live project components

Play

Cognition

Neurobiology

Social-emotional Development, Mental Health, & Functioning

Trauma & Stressful Life Events

Resources & Services

Culture & Social Norms

Caregiving & Relationships

Demographics

Health & Nutrition

See where each component belongs by clicking the green tiles.

Support & Agency

Climate & Environmental Health Conditions

INDIVIDUAL

EXOSYSTEM & MACROSYSTEM

MICROSYSTEM

This study’s design is predicated on bioecological frameworks (e.g., Bronfenbrenner) that situate human development within physical and relational contexts, where development unfolds as the result of complex dynamic processes between the developing person and its environment. A bioecological framework allows us to identify factors at all levels of human functioning in order to get a better sense of factors that support or undermine healthy development and learning.

Caregiver- child interactions

Opportunities for Early Learning

Romatic relationship

Family relationships

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Return

We use a widely validated measure to assess the home learning environment, including the availability of books and toys, and the extent to which adults in the home use them with their children. In addition, we developed a novel measure of caregiving for Rohingya caregivers in this context. The measure asks fathers and mothers about a range of culturally-expected and gender-specific caregiving activities and how often they perform those activities. We ask pregnant women about their relationships to their husbands and other family members, as well as husbands about their relationships with their wives and their children. Mothers and fathers report on their levels of stress associated with being a parent, and how they perceive positive and negative aspects of parenting.

Caregiving & relationships

TRAUMA & STRESSFUL LIFE EVENTS

Social-emotional Development, Mental Health, & Functioning

Expressive language scales

Receptive language scales

Executive Functioning

Cognitive Scales

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

RESOURCES & SERVICES

Return

Cognition, including higher order cognitive processes like executive functions, plays a critical role in a person’s ability to partake in life, broadly speaking. Cognitive functions are involved in language and communication, spacial awareness, reasoning, forming and retrieving memories, and critical social processes including behavioral and emotional regulation (i.e., self-regulation), and interpreting social interactions. We use standardized and internationally validated direct assessment methods to measure neurocognitive development starting a few weeks after birth and at 6 months in the target child, and at recruitment of the older sibling. We further assess caregiver executive functioning, that have been linked to mental, wellbeing, functioning, and caregiving among other things.

Cognition & language

Air Quality

High temperature

Weather events

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Flooding

Social-emotional Development, Mental Health, & Functioning

Mudslides

Return

Due to its geographic location, Bangladesh has always been prone to flooding and other major weather events. This is only being exacerbated by climate change. In addition, air quality is one of the worst, globally. The Rohingya primarily reside in shelters lacking modern amenities, facing heightened vulnerability to severe weather conditions and inadequate ventilation. Fires, flooding, mudslides and excessive heat are annual occurrences affecting the Rohingya and host communities alike. By measuring indoor air quality and temperature, and drawing from publicly available data on adverse weather events, temperature, and air pollution we investigate the connection between these environmental conditions and children’s developmental outcomes.

Climate & environmental conditions

Intra-and inter-family relationships

Religious and spiritual traditions

Camp and host community interactions

International aid and relief organizations

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

Return

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Rohingya women’s lives are strongly influenced by her birth family and, for married women, by her husband and husband’s family, and shaped by cultural norms and practices. This holds true for Bangladeshi women from the host communities to a degree also, however, the specifics of what this looks like differ. Pregnant Rohingya women often follow social and cultural norms and practices that relate to physical and mental health, as well as the health of their child. Religious and spiritual traditions influence many aspects of a woman’s pregnancy, from the types of food she eats to the people she can associate with. Some of these traditions have changed since arriving in Bangladesh due to contextual factors, for instance particular foods recommended during pregnancy not being available to them in the camps. A large presence of international organizations, along with the Bengali and Chittagonian host communities, has had a further significant influence on Rohingya people’s individual and communal life through humanitarian programs and general daily interactions. Our research explores how these familial, social, and cultural traditions impact caregiving and family relationships and how they are changing in the Camp setting, using a range of methods, including survey questions, semi-structured and key informant interviews, focus group discussions, and participatory workshops.

Culture & social norms

Age & sex

Current residence & migration history

Education & literacy

Current & past working history

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Marital status

Parental age at child birth(s)

Return

We use surveys to collect standard demographic data, such as age, education, marital status, current and past working history, and current residence and migration history. Using a simplified household roster we collect information on children living in the household, identifying biological children of the pregnant woman, their age and sex. Demographic household information is used to account for basic household (composition, size) as well as individual caregiver characteristics.

Demographics

Length / height

Good health

PLAY

Gestational age

CULTURE & SOCIAL NORMS

Adequate nutrition

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

Weight

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

Head & mid-upper arm circumference

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Return

Adult and pregnancy health are pivotal aspects of caregiver well-being, bearing substantial implications for children's physical and cognitive development. Assessing adult physical health through self-rated measures, standardized health surveys adapted for the context, and sleep quality questionnaires, allows us to discern the well-being of caregivers and the foundation they provide, even before a child's birth, which wields significant influence over the child's development and life-long health. Pregnancy health is a critical piece of our research, allowing us to account for how factors such as anemia and under-/malnutrition influence variations in pregnancy, birth, and child development outcomes. We use standard survey modules to ask about current and previous pregnancies, and collect measures of hemoglobin, blood pressure, weight, height, and mid-upper arm circumference from the mother during pregnancy. We record pregnancy outcomes (e.g., miscarriages, stillbirths), and birth outcomes (gestational age, birth weight, length, mid-upper arm circumference (MUAC), and head circumference), and continue to monitor health and growth of the baby. These data allow us to understand the source of variation in birth and child outcomes we may observe, and pinpoint particular areas in need of additional investments in this population.

Health & nutrition

Autonomic nervous system

Epi-/genetics

Proteins & metabolites

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Return

Direct measures of neurobiological functioning delve into the intricate connections between environment, experiences, and stress, and its effects on the development, mental and physical health, and functioning of current and future generations. By investigating the links between traumatic and stressful life events and a person’s neurobiology, we want to understand the implications of experiencing war and displacement on physical and mental health, potentially leading to conditions like heart disease and diabetes. This understanding extends beyond isolated factors, revealing the complex interplay between biology, culture, and society. Importantly, our investigations extend beyond a single lifespan. Evidence suggests that the impacts of trauma may ripple across generations, influencing the health of offspring. Through a number of field friendly and contextually and culturally appropriate and feasible collection methods we are collecting information on the autonomic nervous, endocrine, immune, and metabolic systems. We have established an extensive biobank of specimens for future analysis (once funding is obtained).

Neurobiology

Early learning

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Attachment

Development of self-regulation

Return

Our research also centers on the power of play during infancy and toddler years as a countermeasure to some of the negative effects of growing up in contexts of war and displacement. Behavioral synchrony, cognitive stimulation, and mutual enjoyment between caregivers and their infants during play supports attachment, early learning and the development of self-regulation, pivotal building blocks for well-being across the lifespan. Multimodal scientific inquiry into the mechanisms of how play facilitates the forging of the caregiver-child bond, strengthening of self-regulation, and the role of neural plasticity primarily comes from high-income countries, lacking insights into the role of play in buffering from and reversing biological embedding of trauma and mental health in contexts of war and displacement. We will assess physiological a-/synchrony (parasympathetic activity) in a touch / no-touch paradigm between the mother and the baby at 28-days and 6-months postpartum as a precursor to later interaction quality. Using a widely used observational protocol, we assess the mother with the older child during a play-based activity on aspects of cognitive stimulation and support of children’s exploration. Through this extensive and nuanced exploration we strive to uncover how the nurturing influence of play can counteract adversities, not just on observational measures but also on biological markers, thus paving the way for healthier developmental trajectories despite the challenges posed by war and displacement.

Play

Access and barriers to ECD services

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Geospacial data

household assets

Return

There is a preponderance of evidence on the relation between resources, or lack thereof, and pregnancy, birth, and child development outcomes, and mental and physical health. There is also research showing that the availability of or access to health and education services does not always mean that people are using them. The reasons for lack of takeup are manifold and vary from situation to situation. We collect data on resources and services available to (and accessed by) the family so that we can better understand the extent to which this impacts child development. We use several strategies, including survey modules questions that tap into household assets, social resources, and physical infrastructure available to the household. We further collect data on the accessibility and take up of general and reproductive health and ECD services. Integrating data from surveys with service providing organizations, and publicly available geospatial data of service providing locations and gps coordinates of households enables us to map the relative availability of relevant services, and potential barriers to access.

Resources & services

Mental health

Ability to perform culturally expected daily tasks

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Self-regulation

Social-emotional Development, Mental Health, & Functioning

Return

If a person is pregnant or fulfilling a caregiving role, poor mental health can impact a range of activities and outcomes, from pregnancy and birth outcomes, to providing support and scaffolding for children’s learning and healthy development. Mental health problems can greatly diminish a person's functioning, or ability to perform cuturally expected tasks, fulfill expected roles, and realize their full potential as a productive member of their community. Early indicators of mental health are often captured in concepts such as temperment and social-emotional development. We developed and adapted a number of scales to measure mental health (including depression, anxiety, PTSD) and functioning for Rohingya in this context. We ask men and women how difficult performing routine tasks are on a given day. If an individual is experiencing mental health problems, , we might also expect them to endorse difficulty in performing these daily expected tasks (poor functioning). Early infant temperament is measured through a caregiver-report survey module. Later child social-emotional development is measured through direct assessments.

Social-emotional Development, Mental Health, & Functioning

Support systems

Agency (or lack thereof)

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL CONDITIONS

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

Return

There is growing evidence that social support is correlated with the health and wellbeing of pregnant women and their children, pre- and postnatally. The availability of social support can moderate the association between past and current exposure to violence, war, and displacement, and mental health (anxiety, depression, PTSD) and child development. Pregnant women’s agency, or the ability to identify one’s goals and to act upon them, has been shown to affect take up of vital maternal healthcare services during pregnancy, delivery and during the first years of a child’s life. For these reasons, our research is designed to understand the types of support systems that exist for pregnant women and families as well as the sense of agency (or lack thereof) that pregnant women experience in making decisions for themselves and their families through survey questions, semi-structured interviews, and focus group discussions.

Support & agency

Exposure to violence

Displacement

Parental childhood adversity

Food & housing insecurity

PLAY

CULTURE & SOCIAL NORMS

CLIMATE & ENVIRONMENTAL HEALTH

DEMOGRAPHICS

NEUROBIOLOGY

COGNITION & LANGUAGE

Return

HEALTH & NUTRITION

SUPPORT & AGENCY

CAREGIVING & RELATIONSHIPS

TRAUMA & STRESSFUL LIFE EVENTS

RESOURCES & SERVICES

Social-emotional Development, Mental Health, & Functioning

The stress and trauma of war and displacement is associated with high rates of mental health disorders, including depression, anxiety, and post-traumatic stress. Childhood traumatic events can themselves affect later mental health, and may also prime an individual to be more or less sensitive to later traumatic events associated with war and displacement. Mental health problems during pregnancy have been linked to poorer birth and offspring developmental outcomes, while postnatal depression can disrupt the ability to provide nurturing care that facilitates learning and healthy development, further undermining offspring development. The Rohingya population have experienced an abundance of traumatic life events long before this most recent wave of persecution and displacement. While not experiencing war, persecution, and displacement, host communities have had their own share of traumatic and stressful life events. Our research is designed to capture experiences of trauma and stressful life experiences during childhood, and adulthood, and during war and displacement specifically, to understand how these experiences affect caregiver mental health and, subsequently, child development.

Trauma & stressful life events

The Microsystem entails settings that the developing person interacts with directly. Settings are physical spaces and the relationships with the people in them. The family is an example of a microsystem setting for caregiver and child. The health clinic is an example of a microsystem setting for a pregnant woman, and becomes a microsystem setting for the child after birth, for example when it goes for vaccines and routine check-ups. As the child grows and gets older, their microsystem expands to include more and more settings (e.g., school).

The individual is nested within contexts and is influenced by and interacts with their environment. The individual, for example the target child in our study (this could be any person who is the focus of the research), has a unique biology that is constantly changing in response to the environment. While genes are fixed (DNA does not change), everything else is very dynamic, allowing the child to respond to environmental stimuli (touch, sounds, smells), learn, and take action (or not). The child, from a very early age, actively shapes its environment, in particular the social environment, in its microsystem.

The Exosystem describes settings outside of the developing person’s microsystem that nonetheless can still indirectly influence them. For instance, a father goes to work to earn income. While the baby does not go to work with him (usually), the income nonetheless affects the baby through a variety of factors (more/better food, less intra-family tension), but it might also mean that the father has little energy left to play with the child after a long day of hard work. Thus the father’s workplace is part of the target child’s exosystem. The Macrosystem represents larger societal forces and influences that guide and structure individual, family, and community life, sometimes in more, sometimes in less tangible ways. For instance, global treaties or policies to reduce pollution in the air in and of themselves have limited bearing on most individuals. But actual reductions in pollution could have significant impacts on the health and development of millions of individuals. Cultural norms, practices, and widely held beliefs guide behaviors of all kinds, consciously and unconsciously. They are akin to tacit agreements on how life and society should be structured. They define what a “good life” looks like, and shape aspirations and child-rearing practices. They often have a great deal of influence on an individual’s choices and decision-making.