Consensus Statement of Indian Academy of Pediatrics on Early Childhood Development

DOLPHIN: A Mixed-Methods Study of a Parenting App to Nurture the First Two Years of Life in the Indian Context

Background

The first two years of life are critical for brain development. Experiences and exposures during this period can have long-term effects on an individual's health. Therefore, we aim to develop a program for new parents in the Indian context to help them understand their developing infant's needs and provide the best possible care grounded in traditional practices to ensure healthy developmental outcomes.

Materials and Methods

The program was developed using the exploratory-confirmatory framework grounded in qualitative methods-(a) collection of empiric evidence base by conducting a thorough literature review, (b) tacit experience, and (c) focus group discussions with relevant stakeholders. Picture-based content (one picture per day for two years) was created, and the program was expert-validated. A web-based application was developed to make it available to parents, and the program was translated into three regional languages to improve its reach. A telephonic user feedback survey was carried out, and descriptive statistics were used to present the findings from the survey.

Results

DOLPHIN stands for "Developing Opportunities of Learning for Parents to Help Infant Nurture." Over 600 parents accessed the program. Feedback is positive in the domains of parental satisfaction and user-friendliness.

Discussion

The program primarily focuses on ensuring appropriate sensorimotor stimulation and meeting the socioemotional needs of the growing infant through the first two years, emphasizing healthy nutrition and hygiene to ensure holistic development. Therefore, its approach is health-promotive and disease-preventive. It incorporates traditional child-rearing practices of India rich in stimulation, promoting secure attachment, and incidental learning: "readiness."

Conclusion

The DOLPHIN program demonstrates a promising approach to supporting new parents in nurturing their infants during the critical first two years of life. With positive feedback and a focus on traditional practices and evidence-based content, it holds potential as a health-promotive and preventive intervention for holistic child development in the Indian context.

Within-Person Temporal Associations Among Self-Reported Physical Activity, Sleep, and Well-Being in College Students

OBJECTIVE

A holistic understanding of the naturalistic dynamics among physical activity, sleep, emotions, and purpose in life as part of a system reflecting wellness is key to promoting well-being. The main aim of this study was to examine the day-to-day dynamics within this wellness system.

METHODS

Using self-reported emotions (happiness, sadness, anger, anxiousness) and physical activity periods collected twice per day, and daily reports of sleep and purpose in life via smartphone experience sampling, more than 28 days as college students ( n = 226 young adults; mean [standard deviation] = 20.2 [1.7] years) went about their daily lives, we examined day-to-day temporal and contemporaneous dynamics using multilevel vector autoregressive models that consider the network of wellness together.

RESULTS

Network analyses revealed that higher physical activity on a given day predicted an increase of happiness the next day. Higher sleep quality on a given night predicted a decrease in negative emotions the next day, and higher purpose in life predicted decreased negative emotions up to 2 days later. Nodes with the highest centrality were sadness, anxiety, and happiness in the temporal network and purpose in life, anxiety, and anger in the contemporaneous network.

CONCLUSIONS

Although the effects of sleep and physical activity on emotions and purpose in life may be shorter term, a sense of purpose in life is a critical component of wellness that can have slightly longer effects, bleeding into the next few days. High-arousal emotions and purpose in life are central to motivating people into action, which can lead to behavior change.

Application of the "Monitoring Child Development in Integrated Management of Childhood Illnesses Context" in Indian Infants and Toddlers

OBJECTIVE

The objective of this study was to determine the diagnostic accuracy of "Monitoring Child Development in the Integrated Management of Childhood Illnesses Context" (MCDIC) for developmental screening of Indian children younger than 3 years.

METHOD

A hospital-based study of diagnostic accuracy was conducted over 17 months after obtaining institutional ethics committee approval. Children younger than 3 years were included in this study. Children with acute illnesses and who presented without their primary caregiver were excluded from this study. The calculated sample size was 272. Eligible children were enrolled after informed consent and stratified by age. MCDIC (index tool) was administrated to primary caregivers by trained interviewers to identify "suspected/probable developmental delay (SDD/PDD)." The reference tools included Developmental Profile, Third Edition, which assessed developmental status based on General Developmental Score (GDS), and Vineland Adaptive Behavior Scale, Second Edition, which evaluated adaptive function based on Adaptive Behavior Composite (ABC). Parameters of diagnostic accuracy were computed according to the number of children with "SDD/PDD" and "developmental delay" (GDS and ABC < -2 SDs).

RESULTS

The number of eligible children was 312. The sensitivity of MCDIC was 88.0% (95% confidence interval [CI] 68.8-97.5), specificity 85.7 (95% CI 81.1-89.6), positive predictive value 34.9 (95% CI 28.0-42.5), and negative predictive value 98.8 (95% CI 96.6-99.6).

CONCLUSION

MCDIC had a high sensitivity and specificity that were above 70% and 80%, respectively, and a high negative predictive value, making it a suitable tool for screening and surveillance of Indian children younger than 3 years.