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The importance of caregiver-child interactions for the survival and healthy development of young children
A Review
Dr Linda Richter
ISBN 92-4-159134-X

The importance of caregiver-child interactions for the survival and healthy development of young children: A Review was published by the Department of Child and Adolescent Health and Development (CAH) at the World Health Organisation.

The author of this review is Dr Linda Richter, Executive Director of the Child, Youth and Family Development research programme at the HSRC. Dr Richter was assisted by Dr R. Dev Griesel, Research Professor in the School of Psychology at the University of Natal, and Ms Julie Manegold, an Intern at the HSRC.

Nearly 11 million children died before reaching their fifth birthday in the past year. Almost 40% of these children die within the first month of life. Millions of children survive but face diminished lives, unable to develop to their full potential. Poor nutrition and frequent bouts of illness limit the young child's opportunities to explore the world during a critical period for learning basic intellectual and social skills. Often neither the caregiver nor health personnel are aware of what to do to prevent or lessen the worst effects of illness, nor how to provide compensatory experiences to get the child's growth and psychological development back on track. This review lays the groundwork for including interventions to improve the relationship between the caregiver and child in an overall strategy to improve the child's survival, health, and development.

You can find the review on the website www.who.int/child-adolescent-health. Hard copies will be available soon from the WHO Department of Child and Adolescent Health and Development, email

Contents include:

Chapter 1. Introduction: The role of caregiving in the development of children
- Methodology for the review
- The caregiver

Chapter 2. Historical background: The importance of stable, loving care for young children
- WHO and the work of John Bowlby
- The effects of separation from a familiar caregiver on the health and development of children

Chapter 3. Advances in child development theory and research: Perspectives from psychology, linguistics, neurobiology, and evolutionary theory
- Contemporary psychological theories of how children develop
- Psychoanalytic theory, particularly Object Relations Theory
- Lev Vygotsky and social mediation
- Developmental psycholinguistics
- Developmental psychology
- Empirical findings regarding the perceptual and learning capacities of infants
- Recent advances in understanding the neurobiology of early experience
- Phylogenetic perspectives on human capacities for social and cultural communication and cooperation

Chapter 4. The nature of caregiver-child relationships: Attachment, development and cultural adaptation
- Attachment theory
- Developmental changes in caregiver-child relationships
- Features of supportive and facilitative caregiver-child interactions
- Mutuality, synchronicity, emotional availability, and social referencing
- Sensitivity
- Responsiveness
- Applicability of caregiver-child dimensions across cultures
- Models of caregiving and parenting

Chapter 5. The impact of caregiver-child interactions on the development and health of children
- Child development outcomes
- Follow-up studies from early interactions
- Psychopathology and child abuse
- Institutional care
- Child health outcomes
- Prematurity and low birth weight
- Growth and failure to thrive
- Malnutrition

Chapter 6. Social and personal determinants of the quality of caregiver-child interactions
- Socio-economic conditions
- Child characteristics
- Caregiver characteristics

Chapter 7. Improving caregiver-child interactions: Implications for intervention

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Chapter 1 + 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6 + 7
Glossary + Bibliography