Caylee Cook, Steven Howard, Jorge Cuartas, Hleliwe Makaula, Rebecca Merkley, Mbulelo Mshudulu, Nosibusiso Tshetu, Gaia Scerif, and Catherine Draper. 11/8/2022. “Child exposure to violence and self-regulation in South African preschool-age children from low-income settings.” Child Abuse & Neglect, 134. Publisher's VersionAbstract
Biological and psychosocial stressors that have been associated with income include family dynamics such as household chaos, family conflict, maternal depression, harsh parenting, lower parental responsiveness, and exposure to violence. Research from high income countries has shown that exposure to violence may have detrimental effects on children's self-regulation, with possible flow-on implications for broad later-life outcomes, but less is known about such links in low- and- middle income countries, where many children live in violent communities and households and where physical punishment remains the norm. This study aimed to investigate exposure to violence, in addition to coercive parenting, and its associations with self-regulation among 243 3- to 5-year-olds (M = 4.7 ± 0.6; 51.9 % female) from low-income settings in Cape Town and who were not attending Early Childhood Care and Education (ECCE). Results showed that self-regulation was not associated with child exposure to community violence, but it was positively associated with coercive parenting (β = 0.17; p = 0.03). The null concurrent associations between exposure to violence and self-regulation suggest the need for additional research aimed at understanding later potential developmental sequelae. It is important that findings regarding coercive parenting are contextualised within local social norms around parenting styles, as well as the influence of living in dangerous communities on parenting practices.
Jorge Cuartas, Emily Hanno, Nonie Lesaux, and Stephanie Jones. 11/3/2022. “Executive function, self-regulation skills,behaviors, and socioeconomic status in early childhood.” PLoS ONE, 17, 11, Pp. e0277013. Publisher's VersionAbstract

Background and objectives

Prior research has established steep socioeconomic status (SES) disparities in children’s cognitive skills at kindergarten entry. Yet, few studies have had comprehensive, multi-informant data to examine SES-related differences in foundational social and emotional skills and executive function. The objective of the current study is to systematically examine SES-related differences in young children’s executive function (EF), self-regulation skills, and behaviors.


The current study analyzed data on 2,309 young children from the Early Learning Study at Harvard (ELS@H). Multi-method (direct-assessment and reports) and multi-informant (parents and early education and care educators) information on children’s executive function, self-regulation skills, and internalizing, externalizing, and adaptive behaviors were used. A parametric framework employing Ordinary Least Squares (OLS) estimation was used to quantify the size of the SES-related differences in this set of children’s foundational social-emotional skills.


On average, there were differences of 0.24–0.45 SD for EF, 0.22–0.32 SD for self-regulation skills, and 0.27–0.54 SD for behaviors favoring children from the highest SES quartile of the distribution of SES relative to children from the lowest quartile. The SES-related differences were consistent across direct assessment, parent reports, and educator reports. Some differences were larger for older children relative to their younger counterparts.


Findings indicate a need for comprehensive intervention efforts well before kindergarten entry aimed at closing early disparities in children’s foundational social and emotional skills and executive function.

Catherine E. Draper, Lisa M. Barnett, Caylee J. Cook, Jorge A. Cuartas, Steven J. Howard, Dana C. McCoy, Rebecca Merkley, Andres Molano, Carolina Maldonado, Jelena Obradović, Gaia Scerif, Nadia C. Valentini, Fotini Venetsanou, and Aisha K. Yousafzai. 10/11/2022. “Publishing child development research from around the world: An unfair playing field resulting in most of the world's child population under-represented in research.” Infant and Child Development. Publisher's VersionAbstract
It has become increasingly apparent that publishing research on child development from certain countries is especially challenging. These countries have been referred to collectively as the Majority World, the Global South, non-WEIRD (Western, Educated, Industrial, Rich, and Democratic), or low- and middle-income countries. The aim of this paper is to draw attention to these persistent challenges, and provide constructive recommendations to contribute to better representation of children from these countries in child development research. In this paper, we outline the history of publication bias in developmental science, and issues of generalization of research from these countries and hence where it ‘fits’ in terms of publishing. The importance of explaining context is highlighted, including for research on measurement child development outcomes, and attention is drawn to the vicious publication-funding cycle that further exacerbates the challenges of publishing this research. Specific recommendations are made to assist child development journals achieve their stated goals of creating a more inclusive, equitable, diverse, and global field of child development.
Jorge Cuartas, Helen Baker-Henningham, Andrés Cepeda, Catalina Rey-Guerra, and ICBF Early Childhood Team. 7/14/2022. “The Apapacho Violence Prevention Parenting Program: Conceptual Foundations and Pathways to Scale.” International Journal of Environmental Research and Public Health, 19, 14, Pp. 8582. Publisher's Version
Jorge Cuartas. 4/28/2022. “Corporal Punishment and Child Development in Low- and- Middle-Income Countries: Progress, Challenges, and Directions.” Child Psychiatry & Human Development. Publisher's VersionAbstract
Most studies and reviews of studies on the developmental consequences of corporal punishment have focused on samples from the U.S. and other high-income countries. This study conducted a rapid review of the literature on the associations between corporal punishment and children’s cognitive and social-emotional development in low- and- middle-income countries (LMICs). Information from more than 42 studies of children younger than 18 years living in 64 LMICs was reviewed. Overall, the reviewed studies show associations between corporal punishment and negative cognitive and social-emotional outcomes, and there is no evidence that corporal punishment may relate to any positive developmental outcome in LMICs. Yet, issues of internal and external validity are common in the literature. The current evidence indicates that corporal punishment might increase the risk of detrimental child outcomes in LMICs, but further research with stronger methodological designs including samples from multiple settings is warranted.
Dana McCoy, Jonathan Seiden, Jorge Cuartas, Lauren Pisani, and Marcus Waldman. 4/13/2022. “Estimates of a multidimensional index of nurturing care in the next 1000 days of life for children in low-income and middle-income countries: a modelling study.” The Lancet Child & Adolescent Health, 6, Pp. 324–34. Publisher's VersionAbstract


Nurturing care is crucial for children's ongoing development during the pre-primary education period, or the next 1000 days of life. We generated nationally representative prevalence estimates of access to ten basic indicators of nurturing care among children aged 3–4 years in low-income and middle-income countries (LMICs).


We applied multiple imputation and predictive modelling to data on children living in LMICs. Individual-level data on ten indicators were from UNICEF's Multiple Indicator Cluster Surveys and the Demographic Health Surveys Program, and we included data on all children aged 36 to 59 months for whom the surveys asked relevant questions on parenting and child development. We defined minimally adequate care as receiving at least one of two indicators in each of five dimensions of nurturing care: responsive caregiving, early learning, safety and security, nutrition, and health. We used a two-step multi-level multiple imputation procedure to address missing data across individuals, indicators, and countries. Using imputed datasets, we generated a set of expected-a-posteriori estimates of the percentage and overall number of children receiving each indicator of nurturing care, as well as overall minimally adequate care, for each country, country income grouping, and region, and across all LMICs. For the 54 countries with individual-level data on all indicators, we also produced subgroup estimates of nurturing care on the basis of household wealth, child sex, and urbanicity.


We included individual-level data collected between 2005 and 2019 on 426 349 children aged 3–4 years in 104 LMICs. Across the 137 LMICs considered in our modelling, we estimated that 62·0 million (90% credible interval [CrI] 51·6–71·7) children aged 3–4 years, equivalent to 25·4% (90% CrI 21·2–29·4) of that age group in LMICs, were receiving minimally adequate nurturing care at the time of assessment, leaving 181·9 million (172·2–192·3) without adequate care. Access to care was highest for nutrition (86·2% [84·2–88·2], or 210·3 million [205·4–215·1], with healthy weight), and lowest for early learning (29·3% [21·5–39·6], or 71·5 million [52·5–96·6], in early childhood care and education), responsive caregiving (29·7% [25·6–34·9], or 72·4 million [62·4–85·0], experiencing adequate stimulation from non-maternal caregivers), and safety and security (32·3% [28·3–36·7], or 78·7 million [68·9–89·5], living without physical punishment). Gaps were evident in the estimates, with 50·8% (38·3–60·7) of children from upper middle-income countries receiving minimally adequate care compared with 5·6% (4·8–6·4) in low-income countries. Within 54 countries with complete child-level data, 10·7% (10·4–10·9) of children from households in the lowest wealth quintile had access to minimally adequate care compared with 41·2% (40·7–41·7) in the highest quintile. Inequalities were also large by urbanicity (17·7% [17·5–18.0] rural vs 32·2% [31·8–32.6] urban) but smaller by child sex (23·9% [23·6–24·2] girls vs 22·1% [21·9–22·4] boys).


Most children in LMICs are not receiving minimally adequate nurturing care during the next 1000-day period. Further investments in indicator measurement and resources for preschool-age children are needed, particularly for low-income populations and in the domains of responsive caregiving, early learning, and safety and security.

Emily Hanno, Jorge Cuartas, Luke Miratrix, Stephanie Jones, and Nonie Lesaux. 2022. “Changes in Children's Behavioral Health and Family Well-Being During the COVID-19 Pandemic.” Journal of Developmental & Behavioral Pediatrics . Publisher's VersionAbstract

Objective: The coronavirus disease 2019 pandemic and associated public health measures have influenced all aspects of life for children and families. In this study, we examine changes in children's behavioral health and families' well-being at the start of the pandemic.

Method: We used longitudinal data on 2880 children from 1 US state collected over 3 waves to compare family and child well-being before and after a state-wide stay-at-home advisory set in March 2020. We descriptively examined levels and changes in 4 child behavioral health outcomes (externalizing, internalizing, adaptive, and dysregulated behaviors) and 4 family well-being outcomes (parental mental health, parental stress, parent-child relationship conflict, and household chaos) across the preshutdown and postshutdown periods. Fixed effects regression models were used to predict within-child and within-family differences in preshutdown and postshutdown outcomes.

Results: Fixed effects analyses showed children's externalizing (0.09 points; 95% confidence interval [CI] 0.05-0.13), internalizing (0.04 points; 95% CI, 0.01-0.08), and dysregulated (0.11 points; 95% CI, 0.06-0.16) behaviors increased after the shutdown, whereas children's adaptive behaviors declined (-0.10 points; 95% CI, -0.15 to -0.05). Parental mental health issues (0.22 points; 95% CI, 0.17-0.27), parental stress (0.08 points; 95% CI, 0.03-0.12), parent-child relationship conflict (0.10 points; 95% CI, 0.04-0.16), and household chaos (0.10 points; 95% CI, 0.05-0.14) all increased relative to preshutdown levels.

Conclusion: Many children experienced declines in behavioral health and many families experienced declines in well-being in the early months of the public health crisis, suggesting the need for family-focused and child-focused policies to mitigate these changes.

Jorge Cuartas. 2022. “The effect of spanking on early social-emotional skills.” Child Development. Publisher's VersionAbstract
Whether spanking is detrimental for social-emotional (SE) development remains controversial, mostly due to disputes around the internal and external validity of existing evidence. This study examined the effect of spanking on the SE development of Bhutanese children, using a national, longitudinal sample (N = 1377; Mage = 50.5 months old; 50% girls). Following best-practice recommendations for mitigating issues of selection bias in observational developmental research, the study employed conservative methods (i.e., child fixed-effects and lagged-dependent variables) and robustness checks to assess the internal validity of estimates. Across approaches, spanking predicted reductions in SE skills of .09–.17 SD, even after controlling for all time-invariant confounders and baseline levels of SE skills. These findings strengthen the argument that spanking might be harmful to young children's SE development.
Dana McCoy, Jorge Cuartas, Jere Behrman, Claudia Cappa, Jody Heymann, Florencia López Boo, Chunling Lu, Abbie Raikes, Linda Richter, Alan Stein, and Günther Fink. 8/25/2021. “Global estimates of the implications of COVID-19-related preprimary school closures for children’s instructional access, development, learning, and economic wellbeing.” Child Development. Publisher's VersionAbstract
Observational data collected prior to the pandemic (between 2004 and 2019) were used to simulate the potential consequences of early childhood care and education (ECCE) service closures on the estimated 167 million preprimary-age children in 196 countries who lost ECCE access between March 2020 and February 2021. COVID-19-related ECCE disruptions were estimated to result in 19.01 billion person-days of ECCE instruction lost, 10.75 million additional children falling “off track” in their early development, 14.18 million grades of learning lost by adolescence, and a present discounted value of USD 308.02 billion of earnings lost in adulthood. Further burdens associated with ongoing closures were also forecasted. Projected developmental and learning losses were concentrated in low- and lower middle-income countries, likely exacerbating long-standing global inequities.
Kaitlin Paxton Ward, Andrew Grogan-Kaylor, Garret T Pace, Jorge Cuartas, and Shawna Lee. 8/2021. “Multilevel ecological analysis of the predictors of spanking across 65 countries.” BMJ Open, 11. Publisher's VersionAbstract

Objective Ending violence against children is critical to promote the health and socioemotional development of children across the globe. To this end, the UNICEF and the WHO have called for the abolishment of spanking, which is the most pervasive form of physical violence against children worldwide. This study used an ecological perspective to examine micro-level and macro-level predictors of parental spanking across 65 countries.

Participants Data came from the fourth and fifth rounds of the UNICEF Multiple Indicator Cluster Surveys, which were administered between 2009 and 2017 (N=613 861 households). We examined the predictors of spanking using multilevel logistic regression analysis.

Results Micro-level factors (ie, those observed at the familial level) were stronger predictors of spanking in comparison to macro-level factors (ie, those observed at the community and country level). Caregiver belief that children need physical punishment in order to be raised properly was the largest risk factor for spanking (OR=2.55, p<0.001). Older child age, the child being female, the head of the household having a secondary education or higher, and higher household wealth were protective factors against spanking, while a higher number of people living in the household was a risk factor for spanking. Living in an urban community was the only macro-level factor associated with spanking.

Conclusions Intervention at the micro-level and macro-level are important to reduce violence against children across the globe.

Jorge Cuartas. 7/21/2021. “Corporal punishment and early childhood development in 49 low- and middle-income countries.” Child Abuse & Neglect, 120. Publisher's VersionAbstract


To systematically assess the association between corporal punishment and young children's development in low- and middle-income countries (LMICs).


Data for 69 population-based surveys from the Multiple Indicators Cluster Survey (MICS) were combined. The sample included 131,164 children aged 36–59 months living in 49 LMICs. The surveys included information about children's developmental status and exposure to corporal punishment in the prior month. Logistic models, random-effects meta-analysis, and moderation analysis were used to obtain pooled estimates and assess the extent to which the association between corporal punishment and child developmental outcomes varied across countries.


On average, children exposed to corporal punishment were about 24% (β = 0.76, 95% CI 0.72–0.80) less likely to be developmentally on track than children who were not exposed to corporal punishment. Challenges in social-emotional development may drive the association between child development and corporal punishment. Corporal punishment was not associated with any positive developmental outcome in any country. There was minor heterogeneity in the estimated associations, which was not explained by the extent to which corporal punishment was normative within countries.


All forms of corporal punishment – including spanking – are likely to be harmful to young children's development and wellbeing. Public education, legal prohibition of corporal punishment, and other efforts are needed to protect children from corporal punishment and promote their wellbeing, health, and development.

Jorge Cuartas. 6/28/2021. “The effect of maternal education on parenting and early childhood development: An instrumental variables approach.” Journal of Family Psychology. Publisher's VersionAbstract
Maternal education is often considered an important determinant of children's early development. However, there is little empirical evidence on whether it is maternal education that contributes to better developmental outcomes or other ecological factors that relate to both education and children's development. This study used data on 4,874 mother-child (M age = 47.7 months) dyads from Uganda of the 2016 Demographic and Health Survey to assess the effects of maternal education on parenting and children's development. Taking advantage of a natural experiment with an instrumental variables approach, the study identified positive causal impacts of maternal schooling on children's development. Additional years of schooling also increased maternal engagement in stimulating activities, children's attendance to early childhood education programs, and reduced harsh corporal punishment. A mediation analysis suggested that increases in maternal stimulation and children's attendance to early childhood education programs and reductions in harsh corporal punishment partially explain the effects of maternal education on children's development. The positive impacts of education on parenting and child development indicate the need for more efforts to expand access to education in Uganda and other low- and- middle-income countries, including the abolishment of school fees for primary education. 
Jorge Cuartas, David Weissman, Margaret Sheridan, Liliana Lengua, and Katie McLaughlin. 4/9/2021. “Corporal punishment and elevated neural response to threat in children.” Child Development. Publisher's VersionAbstract
Spanking remains common around the world, despite evidence linking corporal punishment to detrimental child outcomes. This study tested whether children (Mage = 11.60) who were spanked (N = 40) exhibited altered neural function in response to stimuli that suggest the presence of an environmental threat compared to children who were not spanked (N = 107). Children who were spanked exhibited greater activation in multiple regions of the medial and lateral prefrontal cortex (PFC), including dorsal anterior cingulate cortex, dorsomedial PFC, bilateral frontal pole, and left middle frontal gyrus in response to fearful relative to neutral faces compared to children who were not spanked. These findings suggest that spanking may alter neural responses to environmental threats in a manner similar to more severe forms of maltreatment.
Marcus Waldman, Dana McCoy, Jonathan Seiden, Jorge Cuartas, and Günther Fink. 4/6/2021. “Validation of motor, cognitive, language, and socio-emotional subscales using the Caregiver Reported Early Development Instruments: An application of multidimensional item factor analysis.” International Journal of Behavioral Development. Publisher's VersionAbstract
The Caregiver Reported Early Development Instruments (CREDI) are assessments tools for measuring the development of children under age three in global contexts. The present study describes the construction and psychometric properties of the motor, cognitive, language, and socio-emotional subscales from the CREDI’s long form. Multidimensional item factor analysis was employed, allowing indicators of child development to simultaneously load onto multiple factors representing distinct developmental domains. A total of 14,113 caregiver reports representing 17 low-, middle-, and high-income countries were analyzed. Criterion-related validity of the constructed subscales was tested in a subset of participants using data from previously established instruments, anthropometric data, and a measure of child stimulation. We also report internal-consistency reliability and test–retest reliability statistics. Results from our analysis suggest that the CREDI subscales display adequate reliability for population-level measurement, as well as evidence of validity.
Jorge Cuartas and Dana McCoy. 1/6/2021. “Causal mediation in developmental science: a primer.” International Journal of Behavioral Development. Publisher's VersionAbstract
Mediation has played a critical role in developmental theory and research. Yet, developmentalists rarely discuss the methodological challenges of establishing causality in mediation analysis or potential strategies to improve the identification of causal mediation effects. In this article, we discuss the potential outcomes framework from statistics as a means for highlighting several fundamental challenges of establishing causality in mediation analysis, including the difficulty of meeting the key assumption of sequential ignorability, even in experimental studies. We argue that this framework—which, although commonplace in other fields, has not yet been taken up in developmental science—can inform solutions to these challenges. Based on the framework, we offer a series of recommendations for improving causal inference in mediation analysis, including an overview of best practices in both study design and analysis, as well as resources for conducting analysis. In doing so, our overall objective in this article is to support the use of rigorous methods for understanding questions of mechanism in developmental science.
Linda Richter, Jere Behrman, Pia Britto, Claudia Cappa, Caroline Cohrssen, Jorge Cuartas, Bernadette Daelmans, Amanda Dervecelli, Günther Fink, Sandra Fredman, Jody Heymann, Florencia Lopez Boo, Chunling Lu, Elizabeth Lule, Dana McCoy, Sara Naicker, Nirmala Rao, Abbie Raikes, Alan Sten, Claudia Vazquez, and Hirokazu Yoshikawa. 2021. “Measuring and forecasting progress in education: what about early childhood?” npj Science of Learning. Publisher's VersionAbstract
A recent Nature article modelled within-country inequalities in primary, secondary, and tertiary education and forecast progress towards Sustainable Development Goal (SDG) targets related to education (SDG 4). However, their paper entirely overlooks inequalities in achieving Target 4.2, which aims to achieve universal access to quality early childhood development, care and preschool education by 2030. This is an important omission because of the substantial brain, cognitive and socioemotional developments that occur in early life and because of increasing evidence of early-life learning’s large impacts on subsequent education and lifetime wellbeing. We provide an overview of this evidence and use new analyses to illustrate medium- and long-term implications of early learning, first by presenting associations between pre-primary programme participation and adolescent mathematics and science test scores in 73 countries and secondly, by estimating the costs of inaction (not making pre-primary programmes universal) in terms of forgone lifetime earnings in 134 countries. We find considerable losses, comparable to or greater than current governmental expenditures on all education (as percentages of GDP), particularly in low- and lower-middle-income countries. In addition to improving primary, secondary and tertiary schooling, we conclude that to attain SDG 4 and reduce inequalities in a post-COVID era, it is essential to prioritize quality early childhood care and education, including adopting policies that support families to promote early learning and their children’s education.
Jorge Cuartas, Dana McCoy, Andrew Grogan-Kaylor, and Elizabeth Gershoff. 9/8/2020. “Physical punishment as a predictor of early cognitive development: Evidence from econometric approaches.” Developmental Psychology. Publisher's VersionAbstract
This study estimates the effect of physical punishment on the cognitive development of 1,167 low-income Colombian children (Mage = 17.8 months old) using 3 analytic strategies: lagged-dependent variables, a difference-in-differences-like approach (DD), and a novel strategy combining matching with a DD-like approach. Across approaches, physical punishment at ages 9–26 months predicted reductions in children’s cognitive development of 0.08–0.21 SD at ages 27–46 months. These results, plus null results of falsification tests, strengthen the argument that physical punishment leads to slower cognitive growth and illustrate the utility of alternative statistical methods to reduce problems of selection bias in developmental research. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Jorge Cuartas, Joshua Jeong, Catalina Rey-Guerra, Dana McCoy, and Hirokazu Yoshikawa. 7/10/2020. “Maternal, paternal, and other caregivers’ stimulation in low- and- middle-income countries.” Plos One, 16, 7, Pp. e0236107. Publisher's VersionAbstract

Background and objectives

Globally, studies have shown associations between maternal stimulation and early child development. Yet, little is known about the prevalence of paternal and other caregivers’ stimulation practices, particularly in low- and- middle-income countries (LMICs).


Data from the Multiple Indicators Cluster Survey (MICS) and the Demographic and Health Survey (DHS) were combined across 62 LMICs (2010–2018). The sample included 205,150 mothers of children aged 3 and 4 years. High levels of stimulation were defined as caregiver engagement in at least 4 out of 6 possible activities with the child. The proportion of mothers, fathers, and other caregivers providing high levels of stimulation was calculated by country, region, and for the whole sample. Socioeconomic disparities within and between countries were estimated.


On average, 39.8% (95% CI 37.4 to 42.2) of mothers, 11.9% (95% CI 10.1 to 13.8) of fathers, and 20.7% (95% CI 18.4 to 23.0) of other adult caregivers provided high levels of stimulation. Stimulation varied by region, country income group, and Human Development Index (HDI), with higher levels of maternal and paternal–but not other caregivers’–stimulation in high-income and high-HDI countries. Within countries, stimulation levels were, on average, lower in the poorest relative to the richest households, and some but not all countries exhibited differences by child sex (i.e., boys vs. girls) or area (i.e., urban vs. rural).


Results suggest a need for intervention efforts that focus on increasing caregiver stimulation in LMICs, particularly for fathers and in low-income contexts.

Jorge Cuartas. 5/29/2020. “Heightened risk of child maltreatment amid the COVID-19 pandemic can exacerbate mental health problems for the next generation.” Psychological Trauma: Theory, Research, Practice, and Policy. Publisher's VersionAbstract
The spread of the COVID-19 disrupted ecological systems in which children develop, exacerbating threats to their safety and increasing their vulnerability to future psychopathology. Supports to reduce sources of stress for caregivers and protect children from threats to their safety are warranted
Sandra García and Jorge Cuartas. 5/19/2020. “Can poverty alleviation programs crowd-in private support? Short- and Middle-Run Effects of a Conditional Cash Transfer Program on Inter-Household Transfers.” Journal of Social Policy. Publisher's Version