Early Childhood Development in the Slums of Cuttack, Odisha, India.

Last registered on November 25, 2015


Trial Information

General Information

Early Childhood Development in the Slums of Cuttack, Odisha, India.
Initial registration date
January 23, 2014

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
January 23, 2014, 10:56 AM EST

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
November 25, 2015, 5:42 AM EST

Last updated is the most recent time when changes to the trial's registration were published.



Primary Investigator


Other Primary Investigator(s)

PI Affiliation
PI Affiliation
PI Affiliation
IFS & Yale University

Additional Trial Information

On going
Start date
End date
Secondary IDs
The intervention aims to promote early childhood development and maternal-child interactions in a very poor urban environment.
The importance of the first 5 years of life for long-term development is well-established. During this vital period the development of children living in poverty is hindered by malnutrition, illness and unstimulating home environments. Evidence shows that interventions in early childhood can be very important for pshychosocial development. We will implement and evaluate a cost effective intervention, delivered by local women through weekly home visits during 18 months and targeted at children 10 – 20 months and their mothers/primary caregivers. Evaluation will be by cluster randomised controlled trial. We will assess child development and conduct household and slum surveys before and after the intervention on a sample of n=400 children in 54 slums in Cuttack, Odisha, India.
External Link(s)

Registration Citation

Attanasio, Orazio et al. 2015. "Early Childhood Development in the Slums of Cuttack, Odisha, India.." AEA RCT Registry. November 25. https://doi.org/10.1257/rct.169-2.0
Former Citation
Attanasio, Orazio et al. 2015. "Early Childhood Development in the Slums of Cuttack, Odisha, India.." AEA RCT Registry. November 25. https://www.socialscienceregistry.org/trials/169/history/6158
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Experimental Details


We will carry out a stimulation programme that aims to improve the interaction between mothers and their infants in everyday activities by introducing a systematic week-by-week curriculum that follows the natural developmental stage of the child. The curriculum will be delivered by local women (home visitor) during weekly individual home visits to 400 children, aged 10 - 20 months at the start of the intervention, and their caregivers.
The key organising element of the home visit will be the curriculum and protocols originally developed by Sally Grantham-McGregor specialy adapted for the context of Odisha. The curriculum is progressive and enables the facilitator to let the child dictate the pace. Emphasis is placed on improving maternal-child interaction, using positive reinforcement, and on using everyday child care activities and household tasks to teach the child new words and concepts. During the visits, the facilitator will interact with the mother and her young child and will demonstrate play activities using home-made toys and objects around the home. She will also discuss child development with the mother and emphasise the importance of chatting and play. As part of this research project, we will ensure that the curriculum is both age relevant and adapted to the cultural context.
Intervention Start Date
Intervention End Date

Primary Outcomes

Primary Outcomes (end points)
Primary Outcomes
Children’s cognitive, receptive language, expressive language, and fine motor development (assessed using Bayley-III at follow-up).
Details of exact analysis to be performed provided in pre-analysis plan.

Secondary Outcomes
1. Quality of the home stimulation environment (as measured by the 'play activities' and 'play materials' subscales of the Family Care Indicators)
2. Maternal time spent on high stimulation activities with children (as measured by time use module in household questionnaire)
3. Mother's knowledge of child development (as measured by a subset of selected items from the KIDI instrument)
Details of exact analysis to be performed provided in pre-analysis plan.
Primary Outcomes (explanation)
Children's cognitive, language, motor and socio-emotional development will be measured using the ASQ-3 (at baseline) and possibly an adapted version of the Bayley-III (at follow up).
Quality of the home environment: play activities and play materials will be measured using FCI instrument at baseline and follow up.
Mother's knowledge of child development will be assessed using the KIDI instrument.

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
Intervention group:
27 clusters will receive psychosocial stimulation through weekly home visits - lasting around one hour - to mothers/primary care givers of children aged 10 - 20 months. The home visitors will be local women and will follow the Grantham-McGregor's curriculum and protocols specially adapted for the context of Odisha. They home visitors will interact with carers and children and will discuss the importance of stimulation and play for child development with the carer.
Control group:
27 clusters will receive no intervention.
Total duration of intervention: 18 months (2 periods of 1 month of data collection will precede and follow the interventions).
Experimental Design Details
Randomization Method
The randomisation is conducted by a computer in the office, using the statistical program Stata version 12. The steps we follow are:
1. Identify sample of eligible slums: this means those with at least 7 children in the defined age range (10 - 20 months). Exclude children with physical or mental disabilities and twins.
2. Stratify sample of slums by slum size, i.e. the stratification variable is an indicator = 1 if the slum has more than nine children in our target age range according to the initial listing conducted in the slums, 0 otherwise.
3. Within strata,
3.1 randomly assign a number between 0 and 1 to each slum;
3.2 sort the number of slums by randomly assigned number;
3.3 assign the first half of the slums to treatment and the second half to control.
Randomization Unit
Slums with at least 7 children aged 10 - 20 months.
Was the treatment clustered?

Experiment Characteristics

Sample size: planned number of clusters
54 slums.
Sample size: planned number of observations
400 children in the target age range.
Sample size (or number of clusters) by treatment arms
27 slum intervention group, 27 slum control group.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
We design the sample to detect a minimum effect of 33% of one standard deviation (SD) of cognitive development on a child development scale (i.e. Bayley-III) for the home visiting intervention against the control group. The level of significance is fixed at 5%, power is fixed at 80%, and the intra cluster correlation at 0.025. This is based in previous estimates from work done by members of the research team in Colombia (intra-class correlation (conditional on observables) between 0.01 and 0.04, depending on the domain of development as assessed by the Bayley-III) and in the more similar context of Bangladesh (conditional intra-class correlation on Bayley-III cognitive development has been found to be 0.01). Sample size requirements are 27 slums per treatment arm (54 total) and 7.5 children per slum on average. We are including 8 children per slum on average to allow for some sample loss between baseline and first follow up. Stratifying the sample by slum size before randomization will also increase statistical power.

Institutional Review Boards (IRBs)

IRB Name
Pratham Ethics Committee (PEC)
IRB Approval Date
IRB Approval Number
IRB Name
University College London (UCL), UCL Ethics Committee
IRB Approval Date
IRB Approval Number
IRB Name
Institute for Financial Management and Research (IFMR)
IRB Approval Date
IRB Approval Number
IRB00007107; FWA00014616; IORG0005894
Analysis Plan

Analysis Plan Documents

Pre-analysis plan

MD5: 5731b6a3c10a0103467aba2f1b7af3bc

SHA1: c0beb08c3b431f47ddd1bdfdd0b3cf1173462969

Uploaded At: November 25, 2015


Post Trial Information

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Is the intervention completed?
Data Collection Complete
Data Publication

Data Publication

Is public data available?

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials