title: A community-based study of early childhood sensory stimulation in home environment associated with growth and psychomotor development in Pakistan.
abstract: OBJECTIVE
  Sensory stimulation (SS) is a non-nutritional modifiable risk factor for early childhood development. We assessed SS in home environment and examined its influence on physical growth and psychomotor development (PD).
  
  
  METHODS
  A cross-sectional study was conducted in 26 communities in Pakistan among children aged <3 (n = 1,219). They were assessed at home visits using (1) Bayley's Infant Developmental Scale for PD, (2) home observation for measurement of the environment inventory for SS, (3) anthropometry and (4) socio-economic questionnaire.
  
  
  RESULTS
  In rural homes, SS provided was lower as compared to urban counterparts (Adj mean diff: 4.47, 95 % CI 3.78, 5.16) and showed an association with stunting (Adj mean diff: -1.30, 95 % CI -1.93, -0.66), and underweight (Adj mean diff: -1.04, 95 % CI -1.71, -0.38) not explained by type of neighbourhood or socio-economic status. SS was associated with PD more than combined contribution of socio-economic status and rural-urban factors (Adj mean diff: 0.47, 95 % CI 0.30, 0.63).
  
  
  CONCLUSIONS
  SS in rural homes may be a significant factor influencing the child development. There is a need to corroborate these results by additional research for integration in health policy initiatives.
authors.affiliation: Informed Decisions for Actions in Maternal and Newborn Health (IDEAS), Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK, bilal.avan@lshtm.ac.uk.
authors.forename: Bilal Iqbal
authors.initials: BI
authors.lastname: Avan
authors.forename: Syed Ahsan
authors.initials: SA
authors.lastname: Raza
authors.forename: Betty R
authors.initials: BR
authors.lastname: Kirkwood
mesh_terms: D015984:Causality; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D010812:Physical Stimulation; D011596:Psychomotor Disorders / Q000453:epidemiology* / Q000517:prevention & control; D011597:Psychomotor Performance / Q000502:physiology; D012044:Regression Analysis; D012424:Rural Population / Q000706:statistics & numerical data*; D012678:Sensation Disorders / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013851:Thinness / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data*