Socioeconomic factors in development and behavioural outcomes in Uruguayan children under 4 years old.  La situación conductual y del desarrollo en la primera infancia (0-4) y su asociación con factores socioeconómicos. Un análisis del caso uruguayo. Peter Fitermann Juan Mila GEF-Grupo de Estudios de Familia - UDELAR (English translation)

The objective of the assesment in early child development Get free access databases about life conditions and context of children and child development (0-3 ) Collect detailed data about health , nutrition and child development and their causes. Follow up of a Panel Sample (next wave: November 2015) Have insights to monitor and design public policies

Instruments Sample: 0–47months N=1163. Socioeconomic questionnaire with contextual information Anthropometric data: height, weight and head circumference Psychometric tests       ASQ: SE       ASQ 3 (from 3rd month )       CBCL (from 18th month)       EEDP (up to 23rd month)       TEPSI language (from the 24th month)       MSP instrument (Uruguay)       Bedregal Instrument(DIEH-Chile)

Socio-Emotional Development Self-regulation Compliance Communication Adaptative functioning Autonomy Affect Interaction with people

ASQ:SE SOCIO-EMOTIONAL DEVELOPMENT

ASQ:SE SOCIO-EMOTIONAL DEVELOPMENT

ASQ:SE Frequencies and % USA Montevideo 6 m 15% 4% 12 m 12% 3% 18 m 9%   USA Montevideo ASQ  Total Risk Risk % Risk % 6 m 71 11 15% 101 4 4% 12 m 85 10 12% 132 3% 18 m 99 9 9% 192 5% 24 m 152 17 11% 188 19 10% 30 m 116 179 22 36 m 28 16% 244 27 48 m 174 20 50 6 TOTAL 876 105 1086 91 8%

ASQ: SE (age in monts) Nomal range Monitoring range

Socio-Emotional Development. Risk Range Normal Range Above Poverty Below Poverty Household Income by quintiles Poverty

Boys Girls Below Poverty Above Poverty Monitoring Range Monitoring Range

CBCL PREESCHOOLARS

CBCL 1 ½-5 preeschoolars Internalized Problems ( %) Externalized Normal Distribution (Percentiles P83-P90)

It is premature to extract optimistic conclusions from the relatively low values from the ASQ:SE and CBCL 1.5 / 5. analysis. CBCL: Total and Internalized problems, parents have reported fewer symptoms and problem behaviors than the average founded in other societies; otherwise, the prevalence of Externalized Problems is similar to the values found in other societies. ASQ:SE: low prevalence of difficulties are founded at low ages (less than 24 months) Cbcl and ASQ:SE search for similar difficulties, sharing only aprox. 10 % of items. Both evaluate the emotional, social and behavioral areas. Both show slightly low means (raw scores). Is the first use in our society in large scale and these results should be analyzed carefully.

URUGUAY

CBCL 1 1/2 - 5 Household Income quintiles Household Income quintiles: from low income (1) to high (5)

CBCL Preschoolars -Clinical Range 18 -23 months 24 -35 months Total Total Problems 5.03 3.07 2.02 3.78 Internalized Problems 1.44 2.92 3.14 2.31 Externalized Problems 11.14 7.44 5.47 8.79

Probability of having problems in different domains, related with educational background (years) of principal caretaker.

ASQ:3 18 Questionnaires, 30 items each (aprox.) From 1 to 47 months in this study (66 months max. the instrument) 5 areas of develoment: Comunication Fine Motor skills Gross Motor skills Problem Resolution Social- Individual

Grafico 1.- Resultados globales para ASQ:3 Sub-muestra Montevideo, 1-47 meses, N=1163 Gross Motor Gross Motor Fine Motor

ASQ:3 % of children within Risk Range <24 months >24 months <24 months >24 months <24 months >24 months <24 months >24 months <24 months >24 months Communication Gross Motor Fine Motor Problem Solving Socio-individual

Gross Motor Communication Problem Fine Motor Solving <24 months >24 months <24 months >24 months <24 months >24 months <24 months >24 months <24 months >24 months Expected Gross Motor Problem Solving Communication Fine Motor

Gross Motor Skills Fine Motor Skills Problem Solving Communication Social-Individual

ASQ:3 results by Household poverty condition Pov Not Pov Pov Not Pov Pov Not Pov Pov Not Pov Pov Not Pov Communication Gross Motor Fine Motor Problem Solving Risk Range Monitoring Range

ASQ:3 Normal Range by Household income quintiles Gross Motor Problem Solving Communication Fine Motor Quintil 1 Quintil 2 Quintil 3 Quintil 4 Quintil 5

ASQ:3 allows to screen motor and psicological -cognitive, social and afective- basic skills Near twice of % expected of children in the Risk Range: 4 - 8 %. Aprox. 11% of children in Monitoring Range (acording to expected %)

ASQ:3.- In four of the five areas evaluated, better performances are achieved in 3 years old children. By contrast, Problem Solving area (Cognitive) show an increased value of children in the Risk zone, reaching values of 8.6% in 3 years old children. In the next wave, the age range studied will include children up to 6 years old.

ASQ:3 and Household Income Worst performances are found in lower income households in four areas: communication, fine motor skills, problem solving and social-individual. Only gross motor skills area show no differences in results by household income.

The following table summarizes the main findings by gender. Statistical tests shows differences between genders are significant at 5% for all areas except Gross Motor. The results indicate a slight advantage in performance for girls. With different methodology, only found in the sample without expanding statistically significant differences in the 95% CI for the areas of communication and fine motor skills. The following table summarizes the main findings by gender.  Range  Communication Gross Motor Skills Fine Motor Skills Problem Solving Social-individual Boys Girls Risk 7,2% 3,4% 4,8% 6,4% 6,2% 2,5% 6,7% 3,8% Monitoring 9,8% 9,0% 9,1% 6,3% 14,0% 8,5% 10,7% 8,9% Normal 83,0% 87,6% 86,0% 87,3% 79,8% 89,0% 82,6%

Risk and Monitoring Ranges. ASQ:3 - Girls and Boys – Risk and Monitoring Ranges. Monitoring Range Risk Range Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls Fine Motor Communication Gross Motor Problem Solving