Psychosocial Stimulation for Early Child Development in Odisha, India

Marta Rubio-Codina
Britta Augsburg
Sally Grantham-McGregor
Smriti Pahwa
Alison Andrew
Monimalika Day
Fardina Mehrin
Cuttack, Odisha, India
54 slums with at least 7 children aged 10 - 20 months
2013 - 2014
Target group:
Children under five Parents Women and girls
Outcome of interest:
Student learning
Intervention type:
Early childhood development
AEA RCT registration number:


Policy issue

Early childhood is a critical time for cognitive, social, and physical development. Unfortunately, in developing countries, many children under five fail to reach their developmental potential, due to poverty and the often associated poor nutrition and lack of psychosocial stimulation. Previous research has shown that encouraging parents to play with their children more can promote greater emotional and intellectual development in these children. Yet there is little evidence on how to successfully scale up early childhood development programs like these, and maintain impact and cost-effectiveness at scale. To address this evidence gap, researchers are evaluating the impact of an early-childhood psychosocial stimulation program that is delivered through local community members on child development outcomes in Odisha, India.

Context of the evaluation

Child health and development in India have improved significantly over the past decade. For example, between 1990 and 2013, the mortality rate for children under five fell by more than half.1 But significant challenges remain; according to a government health survey conducted in 2013, approximately one-fifth of infants in Odisha were of low birthweight, weighing less than 2.5 kg.2 This study is taking place in Cuttack, the state’s second largest city.

Details of the intervention

Researchers will evaluate the impact and scalability of an early-childhood psychosocial stimulation program on children’s social and cognitive development, implemented through trained local women. They will identify 54 slums surrounding Cuttack in which at least 7 children, aged 10-20 months, reside. A random half of these slums will receive the program; the other half will not receive the program and form the comparison group.

The year-long program has been adapted from a psychosocial stimulation curriculum that demonstrated significant improvements in children’s development in a prior study in Jamaica. The curriculum aims to improve maternal-child interaction, through weekly home visits from trained visitors to children, aged 10-20 months, and their caregivers. The home visitor will demonstrate play activities with the child using home-made toys and objects around the home, and discuss child development issues with the caregiver, emphasizing the importance of play and conversation.

To test the scalability of this program through local infrastructure and existing social networks, the program will be delivered by local women. The home visit curriculum itself, because it is prescriptive and easy-to-follow, can be delivered with minimal training.

Researchers will collect data before and after the program on information including the quality of the home environment and children’s physical height and weight. They will also use the Bayley-III scale of infant and toddler development to measure children’s cognitive development. The scale has indicators on cognition, receptive language, expressive language, and motor skills.3

Results and policy lessons

Results forthcoming.

Andrew, Alison,  Orazio Attanasio, Britta Augsburg, Monimalika Day, Sally Grantham‐McGregor, Costas Meghir, Fardina Mehrin, Smriti Pahwa, and Marta Rubio‐Codina. 2019. "Effects of a Scalable Home‐Visiting Intervention on Child Development in Slums of Urban India: Evidence from a Randomised Controlled Trial. "Forthcoming in the Journal of Child Psychology and Psychiatry.

UNICEF, State of the World’s Children 2015.
Government of India. 2013. Annual Health Survey 2012-2012 Fact Sheet: Odisha. p. 89.
The Bayley Scales of Infant Development are widely accepted standards used in clinical psychology to measure the development of children aged 0-3. The standards include indicators on levels of cognition, language skills, motor skills, adaptive behavior, and social-emotional skills.