Early childhood development coming of age: science through the life course
Open accessAbstract
Early childhood development programmes vary in coordination and quality, with inadequate and inequitable access, especially for children younger than 3 years. New estimates, based on proxy measures of stunting and poverty, indicate that 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of not reaching their developmental potential. There is therefore an urgent need to increase multisectoral coverage of quality programming that incorporates health, nutrition, security and safety, responsive caregiving, and early learning. Equitable early childhood policies and programmes are crucial for meeting Sustainable Development Goals, and for children to develop the intellectual skills, creativity, and wellbeing required to become healthy and productive adults. In this paper, the first in a three part Series on early childhood development, we examine recent scientific progress and global commitments to early childhood development. Research, programmes, and policies have advanced substantially since 2000, with new neuroscientific evidence linking early adversity and nurturing care with brain development and function throughout the life course.
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An estimated more than 250 million children are at risk of not reaching their developmental potential.
“it is estimated that in excess of 250 million children are at risk of failing to meet their developmental potential (Black et al., 2017).”
From Shared Picture Book Reading Interventions for Child Language Development: A Systematic Review and Meta-Analysis (2020) · cites this paper as Black et al., 2017
The section ‘Estimates of children at risk of not attaining developmental potential’ reports that 249.4 million children under 5 in low- and middle-income countries were at risk in 2010. This supports the approximate scale of the claim, but not ‘in excess of 250 million’; the section’s higher estimate of 279.1 million refers to 2004. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEarly developmental and language deficits are concentrated in low- and middle-income countries, especially Sub-Saharan Africa and Asia.
“This is a particularly important question, given that the burden of early developmental and language deficit falls in LMICpredominantly in Sub-Saharan Africa and Asia (Black et al., 2017).”
From Shared Picture Book Reading Interventions for Child Language Development: A Systematic Review and Meta-Analysis (2020) · cites this paper as Black et al., 2017
The section “Estimates of children at risk of not attaining developmental potential” (page unavailable) reports a large burden among children under 5 in LMICs, a high prevalence in sub-Saharan Africa, and a large number at risk in South Asia. It measures risk using stunting and extreme poverty, however, rather than establishing the geographic distribution of observed developmental or language deficits; it also specifies South Asia, not Asia generally. (LLM, conf=0.87)
Experimental — accuracy not yet measuredA bedtime routine itself embodies nurturing care and early child stimulation.
“A bedtime routine, in and of itself, embodies the characteristics of nurturing care and early child stimulation [1,3].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The life course conceptual framework describes nurturing care as responsive, emotionally supportive, and developmentally stimulating. The Home activities section identifies storytelling and singing as activities that promote early development. The paper does not discuss bedtime routines or establish that a routine, in and of itself, has those characteristics; pages were not supplied in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredParent-child attachment, child mood and emotional-behavioral regulation, and family stress levels are interrelated outcomes.
“parent–child attachment, child mood and emotional–behavioral regulation, and family stress levels are interrelated outcomes [1].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The 'Accumulation of adversities' section links family stress with difficulties in children’s self-regulation and says family adversity can undermine nurturing care. The 'Life course conceptual framework' also describes caregiver–child interactions and socio-emotional development as interconnected. Our copy does not specifically establish child mood, parent–child attachment, and family stress levels as interrelated outcomes. (LLM, conf=0.82)
Experimental — accuracy not yet measuredA large body of research indicates that proper nutrition in early childhood is necessary for physical health, including adequate growth and illness prevention.
“A large body of research indicates that proper nutrition during early childhood is necessary for physical health, including adequate growth and the prevention of illness”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The Health and nutrition section (page unavailable) says that undernourished children are at high risk for developmental problems and that nutrition interventions are necessary to promote child development. The Early brain development section also links nutritional deficiencies to adverse growth outcomes. Neither passage establishes the claim that proper nutrition during early childhood prevents illness. (LLM, conf=0.83)
Experimental — accuracy not yet measured
Frequent, high-quality reading or singing interactions beginning early in development promote early literacy and cognitive development.
“Recommendations to promote early literacy and cognitive development have emphasized the need for frequent, high-quality interactions around reading or singing that begin early in development [18], in order to capitalize on increased neuroplasticity between ages 0 and 3 y [1,103,104].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The Home activities section says storytelling and singing expose young children to experiences that promote early development, and it discusses adults reading to children. The life course framework also emphasizes responsive caregiving and early learning. Neither passage specifically recommends frequent, high-quality reading or singing interactions or links those activities to early literacy and cognitive development; page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredInvesting early in the health and wellbeing of all children, especially those at increased risk for poor outcomes, is a robust and cost-effective method for conferring positive short- and long-term developmental outcomes.
“investing early in the health and wellbeing of all children, but especially those who are at increased risk for poor outcomes, has been shown to be a robust and cost-effective method for conferring positive short- and longterm developmental outcomes [1,2].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The Introduction reports long-term benefits of early interventions for children exposed to poverty or adversity and says these findings provide strong economic justification for investment. The Delivery strategies section favors reaching vulnerable groups and discusses universal programming in communities facing extreme poverty or malnutrition. These passages support early investment, particularly for at-risk children, but do not establish that investment for all children is uniformly robust and cost-effective; the copy provides no page numbers for these passages. (LLM, conf=0.83)
Experimental — accuracy not yet measuredLower SES children and families have increased risk for dental caries, other health concerns, and lower levels of school readiness and academic achievement.
“studies have shown increased risk for dental caries, other health concerns, and lower levels of school readiness and academic achievement in lower SES children and families [1,97,107].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The ‘Adversity, brain development, and protective influences’ section links low socioeconomic status and poverty to poorer cognitive and academic performance. The ‘Accumulation of adversities’ section describes broader developmental and health-related risks of poverty. Our copy does not address dental caries or explicitly establish lower school readiness among lower-SES children. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAn adaptive bedtime routine generates rich opportunities to support positive early childhood developmental outcomes and is a framework for promoting nurturing care and early child stimulation.
“An adaptive bedtime routine generates rich opportunities to support positive early childhood developmental outcomes, and is a clear framework for promoting nurturing care (adequate health, nutrition, security and safety, responsive caregiving, and early learning opportunities) and early child stimulation [1,3].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The Life course conceptual framework section links nurturing care—including responsive, developmentally stimulating care—to positive child development. The Home activities section says storytelling, singing, and play promote early development. Neither section identifies an adaptive bedtime routine as a framework or establishes its developmental effects; page numbers were not available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredA bedtime routine that includes appropriate nutrition, hygiene, and communication-related activities may be critical in health promotion for lower SES children.
“A bedtime routine that includes appropriate nutrition, hygiene, and communication-related activities may be critical in health promotion for these children, given that studies have shown increased risk for dental caries, other health concerns, and lower levels of school readiness and academic achievement in lower SES children and families [1,97,107].”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The paper’s “Adversity, brain development, and protective influences” section (page unavailable) links low socioeconomic status and poverty with poorer cognitive and academic performance. Its “Home activities” section (page unavailable) also describes developmental benefits of activities such as storytelling and reading, with disparities by wealth. The copy does not support the more specific claim about bedtime routines, hygiene, dental caries, or school readiness. (LLM, conf=0.86)
Experimental — accuracy not yet measuredProper early childhood nutrition supports brain growth, while protein malnutrition and micronutrient deficiencies impair cognitive development and raise the risk of poor neuro-behavioral outcomes.
“Proper nutrition during early childhood also helps to support brain growth [1], whereas protein malnutrition and micronutrient deficiencies inhibit cognitive development and increase childhood risk for poor neuro-behavioral outcomes”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
Adversity within low-and middle-income countries (LMICs) poses severe threats to neurocognitive development.
“Adversity within low-and middle-income countries (LMICs) poses severe threats to neurocognitive development, which can be partially mitigated by high-quality early family experiences.”
From Early Family Experiences and Neural Activity in Rural Pakistani Children: The Differential Role of Gender (2024) · cites this paper as Black et al. 2017
Children in impoverished areas of LMIC are exposed to severe threats to development, such as malnutrition, lack of access to healthcare, and poor sanitation.
“Children in impoverished areas of low-and middle-income countries (LMIC) are exposed to severe threats to development, such as malnutrition, lack of access to healthcare, and poor sanitation (Black et al. 2017).”
From Early Family Experiences and Neural Activity in Rural Pakistani Children: The Differential Role of Gender (2024) · cites this paper as Black et al. 2017
Hygiene activities such as bathing and brushing teeth directly affect children's health by preventing illness and disease.
“Hygiene-related activities such as bathing and brushing teeth have direct effects on children's health by preventing illness and disease”
From Benefits of a bedtime routine in young children: Sleep, development, and beyond. (2018) · cites this paper as [1]
The Home activities section discusses storytelling, singing, and play, while Health and nutrition discusses illness as a risk for developmental problems. Neither addresses whether bathing or brushing teeth prevents illness or disease in children; searches for those activities and hygiene found no supporting passage in our copy. (LLM, conf=0.74)
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References 108 · Cited by 3,014
- Authors
- Black, M. M., Walker, S. P., Fernald, L. C. H., Andersen, C. T., DiGirolamo, A. M., Lu, C., McCoy, D. C., Fink, G., Shawar, Y. R., Shiffman, J., Devercelli, A. E., Wodon, Q. T., Vargas-Barón, E., & Grantham-McGregor, S.
- Affiliations
- University of Maryland, Baltimore (US)
- University of the West Indies System (JM)
- University of California, Berkeley (US)
- Harvard University (US)
- Georgia State University (US)
- Brigham and Women's Hospital (US)
- University of Pennsylvania (US)
- American University (US)
- World Bank Group (US)
- Corresponding author
- Black, Maureen M
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 389
- Issue
- 10064
- Pages
- 77-90
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC5884058
- OpenAlex
- W2528342610
- Cited by
- 3,014
- References
- 108
- Citations by year
- 2026: 335 · 2025: 368 · 2024: 319 · 2023: 418 · 2022: 395 · 2021: 383 · 2020: 276 · 2019: 242 · 2018: 165 · 2017: 89 · 2016: 16 · 2015: 2
- FWCI
- 22.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Archive @ GSU (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Bill and Melinda Gates Foundation
- Conrad N. Hilton Foundation
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K01HD071929)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Education › Early Childhood Education and Development
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- early childhood development, early childhood development programs, child stunting, child poverty, low- and middle-income countries, responsive caregiving, early learning, childhood adversity, nurturing care, brain development, life course, Sustainable Development Goals, early childhood education policy
- MeSH terms
- Brain, Child, Child Development, Developmental Disabilities, Child Nutritional Physiological Phenomena, Child Welfare, Child, Preschool, Delivery of Health Care, Developing Countries, Growth Disorders, Humans, Poverty, Preventive Health Services, Risk Factors
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