1. Effect of grandparental child rearing on cognitive development among 12-month-old Thai infants: the prospective cohort study of Thai children Miss Sukanya Kansin Dr.P.H.Batch#5

2. Background Grandparental rearing children Cognitive development ? Important human resource 26.7 %,2009 50.3 %,2008

3. Background(cont.) - In children most studies of styles and factors related to child rearing. - Few studies on the child development and dimensions of child rearing on the cognitive development.

4. Objective of the study Aim 1: Study children’s cognitive developmental quotient among 12-month-old Thai infants Aim 2: Study effect of grandparental child rearing on the cognitive development among 12-month-old Thai infants.

5. Methodology  Population and sample -From 5 areas; one district in each region of Thailand: North, Northeast, South,Central and Bangkok  Protection of human subjects Approved by the Nation Ethics Committee of the Ministry of Public Health on 22 September 2000.

6. Methodology(cont.)  Study design - This study is part of the prospective cohort study of Thailand (PCTC) -Collected via interviews or extracted from existing records. -Cognitive development was measured by pediatricians using Capute scale(Bayley, N., 1993) -Interest factor was grandparental child rearing -Primary outcome was cognitive developmental quotient -Secondary outcome was effect of grandparental child rearing on the cognitive development  Statistical analysis -Using Stata version 12 -Mean and standard deviation for continuous variable -Frequency and percentage for categorical variable -95% confidence (CI) -Logistic regression

7. Children's RESULTS Demographic Characteristics of children

8. RESULTS Demographic Characteristics of Caregiver

9. RESULTS (cont.) Demographic dimensions of child rearing Responsiveness Yes No

10. RESULTS(cont.) Demographic dimensions of child rearing

11. RESULTS(cont.) Aim:1 Cognitive developmental quotient 4.7% Were delay

12. RESULTS(cont.) Aim:1 Cognitive developmental quotient Total score 4.7% Were delay

13. RESULTS(cont.) Aim:2 Effect of grandparental child rearing on cognitive development

14. RESULTS(cont.) Factors effecting on children’s cognitive development adjusted for all other factors

15. RESULTS(cont.) Factors effecting on children’s cognitive development adjusted for all other factors

16. RESULTS(cont.) Factors effecting on children’s cognitive development adjusted for all other factors

17. Discussion Aim:2 Grandparental child rearing effecting on the children’s cognitive development -Children who reared by grandparents had chance of being delayed cognitive development for Total score and CLAMS than those reared by parents congruent with the studies by Nanthamongkolchai et.al,2009,2011 -While gathering analyzed with child, caregiver and dimensions of child rearing variants pointed out that the child reared by grandparent not significantly -That is because Child rearing is a dynamic and has a bi-directional So the factors that influence the complex processes associated with child rearing (Berns,1993)

18. the wealth of prospective, longitudinal  Strengths -The evidence that was based on the largest cohort study of Thai children -Followed 4,245 infants from birth in October 2000 to September 2002 until three years old -Deep investigated to dimensions of child rearing. This made we know which items and activity should be caregiver strongest done to promote children’s cognitive development.  Limitation -Should be recognized. Confounding bias from other factors such as experience of child rearing, health status and substance abuse of caregiver Strengths and Limitation

19. the wealth of prospective, longitudinal to exchange experience and knowledge of child rearing; emphasized caregiver to Interactive talking, exhortations to children to observe things and people,hug or kiss, compliment and happy smiling or clapping with children -State and relevant agencies should propose a policy in promoting the cognitive development of children since was subjected in the womb maternal and should systematically and continuously intervention in the family have children cognitive developmental delayed.  Conclusion Child rearing by grandparents was at substantial risk for delay of cognitive development when combined with other factors to promote.  Recommendations - Health officials in the area should encourage the integration of caregiver Conclusion and Recommendations