We triangulated relevant quantitative and qualitative findings to determine the defining features of the home learning environments. Below, we begin with an overview of participant characteristics and then present our findings related to physical and social settings, childcare practices, and caregivers’ psychology.
3.1 Participant characteristics
A total of 30 caregiver-child dyads participated in the study, with 10 from each of the three child age groups. As displayed in Table 2, the majority of caregivers were mothers of the index child; two grandmothers and an aunt also participated. Most caregivers were between 21-40 years of age, had completed secondary school, and had improved water and sanitation infrastructure in their homes.
3.2 Physical and social settings for play
The homes in peri-urban Villa El Salvador were generally in close proximity to one another and multi-generational. In many cases, extended families lived in larger homes where young couples with one or more children each occupied a single room. Among our study population, approximately two-thirds of the households included four or more adults, and all but one household had at least two children (Table 2). As a result, children played with siblings, cousins, or other relatives that were close in age on a daily basis. As one mother of a ten-month-old child with two siblings reflected, “His brother is a huge help—without him, he [9-month-old child] wouldn’t have anyone to play with. The two of them are always over there, playing [gesturing to bedroom].”
Study participants reported that these playtimes rarely took place outside, given residents’ safety concerns; several caregivers mentioned recent increases in gang activities and theft, and alluded to a lack of trust in their neighbors. Most men worked in the informal sector and were generally away from home during the day. Nevertheless, 20 (66.7%) caregivers reported that the child’s father provided some attention or care to the child every day.
Within the homes, toys and other learning materials were present to varying extents. Based on our spot-check data, the most common types of toys were those classified by the HOME-IT as “cuddly or role-playing toys” (e.g., stuffed animals, dolls, action figures); these were present in 24 (80.0%) homes and popular among all age groups (Table 3). Of these, stuffed animals were the most common, with more than one present in the majority of households. “Motor activity toys or equipment” (i.e., balls, rattles, rocking horses) and “simple hand-eye coordination toys” (i.e., rattles, marbles, and stones) were each present in 22 (73.3%) homes and were slightly more common among the youngest age group (some items were double-coded into these two categories). “Complex hand-eye coordination toys” (i.e., blocks, jigsaw puzzles) were the least common category of toys, present in 40.0% of households across all age groups. Only two (6.7%) households had any type of “puzzle” game, while 11 (36.7%) had building blocks or Lego-like toys. During the semi-structured interviews, caregivers’ reporting of children’s activities generally aligned with the presence of toys at home: while playing with balls was very popular (90.0% of children did this at least several times per week), the majority of children had never used building blocks or playsets (Table 4). Greater variability was noted with respect to playing with electronic toys (i.e., toys that produce sounds, lights, music, or words when child touches a button): while nearly two-thirds of children played with such toys often or every day, more than one-third of children had never played with them given a lack of ownership.
“Toys for literature and music” were present in 19 (63.3%) homes. Books for young children were recorded in nine (30.0%) homes, eight of which had only one or two books in total. During the spot-checks, field workers also noted that books for older children, which were provided by the government for public education, were present in approximately two-thirds of the homes. In terms of music, rattles were somewhat common (43.3%), yet other toys for making music, such as a plastic tambourine, were recorded in only nine (30.0%) households. In addition to the items specified on the spot-check instrument, caregivers reported that children used a number of other everyday objects as toys, including plastic soda bottles, plastic cups, clothespins, and empty containers. Fifteen (50.0%) caregivers reported that their children used household objects house as toys everyday (Table 4). At least one color-television set was present in all homes.
3.2 Childcare practices surrounding play and communication
Observation data revealed that caregivers generally had low or inconsistent levels of interaction with their children in the context of play. As displayed in Table 5, the average score for the IPCI construct of “descriptive language” was 1.5/4, indicating that caregivers’ use of multiple-word phrases or sentences to describe activities, objects, behaviors, or feelings was relatively rare (55). In several (13 of 29) cases, there was only one instance during the 30-minute observations that the caregiver’s remarks met the definition of descriptive language, and in two cases, this did not happen at all. Caregivers overwhelmingly used single words to give commands or comment on something to a child, such as saying “¡Patea!” (“Kick!”) while the child played with a ball, or “¡Gato! ¡Mira!” (“Cat!”) when pointing to a stuffed animal of a cat.
Accordingly, several daycare instructors commented on the low levels of verbal communication in the home setting, pointing out that it was customary for caregivers to use affectionate, diminutive terms rather than longer sentences. As one instructor reported, “The moms don’t talk clearly to them [young children]—they don’t say words and how they’re pronounced…So the majority [of children] here in this community don’t speak much.” During the observations, children—even those close to 24 months of age—rarely said words themselves.
With regards to playing with children, observation data revealed that caregivers at times “followed the child’s lead” by joining or imitating an activity in a non-intrusive manner, such as tossing a ball back to the child. The majority of caregivers (89.7%) provided toys or other objects for the child to play with during the observation; toys were entirely absent in only two cases. However, it was far less common for caregivers to engage the child in a way that “maintains or extends the child’s focus,” described by the IPCI as a “higher order skill” as compared to simply following the child’s lead. Caregivers rarely introduced novel, stimulating activities through words, expressions, or gestures. Rather, caregivers tended to watch or leave the room once children became interested in an activity, at times leaving them to play with older siblings or other children.
Caregivers reported that they rarely interacted with their young children in the context of storytelling and reading: 18 (60.0%) and 15 (50.0%) caregivers reported that they told stories and read to children less than once a month or not at all, respectively (data not shown). In contrast, singing to children was extremely common, as the overwhelming majority of caregivers reported doing this every day, even for the youngest children (Table 4). As one mother said of her eight-month-old infant,
I sing to him. Everything that I learned in school, the knees and toes—'Head, Shoulders, Knees and Toes.’ I sing about the little chicks, about what the different foods are, about the maracas…. [Gesturing] ‘The maracas, the maracas, above, above! …The maracas, the maracas, below, below!’
Participants enthusiastically mentioned a number of different songs that they sang to their children; the most popular songs were centered around animals, such as La Vaca Lola (“The Cow Lola”), El Pato Renato (“The Duck Renato”), and El Caracolito (“The Little Snail”).
Several participants also mentioned singing traditional songs in Quechua (the native indigenous language of some grandparents) to their children. Other family members, including children’s older siblings, fathers, and grandmothers, also sang often. In addition, caregivers frequently played music from the radio or from their cell phones to entertain their children. A 19-year-old mother spoke of her 23-month-old child’s enthusiasm for these activities:
Almost every night I put some music on, and he starts to dance. He loves to dance! Like this [gesturing] with his movements. He knows how to sing …most of all he likes the songs from [TV] commercials.
The IPCI construct of “conveys acceptance and warmth” yielded the highest average score (1.8/3). Most caregivers consistently displayed warmth through nonverbal communication such as affectionate touch and smiling at the child. Caregivers also commonly demonstrated approval through verbal feedback such as saying “¡Bravo!” or “¡Eso!” (“That’s it!”) in an excited tone, often accompanied by clapping.
Observations revealed differences in the ways that caregivers communicated to redirect children’s behavior when they did something deemed inappropriate or unsafe, referred to as “interrupting behaviors” by the IPCI. The average scores for “uses restrictions/intrusions” was 0.9/3, as compared to an average score of 0.5/3 for “uses interruptions with an explanation,” reflecting that caregivers were more likely to interrupt a child’s behavior with a short command (“No!” or “Leave it alone!”) rather than provide an explanation or learning objective. In ten cases, caregivers appeared to provide an explanation when discouraging a certain behavior; for example, in one instance when a 15-month-old boy threw a toy, her mother calmly stated, “Don’t throw that, you could hurt someone.”
Across all age groups, caregivers frequently put the television on or played videos on their cell phones for their children, according to data collected through both observations and interviews. Eight (27.6%) observed children watched TV or cell phone videos for at least a portion of 30-minute observations; in two of these cases, this activity occupied the majority of the observation period. In cases where participants were not directly watching TV, it often remained turned on: in 13 (44.8%) participating homes, the TV was on in the background for all 30 minutes of the direct observation.
During the interviews, 70-80% of caregivers within each child age group reported that their children watched TV every day (Table 4). For example, when describing the previous day’s activities, one mother of a 22-month-old reported,
He woke up around 5:30 and starts watching children’s videos on the DVD. Around 7:30, he ate breakfast with his siblings, but when they have breakfast, I always turn the TV off. Around 9, I took him to the market with me…when we returned, I started the DVD again while he ate his mid-morning fruit. Then he started to play—yesterday he was playing alone during the day, but with the TV on.
Daycare instructors also remarked on the large role that TV played in children’s daily lives, mentioning that they served as a means of entertainment as well as distraction. One instructor suggested that technology is used as a way to “calm or quiet their children while they [the caregivers] are doing chores at home.”
3.3 Caregiver perspectives on play
During the interviews, caregivers displayed mixed understandings of the overall importance of play for child development. Some caregivers discussed play as having an important role for motor skills, such as walking, kicking, and “learning how to move,” without referencing the less observable aspects of development such as cognitive and socio-emotional growth. However, other caregivers spoke of the importance of play for thinking, learning new things, or “waking up the mind.”
Caregivers’ ratings for the learning value of specific play-based activities ranged from 6.8 (for using everyday objects around the house as toys; SD 2.6) to 9.7 (for reading a book to a child; SD 0.5), out of a maximum of ten possible points. As displayed in Figure 1, relative perceptions of learning values were not always closely aligned with how often children engaged in the activities. For example, caregivers mentioned that playing with building blocks and electronic toys had relatively high potential to assist with a child’s learning (each received an average rating of 9.1 and SD of 1.3), yet these are among the most infrequently practiced activities. In contrast, the lowest average rating was assigned to the more commonly practiced activity of using everyday objects around the house as toys.
The high rating that caregivers assigned to reading to a child suggests that the low levels of engagement with this activity were not due to a lack of perceived value. Caregivers explained that even though they knew the merits of reading, they generally did not have books for young children at home and/or did not have enough time to read, given that their days were filled by making trips to the market, domestic responsibilities such as cooking and cleaning, and accompanying other children to and from school. As one mother of three commented,
I don’t read books to her at this time. When my [older] daughter sits down to do her homework, sometimes I show her my [older] daughter’s book…but there aren’t any books for babies in here.
Caregivers on average assigned a moderately high learning value for the two most common activities of listening to music/singing and playing with balls (8.4 and 8.7, respectively). Interestingly, there was high variability in caregivers’ perceptions of listening to music/singing, as ratings ranged from 1 to 10; in comparison, the ratings for reading had a far smaller range of 8 to 10. Nevertheless, the participating daycare instructors unanimously spoke of the benefits of songs for learning and described their extensive use of them in the classroom. One instructor explained, “There are a ton of songs—a ton! Songs help develop everything. For example, when you sing a song about rabbits, they are skipping, jumping, running around, looking for the carrot in the song.”
The learning value of watching TV programs or videos received an average rating of 9.0. During the interviews, some caregivers referred to “educational” videos that they played on their smartphones from YouTube or other websites. One mother of a 23-month-old boy described how these types of programs “help to develop his mind” by differentiating colors and letters, for example.