IV.III Relational early intervention: saving brains grenada

Saving Brains Grenada is an ongoing early child development (ECD) Programme launched in 2014 in the tri-island state of Grenada, West Indies, with a dual focus on: (1) enhancing neurodevelopment, and thereby human capital, by imparting knowledge and skills to adult caregivers that build emotional regulation and a strong social emotional connection with the child, thereby enhancing child safety, exploration, and stimulation, while (2) addressing culturally entrenched, postcolonial practices of harsh corporal punishment and related violence against children. The Programme uses an adapted Conscious Discipline (CD) curriculum, which is a trauma-informed triune brain state model with a specific focus on adult skill-building in a context in which licks, spanks, and beatings are culturally normative despite overwhelming evidence that violence is harmful for children’s health and brain development. The curriculum is delivered to families through a home visiting program by community-based social workers (i.e., Roving Caregivers) to communities through a mobile unit (The Saving Brains Bus) and, more recently, to pre-primary schools through an adaptable coaching system administered both in-person and virtually. A key element is the Programme’s brain-based focus on safe, connected relationships in which to maintain composure, resolve conflicts, and solve problems. A parallel single-blind waitlist-controlled trial design was used in which children from age 0-2 and their parents were enrolled in the home visiting program and assigned to a CD Intervention group versus a Waitlist Control (WC) group. The total number of parents and children under age two years enrolled in this study was 1,043, which represented 19.8% of all children under this age in Grenada at that time. A total of 752 parents and their children were recruited by the Roving Caregiver program and served as the CD Intervention group. A total of 291 parents and their children were recruited into the WC group. A total of 333 participants (Intervention: n=165; WC: n=168) remained after the data was cleaned. Upon turning 2 years of age, children were assessed and the CD Intervention group was compared to the WC group on measures of neurodevelopmental outcomes (INTERGROWTH-21st Neurodevelopment Assessment [INTER-NDA], demographics, mother pregnancy and birth outcomes, maternal mental health indicators, home environment, food security). Mothers were also assessed for attitudes and behaviors around corporal punishment. Results demonstrated: (1) improved neurodevelopment in children; (2) significant shifts in knowledge about developmentally appropriate child rearing practices and skills among teachers, Roving Caregivers, and parents; (3) moderate shifts in attitudes toward the use of corporal punishment in teachers and Roving Caregivers, and (4) incremental shifts in attitudes toward the use of corporal punishment among parents. Whether a reduction in attitudes and behaviors toward corporal punishment is needed for improvement (or greater improvement) in neurodevelopment remains an outstanding question.