by gender. Girls (but not boys) were more likely to judge inkblots as pleasant when they followed flower primes. Children in Study 3 showed predicted affect misattribution following happy as compared to sad face primes. In addition, children’s responses on this child-friendly AMP predicted their self-reported empathy; the greater children’s spontaneous misattribution of affect following happy and sad primes, the more children reported feeling the joy and pain of others. These studies provide evidence that the AMP can be adapted as an implicit measure of children’s attitudes and the results of Study 3 offer novel insight into individual differences in children’s affective responses to the emotional expressions of other

Ethnic In-Group Favoritism Among Minority and Majority Groups: Testing the Self-Esteem Hypothesis Among Preadolescents

The self-esteem hypothesis in intergroup relations, as proposed by social identity theory (SIT), states that successful intergroup discrimination enhances momentary collective self-esteem. This hypothesis is a source of continuing controversy. Furthermore, although SIT is increasingly used to account for children’s group attitudes, few studies have examined the hypothesis among children. In addition, the hypothesis’s generality makes it important to study among children from different ethnic groups. The present study, conducted among Dutch and Turkish preadolescents, examined momentary collective self-feelings as a consequence of ethnic group evaluations. The results tended to support the self-esteem hypothesis. In-group favoritism was found to have a self-enhancing effect among participants high in ethnic identification. This result was found for ethnic majority (Dutch) and minority (Turkish) participants.

Training early childhood development cadres in low-resource contexts

This brief summarises findings from an extended literature review on the current status of early childhood development (ECD) cadres training and a Delphi survey of expert consensus on training needs for different ECD cadres operating in low-resource contexts (Pearson et al., 2017) titled Reaching expert consensus on training different cadres in delivering early childhood development at scale in low-resource contexts. The work was funded by DFID and led by a team at Bishop Grosseteste University in collaboration with colleagues from The University of Hong Kong, McGill University, University of Nebraska, University of Wollongong and University College London. The following overarching questions guided this study: ? To whom does the term ?ECD cadre? most usefully apply, given the wide range of settings and aims of early childhood development programmes? ? What are expert views on essential knowledge and skills required of ECD cadres working in different contexts? ? What are expert views on appropriate methods for delivery of training, and post-training follow-up, for ECD cadres? ? What are expert views on the necessary conditions for effective scale-up of ECD cadres training

Lipid-soluble Vitamins A, D, and E in HIV-Infected Pregnant women in Tanzania.

There is limited published research examining lipid-soluble vitamins in human immunodeficiency virus (HIV)-infected pregnant women, particularly in resource-limited settings. This is an observational analysis of 1078 HIV-infected pregnant women enrolled in a trial of vitamin supplementation in Tanzania. Baseline data on sociodemographic and anthropometric characteristics, clinical signs and symptoms, and laboratory parameters were used to identify correlates of low plasma vitamin A (<0.7 micromol/l), vitamin D (<80 nmol/l) and vitamin E (<9.7 micromol/l) status. Binomial regression was used to estimate risk ratios and 95% confidence intervals. Approximately 35, 39 and 51% of the women had low levels of vitamins A, D and E, respectively. Severe anemia (hemoglobin <85 g/l; P<0.01), plasma vitamin E (P=0.02), selenium (P=0.01) and vitamin D (P=0.02) concentrations were significant correlates of low vitamin A status in multivariate models. Erythrocyte Sedimentation Rate (ESR) was independently related to low vitamin A status in a nonlinear manner (P=0.01). The correlates of low vitamin D status were CD8 cell count (P=0.01), high ESR (ESR >81 mm/h; P<0.01), gestational age at enrollment (nonlinear; P=0.03) and plasma vitamins A (P=0.02) and E (P=0.01). For low vitamin E status, the correlates were money spent on food per household per day (P<0.01), plasma vitamin A concentration (nonlinear; P<0.01) and a gestational age <16 weeks at enrollment (P<0.01). Low concentrations of lipid-soluble vitamins are widely prevalent among HIV-infected women in Tanzania and are correlated with other nutritional insufficiencies. Identifying HIV-infected persons at greater risk of poor nutritional status and infections may help inform design and implementation of appropriate interventions

Development and validation of the Australian Aboriginal racial identity and self-esteem survey for 8-12 year old children (IRISE-C)

Introduction: In Australia, there is little empirical research of the racial identity of Indigenous children and youth as the majority of the current literature focuses on adults. Furthermore, there are no instruments developed with cultural appropriateness when exploring the identity and self-esteem of the Australian Aboriginal population, especially children. The IRISE-C (Racial Identity and Self-Esteem of children) inventory was developed to explore the elements of racial identity and self-esteem of urban, rural and regional Aboriginal children. This paper describes the development and validation of the IRISE-C instrument with over 250 Aboriginal children aged 8 to 12 years. Methods: A pilot of the IRISE C instrument was combined with individual interviews and was undertaken with 35 urban Aboriginal children aged 8-12 years. An exploratory factor analysis was performed to refine the survey and reduce redundant items in readiness for the main study. In the main study, the IRISE C was employed to 229 Aboriginal children aged 6-13 years across three sites (rural, regional and urban) in Western Australia. An exploratory factor analysis using Principal axis factoring was used to assess the fit of items and survey structure. A confirmatory factor analysis was then employed using LISREL (diagonally weighted least squares) to assess factor structures across domains. Internal consistency and reliability of subscales were assessed using Cronbach's co-efficient alpha. Results: The pilot testing identified two key concepts - children's knowledge of issues related to their racial identity, and the importance, or salience, that they attach to these issues. In the main study, factor analyses showed two clear factors relating to: Aboriginal culture and traditions; and a sense of belonging to an Aboriginal community. Principal Axis Factoring of the Knowledge items supported a 2-factor solution, which explained 38.7 % of variance. Factor One (Aboriginal culture) had a Cronbach's alpha of 0.835; Factor 2 (racial identity) had a Cronbach's alpha of 0.800, thus demonstrating high internal reliability of the scales. Conclusion: The IRISE-C has been shown to be a valid instrument useful of exploring the development of racial identity of Australian Aboriginal children across the 8-12 year old age range and across urban, rural and regional geographical locations