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Effects of home-based play-assisted stimulation on developmental performances of children living in extreme poverty : a randomized single-blind controlled trial

Berhanu Nigussie Worku, Teklu Gemechu Abessa, Mekitie Wondafrash Kibebew UGent, Johan Lemmens, Jan Valy, Liesbeth Bruckers, Patrick Kolsteren UGent and Marita Granitzer (2018) BMC PEDIATRICS. 18.
abstract
Background: Children living with foster families in a resource-limited setting such as Ethiopia are at risk of developmental problems. It is not yet clear whether intensive home-based developmental stimulation assisted by play can reduce these problems. The main objective of this study was to examine the effects of play-assisted intervention integrated into basic services on the developmental performance of children living with foster families in extreme poverty. Methods: A randomized single-blind (investigator) controlled trial design was used. The study was conducted in Jimma, South West Ethiopia. Using computer-generated codes, eligible children of 3-59 months in age were randomly allocated to intervention (n = 39) and control (n = 39) groups at a 1:1 ratio. Children in the intervention group received home-based play-assisted stimulation in addition to the basic services provided to children in both groups. The intervention consisted of an hour of play stimulation conducted during a weekly home visit over the course of six months. Personal-social, language, fine and gross motor outcomes were assessed using Denver II-Jimma, and social-emotional outcome was obtained using an adapted Ages and Stages Questionnaire: Social-Emotional (ASQ: SE). Information about sociodemographic characteristics was collected using a structured questionnaire. Anthropometric methods were used to determine nutritional status. The effects of the intervention on the abovementioned outcomes over the study period and group differences in change over time were examined using Generalized Estimating Equations (GEE). Results: Statistically significant intervention effects were found for language (P = 0.0014), personal-social (P = 0.0087) and social-emotional (P < 0.0001) performances. At the midline of the study, language (effect size = 0.34) and social-emotional (effect size = - 0.603) benefits from the play-assisted stimulation had already been observed for the children in the intervention group. For language, the intervention effect depended on the child's sex (P = 0.0100) and for personal-social performance, on family income (P = 0.0300). Conclusions: Intensive home-based play-assisted stimulation reduced the developmental problems of children in foster families in the context of extreme poverty. Longer follow-up may reveal further improvements in the developmental performance of the children.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Developmental performance, Developmental stimulation, Extreme poverty, Foster family, Home-based, Play-assisted stimulation, MIDDLE-INCOME COUNTRIES, SOCIAL-EMOTIONAL PROBLEMS, YOUNG-CHILDREN, EARLY INTERVENTION, EARLY-CHILDHOOD, FOSTER-CARE, PARENTING INTERVENTION, DEVELOPMENT PROGRAM, ADVERSE OUTCOMES, FOLLOW-UP
journal title
BMC PEDIATRICS
BMC Pediatr.
volume
18
article number
29
pages
11 pages
Web of Science type
Article
Web of Science id
000424208700004
ISSN
1471-2431
DOI
10.1186/s12887-018-1023-0
language
English
UGent publication?
yes
classification
A1
copyright statement
Creative Commons Attribution 4.0 International Public License (CC-BY 4.0)
id
8547918
handle
http://hdl.handle.net/1854/LU-8547918
date created
2018-02-06 09:14:09
date last changed
2018-03-05 09:31:40
@article{8547918,
  abstract     = {Background: Children living with foster families in a resource-limited setting such as Ethiopia are at risk of developmental problems. It is not yet clear whether intensive home-based developmental stimulation assisted by play can reduce these problems. The main objective of this study was to examine the effects of play-assisted intervention integrated into basic services on the developmental performance of children living with foster families in extreme poverty. 
Methods: A randomized single-blind (investigator) controlled trial design was used. The study was conducted in Jimma, South West Ethiopia. Using computer-generated codes, eligible children of 3-59 months in age were randomly allocated to intervention (n = 39) and control (n = 39) groups at a 1:1 ratio. Children in the intervention group received home-based play-assisted stimulation in addition to the basic services provided to children in both groups. The intervention consisted of an hour of play stimulation conducted during a weekly home visit over the course of six months. Personal-social, language, fine and gross motor outcomes were assessed using Denver II-Jimma, and social-emotional outcome was obtained using an adapted Ages and Stages Questionnaire: Social-Emotional (ASQ: SE). Information about sociodemographic characteristics was collected using a structured questionnaire. Anthropometric methods were used to determine nutritional status. The effects of the intervention on the abovementioned outcomes over the study period and group differences in change over time were examined using Generalized Estimating Equations (GEE). 
Results: Statistically significant intervention effects were found for language (P = 0.0014), personal-social (P = 0.0087) and social-emotional (P {\textlangle} 0.0001) performances. At the midline of the study, language (effect size = 0.34) and social-emotional (effect size = - 0.603) benefits from the play-assisted stimulation had already been observed for the children in the intervention group. For language, the intervention effect depended on the child's sex (P = 0.0100) and for personal-social performance, on family income (P = 0.0300). 
Conclusions: Intensive home-based play-assisted stimulation reduced the developmental problems of children in foster families in the context of extreme poverty. Longer follow-up may reveal further improvements in the developmental performance of the children.},
  articleno    = {29},
  author       = {Worku, Berhanu Nigussie and Abessa, Teklu Gemechu and Wondafrash Kibebew, Mekitie and Lemmens, Johan and Valy, Jan and Bruckers, Liesbeth and Kolsteren, Patrick and Granitzer, Marita},
  issn         = {1471-2431},
  journal      = {BMC PEDIATRICS},
  keyword      = {Developmental performance,Developmental stimulation,Extreme poverty,Foster family,Home-based,Play-assisted stimulation,MIDDLE-INCOME COUNTRIES,SOCIAL-EMOTIONAL PROBLEMS,YOUNG-CHILDREN,EARLY INTERVENTION,EARLY-CHILDHOOD,FOSTER-CARE,PARENTING INTERVENTION,DEVELOPMENT PROGRAM,ADVERSE OUTCOMES,FOLLOW-UP},
  language     = {eng},
  pages        = {11},
  title        = {Effects of home-based play-assisted stimulation on developmental performances of children living in extreme poverty : a randomized single-blind controlled trial},
  url          = {http://dx.doi.org/10.1186/s12887-018-1023-0},
  volume       = {18},
  year         = {2018},
}

Chicago
Worku, Berhanu Nigussie, Teklu Gemechu Abessa, Mekitie Wondafrash Kibebew, Johan Lemmens, Jan Valy, Liesbeth Bruckers, Patrick Kolsteren, and Marita Granitzer. 2018. “Effects of Home-based Play-assisted Stimulation on Developmental Performances of Children Living in Extreme Poverty : a Randomized Single-blind Controlled Trial.” Bmc Pediatrics 18.
APA
Worku, B. N., Abessa, T. G., Wondafrash Kibebew, M., Lemmens, J., Valy, J., Bruckers, L., Kolsteren, P., et al. (2018). Effects of home-based play-assisted stimulation on developmental performances of children living in extreme poverty : a randomized single-blind controlled trial. BMC PEDIATRICS, 18.
Vancouver
1.
Worku BN, Abessa TG, Wondafrash Kibebew M, Lemmens J, Valy J, Bruckers L, et al. Effects of home-based play-assisted stimulation on developmental performances of children living in extreme poverty : a randomized single-blind controlled trial. BMC PEDIATRICS. 2018;18.
MLA
Worku, Berhanu Nigussie, Teklu Gemechu Abessa, Mekitie Wondafrash Kibebew, et al. “Effects of Home-based Play-assisted Stimulation on Developmental Performances of Children Living in Extreme Poverty : a Randomized Single-blind Controlled Trial.” BMC PEDIATRICS 18 (2018): n. pag. Print.