Open-access Association between early childhood development and shared play and reading

Associação entre desenvolvimento precoce infantil e brincadeiras e leitura compartilhadas

Relación entre el desarrollo de la primera infancia y el juego y la lectura compartidos

Abstract

The impact of shared parental/family interaction on domains of early childhood development beyond language is unclear. We investigate the association between parental/family interaction (through shared reading/playing) and early childhood development at age 2. We used data from the 4th wave of a cohort following mothers and babies born between July and August 2020, named IRACEMA-Covid. Information on parental/family interaction was self-reported, and domains of child development were measured using the Caregiver Reported Early Development Instrument (CREDI). Descriptive statistics were performed using means and standard deviations. Inferential analyses were conducted using x2, Kruskal-Wallis, and crude and adjusted linear regression models. Family/parental interaction, as represented by playing/reading together, was associated with better development not only in language (0.81), as measured by CREDI, but also in cognition (0.62), motor (0.69), socio-emotional (0.80), and overall (0.75) domains. The results suggest that promoting shared play and reading in child intervention programs would be beneficial.

Key words:
Child development; Family; Reading; Playing

Resumo

Os impactos da interação entre pais e família em domínios do desenvolvimento da primeira infância para além do desenvolvimento da linguagem permanecem incertos. Investigamos a associação entre a interação parental/familiar (por meio de leitura/brincadeiras compartilhadas) e o desenvolvimento da primeira infância aos 2 anos de idade. Utilizamos dados da 4ª onda de uma coorte que acompanha mães e bebês nascidos entre julho e agosto de 2020, denominada IRACEMACovid. As informações sobre a interação parental/familiar foram autorreferidas e os domínios do desenvolvimento infantil foram medidos pelo Caregiver Reported Early Development Instrument (CREDI). A estatística descritiva foi realizada por meio de medidas de dispersão (médias e desvios padrão). As análises inferenciais foram conduzidas utilizando x2, Kruskal-Wallis e modelos de regressão linear bruto e ajustado. A interação família/pais, representada pelo brincar/ler em conjunto, está associada a um melhor desenvolvimento não só da linguagem (0,81), medido pelo CREDI, mas da cognição (0,62), motora (0,69), socioemocional (0,80) e domínios gerais (0,75). Os resultados sugerem que seria benéfico promover a brincadeira e a leitura compartilhadas em programas de intervenção infantil.

Palavras-chave:
Desenvolvimento infantil; Família; Leitura; Brincadeira

Resumen

Los impactos de la interacción entre padres y familia en dominios del desarrollo de la primera infancia más allá del desarrollo del lenguaje siguen siendo inciertos. Investigamos la asociación entre la interacción entre padres y familia (mediante la lectura y el juego compartidos) y el desarrollo infantil temprano a los 2 años de edad. Utilizamos datos de la cuarta ola de una cohorte que sigue a madres y bebés nacidos entre julio y agosto de 2020, llamada IRACEMACovid. La información sobre la interacción entre padres y familia fue autoinformada y los dominios del desarrollo infantil se midieron mediante el Instrumento de Desarrollo Temprano Informado por el Cuidador (CREDI). Se realizó estadística descriptiva utilizando medidas de dispersión (medias y desviaciones estándar). Se realizaron análisis inferenciales utilizando x2, Kruskal-Wallis y modelos de regresión lineal crudos y ajustados. La interacción familia/padres, representada por jugar/leer juntos, se asocia con un mejor desarrollo no sólo del lenguaje (0,81), medido por CREDI, sino también de los dominios cognitivo (0,62), motor (0,69), socioemocional (0,80) y general (0,75). Los resultados sugieren que sería beneficioso promover el juego y la lectura compartidos en los programas de intervención en la primera infancia.

Palabras clave:
Desarrollo infantil; Familia; Lectura; Broma

Introduction

The idea of play is deeply rooted in human culture, life, and it plays an important role in human development. Playing can be defined as “a transaction between the individual and the environment that is intrinsically motivated, internally controlled, and free from many of the constraints of objective reality and skills related to framing (giving and responding to cues)”1. It has a wide range of benefits for children, including improved language skills and better physical development. The activity of playing can manifest in various ways, such as engaging in physical play, imaginative play, and playing with conventional toys and shape sorters2.

In addition to playing, another crucial developmental stimulus is the practice shared book reading, which involves reading to or with the child. This practice has been found to bring benefits to several areas of child development, particularly language. It can be done individually or in groups and is suitable for both literate and non-literate children3.

While shared playing and reading are often cited as positive stimuli for child development in the first 2 years of life, the literature has largely focused on their facilitation or stimulation of language development. This is due to increased interaction and communication between parents and children4. Some studies have reported positive associations between shared playing/reading and socio-emotional factors5, academic skills6, and vocabulary and sustained attention skills7. However, to the best of our knowledge, no studies have used instruments that simultaneously gather information on cognitive, language, motor, and socio-emotional domains. Exploring the association between shared playing/reading and other domains of child development beyond language could provide valuable insights for discussing of individual or collective interventions aimed at enhancing early childhood development. This could ultimately have a positive impact on the child’s long-term outcomes.

Our objective is to fill this gap by evaluating the association between parental/family interaction, specifically shared playing/reading, and child development at 2 years of age.

Materials and Methods

This study uses data from Iracema-COVID, a cohort study that follows mothers and their children born between July and August 2020, in the city of Fortaleza, the capital of the state of Ceará, in northeastern Brazil. Recruitment was conducted using the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos - SINASC), which identified and contacted by phone mothers who gave birth in public hospitals and reside in Fortaleza. Data collection was conducted by interviewers at the participants’ homes. The cohort design has been previously described in detail elsewhere8-10. We conducted a cross-sectional analysis of 317 dyads (mothers and children) using data from the fourth wave of Iracema-COVID, when the children were 2 years old. We excluded 11 children with neurological disorders reported by their mothers, from the analysis. Information on daily playing/reading between the child and the family, collected through the following question: “Every day, do you or someone else in your family usually play, read, or talk only with the child?”, was exposure variable. This question allowed for a “Yes” or “No” response.

The outcome Child development is the outcome of the analysis and was assessed using the Caregiver Reported Early Development Instrument (CREDI), a tool designed for population-level use, and comparable across cultures. It collects data on child development across five domains: cognitive, language, motor, socio-emotional, and overall11. The long version of the instrument, consisting of 117 questions, was utilized in this study. It has been translated and validated for use in Brazil12, and here we utilized the long version of 117 questions. The scores for each domain were calculated using to an algorithm provided by the developers of CREDI (https://credi.shinyapps.io/Scoring_App/). The results are presented and analyzed as age-adjusted z-scores, assuming a normal distribution, and categorized as follows < -2SD; -2 ≤ SD ≤ -1; -0.99 ≤ SD ≤ 0.99; 1 ≤ SD ≤ 2; and > 2SD.

To adjust the models, two variables related to psychosocial stimulation were selected to adjust the models because they were believed to be associated with the exposure and outcome13. These variables were: a) the presence of books, newspapers, and magazines in the home, and b) ownership of children’s books with pictures. In addition, the following self-reported variables were used in the analysis including the child’s sex (male/female), prematurity (Yes/No); child attendance at daycare (Yes/No), maternal education (in years), mother’s skin color (white, yellow, black/brown, other); mother living with a partner (Yes/No), income (monthly family minimum wage: < 1; 1-2; 3 or more), whether the mother has other children < 6 years old (Yes/No), whether the mother receives help with child care (Yes/No), whether the mother receives government cash transfer (Yes/No), whether the mother has private health insurance (Yes/No), and maternal common mental disorders (Self-Reported Questionnaire (SRQ20): negative: < 8; positive: 8 or more).

The study conducted a descriptive analysis using means, standard deviations, raw and relative frequencies. The distribution of CREDI scores according to shared play/reading was described using the Kernel density estimator. Bivariate analyses were performed using the chi-squared and Kruskal-Wallis tests. Crude and adjusted linear regression models were run for each of the CREDI domains to determine the association between shared play/reading between family members and children and better child development. All covariates that showed statistical significance at the 0.05 to 0.20 level in the crude bivariate analysis were included in the adjusted model. Final covariates included in the multivariable model were selected using a backward stepwise approach. All models were adjusted for variables related to the availability of magazines/newspapers and children’s books at home. The analyses were performed using Stata v.11.

Results

Out of the 306 children studied, 285 (93.11%) engaged in daily reading/playing activities with their parents or relatives. About half were male, 10.46% were born prematurely, and 22.08% were attending kindergarten. The mean CREDI z-scores by domain were -0.33 for cognition, -0.54 for language, -0.45 for motor skills, -0.32 for socio-emotional, and -0.45 for the overall. The mothers’ mean age was 26.18 years and their mean years of education was of 10.67 at the time of the interview. Additionally, 83.01% of the participants self-identified as having black or brown skin color, 75.81% lived with a partner, 53.19% reported a monthly income between 1 and 2 minimum wages, and 63.07% received cash transfer assistance (Tables 1 and 2).

Table 1
Parent-child shared book reading/play, according to CREDI domains and maternal age and education, Iracema-COVID Cohort Study. Fortaleza, Brazil, 2021-2022.
Table 2
Parent-child shared book reading/play, according to maternal and child features (categorical variables), Iracema-COVID Cohort Study. Fortaleza, Brazil, 2021-2022.

The Kernel distribution of the CREDI scores disaggregated by shared playing/reading status indicates that results for children who were exposed to shared playing/reading had better results in all CREDI domains (Figure 1).

Figure 1
Kernel density estimator charts of CREDI domains according to shared play/reading.

Tables 3 and 4 show a significant difference in the CREDI domains, with better outcomes (higher scores) for children who participated in shared playing/reading activities with parents or family members. Furthermore, a crude analysis, stratified for each of the CREDI domains revealed a statistically significant association between the child’s sex and all of the CREDI domains, with girls achieving higher scores. Maternal age was also positively associated with higher scores in language, socio-emotional, and overall CREDI domains. Higher maternal education was associated with better cognition results, the presence of a partner in the household was associated with better scores in the cognition, motor, socio-emotional, and overall domains. Adjusted regression analyses showed that engaging in playing/reading activities with parents or family members contributed to improved child development across all domains measured by the CREDI (Tables 3 and 4).

Table 3
Models of crude and adjusted linear regression analysis of child development domains, according to parent-child shared book reading/play and maternal and child characteristics.
Table 4
Models of crude and adjusted linear regression analysis of child development domains, according to parent-child shared book reading/play and maternal and child characteristics.

Discussion

This study investigated the relationship between shared play and reading activities among children and their parents or relatives, and child development. The results indicate that shared play and reading activities may improve cognitive, language, motor, socio-emotional, and overall development in 2-year-old children.

The literature consistently reports that exposure to conversation14, shared book reading15, and playing2 are factors that contribute to greater language development in children. This might be because this activity stimulates an increase in the density and myelination of the fibers that compose the brain’s white matter, which enhances language skills16. Our results support these findings and demonstrate a positive association between language development and playing/reading.

However, engaging in play can offer benefits in other aspects such as social and emotional behavior, cognition17, and physical skills18. In many mammals, the neocortex, which is responsible for functions such as sensory perception, emotion, and cognition, is more frequently activated during play time19. Additionally, among primates, a study with primates showed that games involving locomotion results in a greater development of motor skills20. These data can support the hypothesis that motor skills can be influenced by games in humans as well. Assuming that humans have similar processes, we would anticipate higher scores in the CREDI cognitive and motor domains in children who experienced a shared play/reading situation, as shown by our results.

Play, especially social play, has been found to promotes the activation of areas of the human brain associated with social processing and empathy, particularly the posterior superior temporal sulcus21. This area is involved in perceiving social cues and understanding and empathizing with others. This suggests that engaging in play with others, particularly with parents and relatives, may have positively impact the socio-emotional development of children.

Our results suggest the benefits of implementing programs and policies to promote shared reading between children and parents or family members can have numerous benefits. Such programs can help to foster positive relationships between children and their caregivers, promote early literacy skills, and support cognitive development. Fortunately, experiences taking place in the home22 are already being reported worldwide, with government support23 or initiated by foundations and non-governmental organizations24, and are considered to be cost-effective, as they can be implemented relatively easily and can have a significant impact on children’s development.

From a global perspective, the information in this study can contribute to achieving one of the goals of the United Nations 2030 Agenda for Sustainable Development, to “ensure that all girls and boys have access to quality early childhood development, care, and preprimary education so that they are ready for primary education”25. By taking action to promote shared reading and invest in quality early childhood development programs, we can help to ensure that all children have the opportunity to reach their full potential and contribute to a more sustainable and equitable future. In addition, from a national perspective, article 3 of the Child and Adolescent Statute provides the following statement:

“Art. 3. Children and adolescents enjoy all the fundamental rights inherent to the human person, without prejudice to the full protection provided by this law, which guarantees them, by law or by other means, all the opportunities and facilities to ensure their physical, mental, moral, spiritual and social development, in conditions of freedom and dignity.”26.

The text of the legal provision emphasizes the importance of promoting the adequate proper development of children, which can also be encouraged through the discussion of the data presented here.

The strength of this study lies in the use of a standardized instrument to measure child development. Therefore, it facilitates the assessment of the benefits of shared playing/reading on various domains of development beyond language. This study also has some limitations. The exposure variable was self-reported by the mother rather than directly observed, which may result in an overestimation of parental behavior. Also, the question that generated the shared play/reading variable includes “talking” only with the child. This could have overestimated the frequency of the exposure variable, however, talking is a fundamental part of the language development stimulation and would likely be included on the playing/ reading activities. Considering the novelty of the proposal presented in this article, it was not possible to find research in the literature that analyzed the association between shared reading and playing and early development through CREDI. It should also be mentioned that CREDI does not provide for any type of adjustment for cases of prematurity. Even though the data analyzed here did not show differences based on this variable, this procedure could be considered and discussed in future research. This may be a secondary limitation of this study, as the discussion cannot be developed in dialogue with papers using the same approach. Since the sample for this research was not specifically designed for the purpose of this article, we have subgroups with few or no representatives in the analyses. Therefore, conducting research with larger and more representative samples would be recommended to confirm our findings. Furthermore, in future studies, it would be important to collect information about reading, playing, and conversations shared with the family separately. Thus, the association of each type of stimulus could be studied individually.

Conclusion

The practice of playing/reading shared between parents/relatives and children was positively associated not only with better language development in 2-year-old children, but also with better cognitive, motor, socio-emotional, and overall development scores. Therefore, we recommend raising awareness and promoting programs that encourage playing/reading.

References

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  • Funding
    Harvard University - David Rockefeller Center for Latin American Studies, Harvard University; Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico; Fundação Maria Cecília Souto Vidigal - Universidade Federal do Ceará.
  • Chief editors:
    Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva

Publication Dates

  • Publication in this collection
    30 May 2025
  • Date of issue
    May 2025

History

  • Received
    07 Nov 2023
  • Accepted
    11 Apr 2024
  • Published
    13 Apr 2024
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