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. Author manuscript; available in PMC: 2025 Sep 3.
Published before final editing as: Int J Behav Dev. 2025 Apr 29:10.1177/01650254251336145. doi: 10.1177/01650254251336145

Multiple child caregivers and multiple cognitive caregiving practices: Associations with early childhood development in 51 low- and middle-income countries

Marc H Bornstein 1,2,3, W Andrew Rothenberg 4, Diane L Putnick 1, Jennifer E Lansford 4
PMCID: PMC12402980  NIHMSID: NIHMS2072314  PMID: 40904857

Abstract

Five issues about three cognitive caregiving practices are addressed in mothers, fathers, and children’s other caregivers in nationally representative samples from 51 low- and middle-income countries with 159,959 36- to 59-month-old children. The five issues include base rates of cognitive caregiving practices of mothers, fathers, and other caregivers of young children, associations of cognitive caregiving practices of the three caregivers with children’s development, associations among the three caregivers’ cognitive caregiving practices, comparison of the three caregivers’ cognitive caregiving practices with girls and boys, and assessments of how overall national development relates to the three caregivers’ cognitive caregiving practices. The data addressing these five issues derive from the maternal reports in UNICEF’s Multiple Indicator Cluster Surveys. Mothers engaged in the most cognitive caregiving, followed by other caregivers, and then fathers. Each caregiver’s cognitive caregiving was uniquely associated with children’s development, but in models that included all three caregivers’ caregiving simultaneously mothers’ cognitive caregiving had the largest association. In addition, mothers’ and fathers’ cognitive caregiving practices covaried, but their cognitive caregiving practices were unrelated to those of their children’s other caregivers. Girls and boys experienced similar levels of cognitive caregiving from the three caregivers. The higher a country’s level of human development, the more mothers and fathers, but not other caregivers, engaged in cognitive caregiving.

The literature in human developmental science is often criticized on two grounds: First, mothers’ roles in child development are emphasized to the sometime neglect or partial deemphasis of fathers and children’s other caregivers and, second, the inclusion of North American and Western European countries to the sometimes neglect or partial exclusion of low- and middle-income countries elsewhere in the world. The two primary aims of the present study were to (1) address these two criticisms by examining and comparing base rates of cognitive caregiving practices of mothers, fathers, and other caregivers with the same young children and (2) to assess the relative individual associations of cognitive caregiving practices of mothers, fathers, and children’s other caregivers with early childhood development in nearly 160,000 children in 51 low- and middle-income countries (LMICs). Three secondary aims were to (1) examine associations among mothers’, fathers’, and others’ cognitive caregiving practices, (2) compare the three caregivers’ cognitive caregiving practices with girls and boys, and (3) assess how overall national development in LMICs relates to the three caregivers’ cognitive caregiving practices. To gain access to mothers’, fathers’, and others’ cognitive caregiving practices and children’s development in LMICs we used the UNICEF Multiple Indicator Cluster Surveys (MICS; UNICEF, 2009, 2013), and to quantify national development of the LMICs we used the UNICEF Human Development Index (HDI; UNDP, 2014). As much less is known about the issues involved in reaching these several aims in LMICs, and childcare in LMICs looks different from childcare in high-income countries (HICs), much of the literature that sets the stage for this study necessarily stems from the knowledge base developed in HICs (Raikes et al., 2019).

Cognitive Caregiving

UNICEF (2023) endorses a nurturing care framework to promote child development around the world. Nurturing care of young children includes (among other parenting responsibilities) cognitive caregiving, viz. caregiving strategies that stimulate children to engage and understand the environment outside the dyad and to enter the world of learning by introducing, mediating, and interpreting the external world to the child, teaching, describing, and demonstrating, as well as provoking or providing opportunities to observe, to imitate, and to learn. Three specific cognitive caregiving practices have been identified as prominent constituents of the nurturing care framework: They are reading to, telling stories to, and naming/counting/drawing with children. Many caregivers have a variety of caregiving responsibilities for children and engage in a variety of caregiving practices that constitute nurturing caregiving (for instance, see Bornstein et al., 2022, and Rothenberg et al., 2023, for investigations of how socioemotional caregiving is associated with child development in LMICs). However, independent investigations by parenting researchers have revealed that the three constituent cognitive caregiving activities are among the most powerful predictors of early childhood development (Bizzego et al., 2022; Bornstein et al., 2022c), and therefore in this report we focus attention on those strategies. Walker et al. (2007) targeted cognitive caregiving stimulation as one of four key factors in need of urgent intervention in LMICs. Cognitive caregiving practices are multidimensional, modular, and specific (Bornstein, 2015). Before young children enter formal schooling, experiences that shape their cognitive development derive largely from the practices of their parents and non-parental caregivers. This study is principally concerned with the three common, prominent, and active forms of cognitive caregiving on the parts of mothers, fathers, and children’s other caregivers that are developmentally significant because they help to lay the foundation for children’s future mental and verbal competencies. Young children learn about the material world and develop mentally and verbally through cognitive interactions with their caregivers, and children rely on cognitive caregiving practices to process information more effectively and efficiently (Magnuson & Waldfogel, 2005). Educating the young is a generic and vital parent caregiving function. Experiments and interventions alike attest to higher mental functioning among children whose parents engage in cognitively stimulating caregiving, and children’s content knowledge expands on account of cognitive caregiving practices they are exposed to. For example, mothers’ specifically encouraging their 5-month infants’ attention to properties, objects, and events in the environment correlates with infants’ visual and haptic exploration of their environment in 11 world societies (Bornstein et al., 2017), and a history of shared work and play activities with parents specifically predicts children’s smooth transition into school; afterward, parents’ specific involvement in children’s school-related tasks predicts children’s school performance and academic attainment (Epstein & Sanders 2002; Pomerantz & Eaton, 2001). The Abecedarian Project (Ramey & Ramey, 2023), an infancy through age-5 intervention designed to provide high-quality educational experiences (including language stimulation, cognitive activities, and responsive caregiving), resulted in better cognitive abilities and language skills at age 5 and greater intellectual functioning and higher academic achievements at age 21 (Ramey & Ramey, 2023; see also Huebner & Rappaport 2011; Olds et al., 210; Schweinhart et al, 1993).

To date, however, few studies have examined international variation in cognitive caregiving practices with young children, especially from LMICs (Bornstein & Putnick, 2012). The practices of mothers, fathers, and young children’s other caregivers collected in the MICS ask about the kinds of cognitive caregiving activities caregivers living in LMICs have enacted. To investigate these practices across diverse LMICs, this study adopted an etic approach to operationalizing cognitive caregiving (van de Vijver, 2010)–that is, studying objective behavioral practices that are likely to occur across countries. Specifically, the MICS ask about those three cognitive caregiving practices with young children: reading, telling stories, and naming, counting, and drawing.

First, joint book reading exposes children to vocabulary and concepts beyond those commonly used in everyday conversations (Hoff, 2015). Mean length of utterance and responsive replies to children are greater during joint book reading than during play and mealtimes (Crain-Thoreson et al., 2001). Parental involvement in children’s reading enhances children’s own interest in reading, and parents who spend more time reading to their children have children who read more (Gershoff et al., 2009). Reading to children is known to vary widely within and between communities (Kim et al., 2020); even in HICs, low socioeconomic status (SES) mothers read less to their children than high-SES mothers (DeBaryshe, 1995).

Second, storytelling is a foremost means of communication in traditional cultural communities, and a significant proportion of everyday conversation is composed of telling stories (Boyd, 2018). Storytelling is both linguistic and educative. Like reading, consistent exposure to storytelling and narrative discourse in the home promotes children’s mental and verbal skills–from complexity of vocabulary and sentence structure to imagination and originality in narrative ability (Wells, 1986). Experience with storytelling also predicts children’s school success (Pollock & Bono, 2013), and the oral tradition of storytelling in many societies is commonly used to transmit cultural values across generations (Miller et al., 2012).

Third, caregivers’ engagement in naming, counting, and drawing each engages children and promotes their mental and verbal development. Parental speech is crucial for children’s early cognitive development for many reasons. Language is an immediate and relevant means parents use to convey both information and affect to young children (Hoff, 2015), and parents’ verbal engagement with their young children strongly influences children’s own language acquisition (Tamis-LeMonda et al., 2019). The mathematics knowledge that children acquire before they begin formal schooling predicts their later academic performance (Duncan et al., 2007; Watts et al., 2014). Finally, even though the arts are commonly viewed as a matter of “feeling” or “inspiration,” in reality they rely on a wide range of cognitive abilities and skills (Winner & Drake, 2022). Drawing, for example, involves perceptions of the visual world, sensitivities to multiple aspects of spatial displays, and capacities to represent and interpret information graphically.

Cognitive Caregiving Practices of Mothers, Fathers, and Other Caregivers

The first Primary Aim of this study was to examine and compare cognitive caregiving practices of mothers, fathers, and other caregivers in a wide swath of LMICs. Young children are normally in the care of a variety of individuals–parents, familial relatives, and nonfamilial caregivers–and some complementary or compensatory, collaborative or competitive divisions of childrearing responsibilities characterize these different individuals in LMICs where nearly half of women over age 15 years are employed (World Bank, 2021). Nonetheless, the relative contributions of these different individuals to early childhood development, although not yet well understood, are likely unequal (NICHD Early Child Care Research Network, 2005). Hence, the first primary aim of this study was to address this dearth of understanding.

Of the several individuals in children’s lives, and given societal dictates that mothers are also ultimately responsible for their offsprings’ health and well-being, females have traditionally become more expert caregivers than males (Bornstein, 2015). In brief, almost all mammalian species are matrilocal, and most human families are matriarchal. Theoreticians distinguish between bringing a new individual into the world (childbearing) and rearing an existing individual (childcaring). Women (mothers) are, of course, the sole bearers of the young, but mammals are also devoted childcarers (Bjorklund, 2020). Cross-cultural surveys and meta-analyses alike attest to the central role that mothers play in child development (Holden & Miller, 1999). Mothers participate in childrearing activities at significantly higher rates than do fathers (Livingston & Parker, 2019); on average, quantitatively, mothers spend between 65% and 80% more time than do fathers in direct one-to-one interaction with their young children. Early maternal care is more common than paternal care; according to Konner (2010), there is not a single traditional society in which fathers devote more time to childcare than mothers. Perhaps infants and young children are closer to mothers on grounds of mothers’ natural biological, nurturant, and temporal involvement with them or reciprocally on account of fathers’ alternative styles of interaction and traditional employment commitments outside the home and away from the family (Parke & Cookston, 2019).

Many modern societies have witnessed increases in the amounts of time fathers spend with their children (Livingston & Parker, 2019); in reality, however, fathers still typically assume little or no responsibility for early childcare and rearing, and fathers are still primarily helpers (Parke & Cookston, 2019). Mothers and fathers do not share the same parenting investment strategies, and the maternal role is better articulated and defined than is the paternal role (Bögels & Perotti, 2011). For these reasons, theorists, researchers, and clinicians have historically concerned themselves preponderantly with mothering, rather than fathering, and a greater body of information has been amassed about mothers and young children, than about fathers, siblings, other relatives, or nonfamilial caregivers and young children (Bornstein, 2015, 2019a). Nonetheless, research undertaken with both mothers and fathers confirms that fathers actively engage in cognitive caregiving and make independent contributions to children’s cognitive development (Jeynes, 2016; McFadden et al., 2012).

The need for nonparental childcare is universal today (Samman et al., 2016), but too little is known about children’s nonparental familial and nonfamilial caregivers’ cognitive caregiving practices, especially in LMICs. Family systems theory supports the notion that many individuals other than parents care for children (Kerig, 2019), and parents regularly rely on children’s siblings and extended family of grandparents and aunts as well as nonfamilial neighbors or other community members to assume some responsibilities of childcare (Kramer & Hamilton, 2019; Powell, 2008; Smith & Wild, 2019). The present study draws on the UNICEF MICS data set which defines “other caregivers” as any other child caregiver in the household over 15 years of age and so likely includes older siblings and grandparents primarily (and perhaps aunts and other relatives secondarily). For example, siblings have continuing access to their sisters and brothers, are sensitive to their needs, and respond to those needs by extending care and support, including various forms of teaching and instruction that scaffold cognitive development (Kramer & Hamilton, 2019; Maynard, 2002; Weisner & Gallimore, 1977). Howe et al. (2016) observed sequences of teaching and learning among sibling dyads. Time use data have shown that siblings spend more time with one another than with parents, peers, or by themselves (McHale & Crouter, 1996), and older siblings can act as critical agents in the socialization of younger siblings (Kramer & Conger, 2009). Siblings have been “expected to provide some caregiving in much of our history and in most cultures” (East, 2010, p. 2), and unlike in HICs where sibling caregiving may be auxiliary to parental caregiving, according to Zukow-Goldring (2002, p. 257), “the majority of the world’s parents assume their children will become competent caregivers and depend on their assistance in socializing younger sisters and brothers” (see also Morrongiello et al., 2007). Likewise, grandparents are alternative likely familial candidates to step into the role of other child caregivers (Raikes et al., 2019; Shwalb & Hossain, 2018; Smith & Wild, 2019), and multigenerational households are common in LMICs (Zimmer & Dayton, 2005). Grandparent involvement and investment in caregiving are contingent on many factors, but the presence of a grandparent in the household is associated with positive child adjustment (Hank et al., 2018; Levetan & Wild, 2016), grandparents and grandchildren can enjoy close and satisfying relationships (Smith & Wild, 2019), and contemporary modern “generative grandparenting” is instrumental and task-oriented (Moore & Rosenthal, 2014).

Mothers’, Fathers’, and Others’ Cognitive Caregiving Practices in Low- and Middle-Income Countries Related to Early Childhood Development

The second Primary Aim of this study was to examine and compare the relative individual associations of mothers’, fathers’, and children’s other caregivers’ cognitive caregiving with development in the same children. Human children cannot survive or thrive in the absence of caregivers; however, caregiving can benefit or disadvantage offspring depending on its character and quality. Positive caregiving in terms of education promotes children’s cognitive and other competencies (Rothenberg et al., 2021). Challenging even in ideal circumstances, successful caregiving is rendered difficult when family resources are insufficient, and compromised caregiving jeopardizes optimal child development, especially among resource-poor parents and other caregivers such as often is the case in LMICs (Rothenberg et al., 2023). Germane to the present study, parents under economic stress generally have difficulty mobilizing effective levels of caregiving. Compared to middle-SES parents, low-SES parents even in HICs are less likely to afford children stimulating learning experiences, such as reading (Hoff & Laursen, 2019) or appropriate play materials in the home (Hurt & Betancourt, 2017). The Family Stress Model of economic hardship underscores how caregiving skills are undermined in parents who live in poverty, struggle day-to-day to secure adequate resources, and incur stresses from living in deteriorated dangerous circumstances (Conger et al., 2010; Masarik & Conger, 2017).

Three Secondary Aims of the Present Study

Three secondary aims of this study were to (1) examine associations among mothers’, fathers’, and others’ cognitive caregiving practices, (2) compare the three caregivers’ cognitive caregiving practices with girls and boys, and (3) assess how overall national development in low- and middle-income countries relates to the three caregivers’ cognitive caregiving practices. Each aim is described and justified in detail in the Supplemental Materials.

The Present Study

The 1990 World Summit for Children adopted the World Declaration on the Survival, Protection, and Development of Children and its Plan of Action, and at the time governments pledged to progress toward achieving goals of the Declaration and Plan. To monitor national progress in this effort, UNICEF developed the Multiple Indicator Cluster Surveys (MICS; UNICEF, 2009, 2013), nationally representative and internationally comparable household canvasses. This study uses data from Rounds 4 and 5 of the MICS, carried out between 2010 and 2017, in nearly 160,000 families with 3- to 5-year-old girls and boys in 51 low- and middle-income countries to address two primary and three secondary aims about young children’s mothers’, fathers’, and other caregivers’ cognitive caregiving and their relations to children’s actual development, to one another, and to national levels of development.

Method

Participants

In all, families of 159,959 children ages 36 to 59 months from 51 low- and middle-income countries provided information for the MICS4 and MICS5 datasets used in the present study. Each country designed and selected a nationally representative probability sample (UNICEF, 2009, 2017). Children were, on average, 47.31 months old (SD = 6.89), and the sample was evenly divided with 49.30% girls and 50.70% boys. If more than one child aged between 36 and 59 months lived in the household (as was the case in 52.98% (N = 84732) of families in this sample), to obviate within-family or within-household variance one of those children was selected using a random selection function in the SPSS statistical program as the target child for analysis.

Mothers in each family reported on the caregiving practices of mothers, fathers, and all the target child’s other caregivers (older than 15 years of age) in the household and on the target child’s development. Demographic information was only available for mothers who were, on average, 32.04 years old (SD = 8.92). Their educational achievements varied widely: 27.88% reported receiving no formal education, 28.44% primary education, 32.44% secondary education, and 11.25% higher education. MICS do not ask mothers to specify the identity of the other caregivers, who could include grandparents, siblings, or other household members.

Procedures

The MICS4 and MICS5 were specifically designed by UNICEF to be implemented in nations that were categorized as “low- or middle-income” according to the World Bank (2025): Definitionally, low- and middle-income countries are those with gross national incomes per capita between USD$0 - $14,005 in 2024 dollars (between USD$0 and $12,475 between 2009 and 2017 when these surveys were collected; World Bank, 2024). UNICEF’s purposes in sampling LMICs in particular with the MICS4 and MICS5 were to identify national indicators of child and human development in those nations and to ensure that they (and the world as a whole) were progressing toward meeting the UN’s Sustainable Development Goals (UNDP, 2014). In each nation, UNICEF-trained enumerators helped mothers complete MICS questionnaires in their homes. The MICS4 and MICS5 each comprised several different questionnaires (UNICEF, 2009, 2013). Data in this study are drawn from the Household Questionnaire and the Questionnaire for Children under Five, which provide information about the development of all children under 5 years of age in a household as well as caregiving practices that support child development. The questions and measures used in this study were the same in the MICS4 and MICS5. All 51 LMICs that collected data on cognitive caregiving and child development in the MICS4 and MICS5 are included in the current data set. Of these 51 nations, two nations included in the MICS4 and MICS5 data set (Barbados, N = 192, and Uruguay, N = 747) were afterward classified as HICs. Notably, the MICS4 and MICS5 were the most recent MICS (at this writing in 2025) where the full data set was available; MICS6 and MICS7 were still in various rounds of data collection or cleaning, which is the reason later MICS 6 and 7 data are not included.

Measures

Cognitive Caregiving Practices.

The MICS4 and MICS5 asked the child’s mother, who was the primary caregiver, whether the mother, father, or any other caregiver over 15 years of age in the household engaged in each of the three different cognitive caregiving practices over the past 3 days: (1) read books or looked at picture books with the child, (2) told stories to the child, and (3) named, counted, or drew with the child. In this study, separate scores were calculated for mothers, fathers, and other caregivers. Therefore, each of the three items was scored 0 = the mother/father/other caregiver did not engage in the practice or 1 = the mother/father/other caregiver did engage in the practice. In accord with previous work (Bornstein et al., 2022; Bornstein & Putnick, 2012), the 3 items were summed to create a cognitive caregiving scale for each caregiver wherein 0 = the caregiver engaged in no activities in the last 3 days to 3 = the caregiver engaged in all three activities in the last 3 days. This scale demonstrated good reliability according to Kuder-Richardson 20 estimates (the dichotomous equivalent of Cronbach’s alpha; DeVellis, 2016) for all three caregivers: ρKR20Mother = .73, ρKR20Father = .68, ρKR20OtherCaregiver = .71.

Early Childhood Development Index.

Ten questions in the Questionnaire for Children under Five measured four domains of early childhood development in children ages 36 to 59 months, including literacy/numeracy development (2 questions concerning the child’s knowing and using numbers/letters/words), socio-emotional development (3 questions concerning the child’s recognizing and expressing thoughts and feelings), physical health (2 questions concerning the child’s developing gross and fine motor abilities), and approaches to learning (3 questions concerning the child’s following directions and independently completing tasks). The mother was asked whether the child displayed each behavior by responding either “Yes” or “No.” Following UNICEF (2017) guidelines, answers to the ten questions that indicated positive child development were summed to compute a total Early Childhood Development Index (UNICEF, 2017); on the 0–10 scale, higher scores indicate more advanced child development. Multiple independent psychometric evaluations have demonstrated the validity and cross-national stability of the ECDI in MICS4 and MICS5 samples (UNICEF, 2017). See Supplemental Materials Table 1 for ECDI scores in each LMIC.

Child and Parent Sociodemographic Characteristics.

Two child sociodemographic characteristics, age in months and gender (0 = female, 1 = male), and two maternal sociodemographic characteristics, age in years and education (0 = no formal education, 1 = primary education, 2 = secondary education, and 3 = higher education), were controlled in all analyses of associations between cognitive caregiving and child development. (The ages and years of education for child caregivers other than the mother were not collected in these MICS.) Maternal education was controlled in these analyses to ensure that an indicator of family socioeconomic status was taken into account when considering associations between cognitive caregiving and child development.

Number of Children Under Age 18 Living in the Household.

On average, 3.26 children under the age of 18 years (SD = 2.32) lived in each household. The number of children under age 18 years who lived in the household was also controlled in analyses of associations between cognitive caregiving and child development to account for the facts that caregivers who must care for more than one young child may have less time to engage in cognitive caregiving practices with any individual child under their care and for the possibility that having more children in the household might increase the chance for “other caregiver” involvement (Juhn et al., 2015).

Country Demographic Characteristics: The Human Development Index.

Given the focus on LMICs, it was also deemed essential to control for the effects of nations’ human development conditions when examining associations between cognitive caregiving practices and child development. Here the United Nations’ Human Development Index (UNDP, 2014) was used. The HDI measures the conditions countries provide to promote the development of the population and their capabilities. The HDI is composed of (1) life expectancy (in years), (2) education (the adult literacy rate and combined gross enrollment in primary, secondary, and tertiary school), and (3) gross domestic product (GDP). The HDI varies from 0 (low) to 1 (high), with the United Nations defining HDI scores below 0.55 as “low,” between 0.55 and 0.69 as “medium,” and 0.70 and above as “high” (UNDP, 2014). The average household HDI score across the entire LMIC sample here is 0.60 (SD = .13), indicating that, on average, households in this sample are living in nations at the lower end of the “medium” human development level according to United Nations criteria.

Analytic Plan

To examine differences in the number of cognitive caregiving practices provided by mothers, fathers, and children’s other caregivers in this sample (Primary Aim 1), we used generalized linear mixed models with a Poisson link using the “proc genmod” function in SAS (SAS Institute, 2015). In these models, the type of caregiver--mothers, fathers, or other caregivers--(the independent variable) was used to predict the number of cognitive caregiving practices (the dependent variable) after controlling for covariates. Nesting of caregivers in families was accounted for in the modelling process by including family ID as a random effect. After modelling was complete, standardized mean differences (SMDs) were computed to examine 3 comparisons: the average differences between mother and father mean cognitive caregiving practices, between mother and other caregiver mean cognitive caregiving practices, and between father and other caregiver mean cognitive caregiving practices. SMDs were calculated utilizing Coxe’s (2009) online calculator. To examine whether mothers’, fathers’, and other caregivers’ cognitive caregiving was associated with children’s early childhood development scores, separate and apart from each other and the aforementioned covariates (Primary Aim 2), we used linear regression analyses. These analyses controlled for nesting of participants in nations in estimating associations between cognitive caregiving and child development. Primary Aim analyses appear in the main body of this report.

To examine associations in cognitive caregiving practices among mothers, fathers, and other caregivers (Secondary Aim 1), we calculated correlations between mother and father, between mother and other caregiver, and between father and other caregiver cognitive caregiving practices. To test whether the numbers of cognitive caregiving practices provided by mothers, fathers, and other caregivers varied by levels of child gender (Secondary Aim 2), we examined separate two-sample t-tests. To evaluate whether the numbers of cognitive caregiving practices provided by mothers, fathers, and other caregivers were associated with national development (Secondary Aim 3), we examined separate country-level correlations. Secondary Aim analyses appear in the Supplemental Materials.

On account of the large sample sizes involved, statistically significant results can emerge even with small effect sizes. A statistically significant result does not necessarily signify a result that is also practically meaningful. For this reason, results are distinguished by statistical and practical significance using effect sizes. Classic rules-of-thumb are adopted to interpret effect sizes (Cohen, 1988). We note, however, that small effect size differences present early in development (as here) tend to increase over time (the “Matthew effect”; Bornstein, 2014; Stanovich, 1986), and therefore early cognitive caregiving practices might have outsized influences on later development.

Results

Primary Aim 1: Cognitive Caregiving Practices of Mothers, Fathers, and Other Caregivers

With respect to Primary Aim 1, as can be seen in Table 1 significant differences emerged among mothers’, fathers’, and other caregivers’ cognitive caregiving practices. Specifically, across the entire sample of three possible cognitive caregiving practices used in the past 3 days, mothers engaged in 1.08, fathers 0.42, and other caregivers 0.71. Notable variability is also evident in the numbers of these practices across caregivers, as 18.62% of mothers, 4.71% of fathers, and 9.74% of other caregivers reported engaging in all 3 cognitive caregiving practices in the past 3 days, whereas 44.33% of mothers, 73.73% of fathers, and 59.51% of other caregivers reported engaging in no cognitive caregiving practices in the same time frame. As demonstrated by the SMD scores in Table 1, each of these differences among caregivers is small-to-medium (SMDrange = 0.26 – 0.49) even after accounting for nesting of caregivers within families and other covariates.

Table 1.

Mother, Father, and Other Caregiver Cognitive Caregiving Practices, Differences Between Reporters’ Cognitive Caregiving Practices, and Early Childhood Development Index Scores in the Total Sample

Mother Cognitive Caregiving Father Cognitive Caregiving Other Caregiver Cognitive Caregiving Mother-Father Mother-Other Caregiver Other Caregiver-Father ECDI
Country N M (SD) M (SD) M (SD) SMD SMD SMD M (SD)
Total sample 159959 1.08a (1.15) 0.42a (0.81) 0.71a (1.01) 0.49* 0.29* 0.26* 5.86b (1.86)
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Note. ECDI = Early Childhood Development Index. All Standardized Mean Difference (SMD) scores can be interpreted as if the second caregiver listed is the caregiver’s practice that is being compared to. So, for instance, the Mother-Father Standardized Mean Difference can be interpreted as “Mothers have a cognitive caregiving practice that is .49 standard deviations larger compared to fathers.” All SMDs reported here account for nesting of caregivers within families and control for child age and gender, number of children in the home, parent education, and country membership.

a

(0–3 Scale)

b

(0–10 Scale)

*

p < .05

The overall finding that mothers engage in the most cognitive caregiving practices, followed by other caregivers, followed by fathers was replicated in most individual LMICs (see Supplemental Materials Table 1). However, this pattern was more strongly replicated for some caregiver differences than others. For instance, in every national sample mothers engaged in significantly more cognitive caregiving practices than fathers. In 71% of nations (36 of 51; Supplemental Materials Table 1), mothers engaged in more cognitive caregiving practices than other caregivers. In 86% of nations (44 of 51), other caregivers engaged in more cognitive caregiving practices than fathers.

Primary Aim 2: Associations of Mother, Father, and Other Caregiver Cognitive Caregiving Practices with Early Childhood Development

ECDI Descriptives.

The overall ECDI mean was 5.86 (on a 0–10 scale; SD = 1.86), indicating that, on average, of the 10 behaviors demonstrating overall adaptive early childhood development, children in this sample displayed about 6. Additionally, child age related to higher ECDI scores, r(159952) = .18, p < .001.

Associations of Cognitive Caregiving with the Early Childhood Development Index, Separate and Apart from Covariates.

Mother, r(159835) = .29, p < .001, father, r(159835) = .18, p < .001, and other caregiver, r(159835) = .10, p < .001, cognitive caregiving practices were significantly positively correlated with children’s ECDI scores in preliminary correlations. With respect to Primary Aim 2, these preliminary correlations were advanced with linear regression analyses examining whether mothers’, fathers’, or other caregivers’ cognitive caregiving practices were uniquely associated with early childhood development, even after taking into account each other and all covariates. As shown in Table 2, mothers, fathers, and other caregivers who used more cognitive caregiving practices had children who demonstrated more advanced early childhood development.

Table 2.

Linear Regression Analyses Comparing the Simultaneous Associations of Cognitive Caregiving Practices and Demographic Characteristics with the Early Childhood Development Index

Early Childhood Development Index (R2 = .255)
β [95% Confidence Interval] p ΔR2
Mother cognitive caregiving practices .101 [.096, .106] <.001 .008
Father cognitive caregiving practices .071 [.067, .076] <.001 .005
Other caregiver cognitive caregiving practices .088 [.084, .093] <.001 .008
Child gender (0 = Female, 1 = Male) −.049 [−.053, −.044] <.001 .003
Child age (Months) .157 [.153, .161] <.001 .025
Mother age (Years) .041 [.037, .046] <.001 .002
Mother education (0–3 Range) .188 [.183, .193] <.001 .022
Number of children in household < 18 years old −.018 [−.023, −.013] <.001 .001
Human Development Index .246 [.240, .251] <.001 .041
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Note.ΔR2 = Proportion of variance uniquely added to model by variable standardized parameter.

Mothers’, fathers’, and other caregivers’ cognitive caregiving practices, respectively, explained 0.8%, 0.5%, and 0.8% of unique variance in Early Childhood Development Index scores separate and apart from each other and the covariates. Mothers’, fathers’, and other caregivers’ effects on early childhood development were therefore each small in size after controlling for covariates.

These effects are more pronounced when comparing caregivers who provided all three cognitive caregiving practices in the last 3 days compared to caregivers who provided 0 such practices. For instance, mothers who provided all three cognitive caregiving practices in the last 3 days had children whose ECDI scores were 0.15 standard deviations higher [95% CI: 0.146–0.163] compared to mothers who provided no cognitive caregiving practices in the last 3 days, even after controlling for nesting of caregivers by family, father and other caregiver cognitive caregiving activities, and all the covariates listed in Table 2. For fathers, the improvement in child ECDI scores for those who engaged in all three cognitive caregiving practices and those who engaged in none was 0.11 [95% CI: 0.102–0.123]. For other caregivers, this improvement was 0.10 [95% CI: 0.081–0.122].

Comparing the three caregivers’ cognitive caregiving scores, mothers’ cognitive caregiving scores had the largest associations with early child development, followed by other caregivers’ cognitive caregiving scores, and then fathers’ cognitive caregiving scores when all three were modeled simultaneously. The differences between mother and other caregiver and between mother and father effects were statistically significant. The 95% confidence interval surrounding the estimated effect of mothers’ cognitive caregiving practices on early childhood development was higher than, and did not overlap with, other caregivers’ or fathers’ cognitive caregiving practices. Similarly, the 95% confidence interval around other caregivers’ cognitive caregiving practices was higher than, and did not overlap with, fathers’ cognitive caregiving practices. These same patterns held for comparisons of mother, father, and other caregiver effect sizes.

Discussion

Children in the 3- to 5-year age range studied here command limited agentic capacities. Accordingly, they depend on parents and other caregivers to provide developmentally important interactions. The caregivers in children’s lives have many responsibilities and engage in many kinds of caregiving. The present study focused on cognitive caregiving practices provided by mothers, fathers, and other caregivers to almost 160,000 young children in 51 low- and middle-income countries. This study had two primary and three secondary aims. Here, we reiterate, summarize relevant findings, and comment on the primary aims of the study (secondary aims are rehearsed and elaborated in the Supplemental Materials).

Primary Aims

First, we examined base rates of cognitive caregiving practices provided by children’s mothers, fathers, and other caregivers as Primary Aim 1. Mothers engaged in more cognitive caregiving practices than fathers and other caregivers, and other caregivers engaged in more cognitive caregiving practices than fathers overall and in most individual LMICs. That said, only one in five mothers engaged their children in all three kinds of cognitive caregiving in the three days prior to enumeration and only 10% of other caregivers and 5% of fathers did so. Reciprocally, nearly half of mothers failed to engage their young children in any of the three cognitive caregiving practices and well over half of other caregivers and nearly three-quarters of fathers failed to do so. These are low and dismaying numbers that, if representative, possibly jeopardize the cognitive development of preschool children across LMICs. The numbers for mothers are low, but the numbers for fathers are additionally troubling as it is now well recognized that mothers and fathers make independent contributions to children’s cognitive development (McFadden et al., 2012; Ryan et al., 2006). It has generally been pointed out that developmental science pays little attention to the contributions to children’s development of fathers and other caregivers relative to the contributions of mothers. This direct comparison of the caregiving practices of the three parties suggests that in the LMICs (as reported by children’s mothers) the cognitive caregiving practices fathers and other caregivers enact are rather minimal. Of course, mothers may underestimate the cognitive caregiving practices of children’s other caregivers, and these other caregivers could be engaging in cognitive caregiving practices different from the three probed in the MICS.

Second, we examined the extent to which mothers’, fathers’, and other caregivers’ cognitive caregiving practices each was associated with child development in Primary Aim 2. Mothers, fathers, and other caregivers who used more cognitive caregiving practices had children who achieved higher levels of development. However, mothers’ cognitive caregiving practices proved to be the most robustly associated with early childhood development, followed by other caregivers’ cognitive caregiving practices and finally fathers’ cognitive caregiving practices when all three caregivers’ caregiving practices were modeled together. Notably, other caregivers’ cognitive caregiving uniquely contributed to child development. Batson et al. (2002) suggested that collectivist motives for communal involvement which are often aroused when acting together can significantly enhance a group’s well-being. For example, on kibbutzim in Israel (rural communities where children are reared in groups during the day by nonfamilial childcare providers; Maital & Bornstein, 2022) children’s overall level of exposure to language from their network of caregiving adults (and not maternal speech alone) accounted for similar or better language development compared with city children (Greenbaum & Landau 1977). The privileged status of mothers in the lives of young children might result in a greater effectiveness of maternal than paternal or non-parental cognitive caregiving (Bornstein, 2015). This pattern of results for cognitive caregiving supports a “specificity” view of caregiver-child relationships (Bornstein, 2022; Lerner & Bornstein, 2021). To wit, the findings show differential strengths of association with children’s development among different actors engaging in the same cognitive caregiving practices. Role differentiation likely characterizes any system of childrearing that involves collaborative childcare arrangements. Overall, however, it appears that mothers’, fathers’, and other caregivers’ combined contributions to early childhood development in these LMIC settings were meager. LMICs are characterized by diminished social and economic circumstances, which likely jeopardize caregiving and in turn place more optimal child developmental outcomes at risk (Rothenberg et al., 2023). Nonetheless, each caregivers’ cognitive caregiving practices “mattered” (even if in small ways) for children’s development. That is, mothers’, fathers’, and other caregivers’ cognitive caregiving practices each had unique and significant (if modest) associations with children’s overall development even after controlling for the other two caregivers’ cognitive caregiving practices as well as a raft of covariates. These small effects are still noteworthy for several reasons. First, these effects persisted in the face of universal developmental factors (i.e., children aging) and other protective factors that have demonstrated substantial power in predicting child outcomes (e.g., parent education, country HDI score; Bornstein et al., 2021; Tran et al., 2017). Second, small effects early in life are known to aggregate to large effects over time (Bornstein, 2014). As the “Matthew effect” asserts, differences present early in development tend to increase over time, so cognitive caregiving early in life is likely to progressively advantage children later in development (Stanovich, 1986). Third, small effects assume practical meaning in comparative context. These results echo those of the NICHD Early Child Care Research Network (2005) in the United States which demonstrated that parental care carries greater variance for children’s developmental outcomes than non-parental care even though the contribution from non-parental care is also consequential. Indeed, the unique variance accounted for in ECDI scores by mother and other caregiver cognitive caregiving practices is as large as the effect of parental divorce on subsequent child well-being (Meyer et al., 2001), and the unique variance accounted for in ECDI scores by father cognitive caregiving practices is as large as the effect of ever smoking on the development of lung cancer 25 years later (Meyer et al., 2001).

Secondary Aims

Secondary Aim backgrounds, results, and discussions are reported in the Supplemental Materials, but overviewed here. With respect to Secondary Aim 1, the more mothers engaged in cognitive caregiving practices, the more fathers engaged in the same cognitive caregiving practices, and this association was stronger than associations between mothers’ and fathers’ cognitive caregiving and their children’s other caregivers’ cognitive caregiving. With respect to Secondary Aim 2, girls and boys experienced roughly equivalent levels of cognitive caregiving regardless of whether the caregiver was their mother, father, or other nonparental caregiver. With respect to Secondary Aim 3, the associations between HDI and mother cognitive caregiving practices and HDI and father cognitive caregiving practices were large, whereas the association between HDI and other caregiver cognitive caregiving practices was small.

Strengths and Limitations

This study has several strengths. Prominent and significant forms of cognitive caregiving by mothers, fathers, and other caregivers with almost 160,000 girls and boys in the 3- to 5-year-old age range in 51 low- and middle-income countries were compared and analyzed for their associations with children’s overall early development and for the roles of gender and national-level development. However, the study also has limitations that raise additional questions about caregiving and child development in LMICs and prompt future directions of research. The MICS include questions about prominent forms of cognitive caregiving, but those small numbers of questions hardly cover a full range of potential forms of cognitive caregiving and they fail to assess the amount of time caregivers spend with children or the quality of caregiver-child cognitive interactions. The MICS also rely on a single specific respondent reporting about a small number of specific caregiving activities of mothers, fathers, or other caregivers, in specific LMICs, for a small specific set of child development indicators, in children of a specific limited age range, surveyed at only one specific point in time in a specific historical time period. The specificity of these parameters enhances their clear representativeness, but at the same time places limits on the generalizability of the findings (Bornstein, 2019b; Bornstein et al., 2013; Jager et al., 2017). Interpreting these results, therefore, calls for considering all these parameters of the design in terms of what they afford and what they constrain. Mothers reported about all three caregivers’ cognitive caregiving and about child development, so shared source variance in the design might inflate associations between maternal self-reports and children’s ECDI. That said, the same shortcoming does not apply to father-- or other caregiver--child associations. As the study design is cross-sectional, direction of effects or causality are also undetermined. Future research needs to address these limitations with longitudinal multi-variate multi-informant multi-method cross-era independent approaches in larger numbers of LMICs and in comparative HICs. Although unique variances accounted for by caregiver cognitive caregiving practices on child development were similar in size to the effects of divorce on child well-being or ever smoking on the incidence of lung cancer, the levels of unique variance accounted for were still small (i.e., less than 1% for each caregiver). Especially given the present study’s large sample size, these modest associations between cognitive caregiving practices and early childhood development scores should be interpreted with caution until replicated. Aggregate data across 51 LMICs were analyzed; future research also needs to attend to variability in nations (Vermeer et al., 2016). For instance, future work could examine whether differences across caregivers in cognitive caregiving practices, and associations between cognitive caregiving and child development, vary across a range of moderating variables such as the geographic region where a country is situated, the cultural values (e.g., individualism, collectivism) held by caregivers, caregivers’ level of education, or caregivers’ religion (e.g., Bornstein et al., 2017; Bornstein et al., 2022; Rothenberg et al., 2024). Additionally, just as cognitive caregiving practices differ over space, they may also differ over time (Bornstein, 2019b; Bronfenbrenner & Morris, 2006; Wachs, 2015). We used data from completed rounds of the MICS (i.e., MICS4 and 5), but those data were collected from 2009–2017. Future work could examine whether trends in cognitive caregiving and associations between cognitive caregiving and child development can be replicated. Finally, more also needs to be known about who children’s “other” caregivers are in MICS data as well as in LMICs generally, and similarities and differences among them in terms of their caregiving investments and achievements for child development.

Implications for Programs, Policies, and Practices

The World Health Organization, United Nations Children’s Fund, and World Bank Group (2018) developed the Nurturing Care Framework to guide public policies, programs, and services to help children reach their full potential. Nurturing Care advocates the kinds of cognitive caregiving studied here. Cognitive caregiving varied among these low- and middle-income countries, and as shown cognitive caregiving mattered to child development. Yet, caregivers in some LMICs, especially those that are low in HDI, appear to neglect cognitive caregiving particularly with almost one-quarter having afforded children no cognitive caregiving experiences over a 3-day period (Bornstein et al., 2022). For different reasons, cultural traditions in some LMICs may be responsible; for example, some caregivers in some cultures reportedly are less verbal with their children or do not have access to or see the necessity or desirability of providing toys and other learning materials for their young children (Bornstein et al., 2022; Kim et al., 2020; Ochs, 1988). In consequence, young children in those settings may be relatively deprived of enriching language and material experiences (LeVine, 2003; Nsamenang & Lo-Oh, 2010). However, caregiving cognitions and practices alike are subject to intervention and change, and in LMICs (as in HICs) high-quality early intervention programs focused on parents and caregivers benefit parents, caregivers, and children alike (Nores & Barnett, 2010; Psaki et al., 2021). The findings reported here impel a policy focus on caregiver cognitions and caregiving practices to optimize development in the next generation. For example, some African cultural traditions discourage parents from verbally engaging with their young children. However, a parenting program designed to encourage Wolof-speaking Senegalese caregivers to verbally engage their 4- to 31-month-olds showed that caregivers in the program almost doubled their amount of child-directed speech, whereas comparable caregivers not in the program showed no change (Weber et al., 2017). After 1 year, children of participating caregivers improved in their language compared to the children of controls. In short, the cognitive caregiving practices identified here are not only meaningful to children’s development, they are also modifiable. The Abecedarian Project reported lifelong learning, health, and social well-being related to cognitive skills beginning in infancy (Ramey & Ramey, 2023). A review of parent-training studies of children’s language in three contexts (parent-child book-reading, parent-child conversations, parent-child writing) revealed that parent training in each context improved children’s language, with effects specific to the targeted skill (Reese et al., 2010). And a meta-analysis of literacy interventions on reading skills in 32 LMICs including more than 200,000 participants in 67 studies demonstrated positive effects of literacy interventions on language growth in children (Kim et al., 2020).

Supplementary Material

1

Funding

MHB and DLP were supported by the Intramural Research Program of the NIH/NICHD, USA (Z99 HD999999); MHB by an International Research Fellowship at the Institute for Fiscal Studies, London, UK, funded by the European Research Council under the Horizon 2020 research and innovation programme (grant agreement No 695300-HKADeC-ERC-2015-AdG); and WAR by the Anonymous Foundation.

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