Neuropsychological development in bilingual and monolingual children from urban and rural areas from Arequipa region.
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Introduction: Several studies have suggested that bilingualism favors development of neuropsychological functions. In addition, it has also been shown, in Latin American countries, children living in urban areas have a higher level of neuropsychological development than their peers who live in rural areas. Objective: To compare the neuropsychological maturity in boys and girls who live in rural and urban areas of Arequipa (Peru), according to sex, area of residence, and bilingualism. Subjects and methods: 140 children were evaluated (52.8% male and 47.2% female) with an average age of 76 months, 50% monolingual and 50% bilingual, 50% living in urban areas and 50% in rural areas. The Childhood Neuropsychological Maturity Questionnaire (CUMANIN) of Portellano et al. (2000) was used. Results: The neuropsychological maturity quotient is located at a high average level in the general sample. Girls presented a higher level of spatial structuring and neuropsychological maturity than boys. Bilingual children had a better performance in expressive language compared to monolinguals with a moderate effect size. Moreover, children residing in urban areas have higher scores in verbal fluency, reading and writing than those in rural areas, with significant differences and sizes of the big effect. Conclusions: The area of residence is determinant in the neuropsychological development of bilingual and monolingual children, in favor of those who come from urban areas in functions such as verbal fluency, reading and writing.
Key words: Neuropsychological maturity, bilingualism, urban environment, rural environment.
In Peru, the indigenous population is of 4,045,713 people, of which 83% are Quechua, 11% Aymara, and 6% belong to the Amazonian peoples(1). When the first migratory waves of Andean settlers moved to the main cities of Peru (mainly to Lima) at beginning of the second half of the 20th century, a variety of studies regarding social psychiatry were carried out. They reviewed the psychic affectation of by migrant residents who lived in poverty and marginality in the city of Lima(2). In this context, Raúl González Moreyra investigated the psycholinguistic development of bilingual children who spoke Quechua and Spanish in urban and rural areas of the country(3,4). Based on studies, it was possible to conclude that Quechua-speaking children presented several cognitive and neurolinguistic deficits, which had negative repercussions on their psychological development and school performance(5). The fact that Quechua-speaking children receive a Spanish education and that their mother tongue is considered inferior, has caused a series of emotional drawbacks, cognitive limitations and educational disadvantages, which has caused their entire development to be at risk.
Although since 1996 policies have been implemented to promote intercultural and bilingual education in many Andean and Amazonian regions of Peru(6), the results have not been very encouraging due to the lack of pedagogical preparation of the Quechua-speaking teachers, the neglect of the socio-emotional aspects of children(7), and the lack of balance between teaching in Quechua and teaching in Spanish, which still seems to mask a deprecative view of Quechua(8). This is added to persistent conditions of poverty and socioeconomic inequality in the country, leaving people who live in rural areas in a disadvantaged position, in comparison to those living in urban areas.
Although investments in road construction, irrigation systems and telecommunications, have had a favorable impact on the productivity of the agricultural sector in rural areas, only 32% of children of indigenous origin between 3- and 5-years old attend school compared to 55% of non-indigenous children(9). At the same time, illiteracy rates continue to be high among children who come from the high Andean areas and the rural jungle and is even worse among women from these regions.(10)
This research, which is part of the developmental neuropsychology, aims to answer the following research questions: What is the level of neuropsychological maturity of a group of children from Arequipa and what differences are recorded based on sex, their area of origin (rural or urban) and their knowledge of one or two languages (bilingual and monolingual)? By neuropsychological maturity we refer to the level of organization and brain development that corresponds to a specific chronological age.(11)
Several studies in English-speaking countries have reported that bilingualism favors childrens cognitive development(12); while recently in Peru, Canales et al.(13) evaluated psycholinguistic skills with three dialectic variations in monolingual university students from Lima (coastal area) and Arequipa (southern Andean area) and bilingual (Quechua-Spanish) of Huancavelica (central mountain range area), reporting that bilingual students from Huancavelica obtain lower scores in most dimensions of oral language, such as comprehension and production. In another investigation, Vásquez(14) compared the vocabulary breadth of 445 eight-year-old children from rural areas of Peru, according to three conditions: early migrant, late migrant, and non-migrant. Their results show that migration before the age of five, as well as the educational level of the mother predict in a positive and highly significant way the development of vocabulary, regardless of gender, access to reading material at home and the school year of the children.
In the case of bilingualism, Sotos studies on cognitive reserve in older adults have revealed that the level of education, literacy level, reading level and bilingual status in Quechua-speakers, may have a protective effect against dementia and mild cognitive impairment(15,16,17). It has also been reported that having attended early stimulation programs has a positive effect on the neuropsychological maturity of three-year-old children compared to those who have not received prior stimulation. However, this study indicates that bilingualism hinders the development of expressive language in these children, while psychomotricity is the most developed ability(18). In another study, neuropsychological performance was compared in children living in urban and rural areas of Arequipa, finding significant differences in the regulation of voluntary activity, phonemic hearing, spatial analysis and synthesis, kinesthetic analyzer, tactile memory, and the kinetic organization of movements, in favor of children from urban areas.(19)
However, neuropsychological maturity of children is subject to a great variety of biological and environmental variables. In first case, there are genetic alterations and/or mutations that affect chromosomes and are related to several neurological, psychological and neuropsychological disorders that directly or indirectly affect the neurodevelopment process, such as neurofibromatosis, Rett syndrome or Tourettes disorder. On the other hand, environmental and cultural factors play an essential role in the neuropsychological development of the child. Thus, it is found that, for example, approximately 75% of the population with mental retardation comes from poor cultural backgrounds, with parents who have a low educational level and limited access to basic services or information and communication technologies(20). The lower the childs socioeconomic level, the lower their performance is on cognitive abilities tests(21). Moreover, given that in many Latin American countries, poverty and lack of access to information and communication prevails in rural areas, it is logical to think of a cognitive and neuropsychological superiority in children from urban areas. Various neuropsychological studies in Mexico have reported that children living in urban areas are ahead of children from rural areas in regulation, control, spatial analysis, synthesis, kinetic organization of movements, language comprehension, language expression, attention, imagination, and memory(22). Even though both groups came from the metropolitan area, similar results have been found in children from urban and rural areas of Arequipa.(19)
The sample consisted of 140 children with an average age of 76 months (SD= 2.60 months); of which 52.8% were male and 47.2% were female. 50% came from the city of Arequipa (urban area) and the other 50% from the city of Chivay (rural area) within the province of Caylloma in the Arequipa region (located at 3,635 masl). Regarding language, 50% were monolingual (Spanish-speaking) and the other 50% were bilingual (Quechua and Spanish), thus four equivalent groups were formed: 35 bilingual children from rural areas, 35 bilingual children from urban areas, 35 monolingual children from rural areas and 35 monolingual children from urban areas. All children belong to a middle or middle-low socioeconomic sector and were selected in a non-probabilistic way using the quota sampling technique, from educational institutions selected by convenience sampling.
CUMANIN (Child Neuropsychological Maturity Questionnaire), developed by Portellano et al. was applied in order to(23) to evaluate boys and girls between 3 to 6 years old (36 to 78 months). The test lasts approximately 30 to 50 minutes and delivers coefficients of neuropsychological maturity and two development indexes: a verbal one and a non-verbal one, with their correspondent coefficients. It includes 83 items that are distributed in 8 scales that evaluate psychomotor skills, language articulation, expressive language, comprehensive language, spatial structuring, visuoperception, iconic memory, rhythm, verbal fluency, attention, reading, dictation and laterality. Number 1 was used whenever the examiners requirements were met, and 0 was used if these failed(11). The test has been validated in Peru, by María Guerrero with acceptable values of validity and reliability (?= 0.87). For the purposes of this analysis, laterality values were not considered since the results have been reported in a previous study.(24)
The participating students were evaluated in their corresponding educational institutions in rural and urban areas, and were included in the sample, provided they met the monolingualism-bilingualism criteria. The necessary permits were obtained from school authorities and parents, who were informed of the purposes of the investigation. Data confidentiality was guaranteed. Approval of the Ethics Committee of the National University of San Agustín was granted.
To perform a statistical processing of the data, descriptive statistics were calculated; and in order to make comparisons, depending on the normality of the variables, the students t or Mann Whitney U test were applied. Effect size was calculated using Cohens d test for Students t test and biserial correlation for the Mann Whitney U test. The JASP versión 0.9.2(25) was used.
Table 1 shows the univariate statistics of neuropsychological maturity variables. Taking into account that the sample is not very large, we analyzed the normality of our variables through the Z asymmetry and Z kurtosis indexes, which must be in the range of [-3.29; 3.29] in order to state that the variables have a normal distribution(26). Thus, we have defined that psychomotricity, iconic memory, rhythm, verbal fluency, attention, writing and quotient variables can be processed using parametric statistics. On the other hand, language articulation, expressive language, comprehensive language, spatial structuring, visual perception, reading, verbal development, non-verbal development and overall development variables must be processed using non-parametric statistics.
Table 2 shows that girls obtained higher averages in the neuropsychological maturity quotient with significant differences (t(138)= -2.183; p=0.031; d=0.370). However, the calculated effect size is small. Furthermore, girls obtained significantly higher scores in spatial structuring (U=1891.5; p=0.017; rbis=0.225) and overall development (U=1946; p=0.038; rbis=0.203) compared to boys, with a small
Table 3 shows that bilingual children obtained higher scores than monolingual children in expressive language with a moderate effect size. (U=1650; p<0.001; rbis=0.327) and spatial structuring with a small effect size(U=1893.5; p=0.016; rbis=0.227). On the other hand, monolingual children scored significantly higher than bilingual children in verbal fluency with a moderate effect size. (t(138)=2.516; p=0.013; d=0.425) and in visuoperception with a small effect size (U=1959.5; p=0.034;
Table 4 compares the averages obtained by the children according to their place of origin depending on whether it is an urban (Arequipa) or rural (Chivay) environment. It can be seen that children who come from the city of Arequipa (urban) obtain higher scores than their peers who come from Chivay (rural). Rhythm (t(138)= -4.621; p<0.001; d=0.781), Oral fluency (t(138)= -11.447; p<0.001; d=1.935), Attention (t(138)= -3.216; p=0.002; d=0.544), Writing (t(138)= -6.362; p<0.001; d=1.075) with large effect sizes and with a small effect size in the neuropsychological Maturity Quotient (t(138)= -2.293; p=0.023; d=0.388). Also, subjects from Arequipa have a better language articulation (U=1952; p=0.030; rbis=0.203), reading (U=1356; p<0.001; rbis=0.447), nonverbal development (U=1917; p=0.218; rbis=0.200) and overall development (U=1925; p=0.029; rbis=0.214), with small effect sizes.
The hypothesis that bilingualism has favorable effects on child development and the maturity of their cognitive and neuropsychological functions has been developed by Alexander Luria(27), based on the ideas of Lev Vigotsky(28), who gave fundamental importance to language and to the cultural historical context, as mediators of the development of higher psychological functions. In this sense, several authors have proven that bilingualism has positive effects on cognition(29). In Peru, studies on bilingualism and cognition also confirm these results(5,13); but in the field of neuropsychology, studies on bilingualism have only been carried out in older adults.
Trying to fill this gap in our regional context, the purpose of this investigation was to compare the neuropsychological maturity in boys and girls who live in rural and urban areas of Arequipa (Peru), according to gender, place of residence, and bilingualism. Our results show that the level of neuropsychological maturity of boys and girls is at a medium high level with an overall development quotient of 123.08. The study also found a superiority in spatial structuring and neuropsychological maturity in girls. Regarding spatial structuring, it is known that males have a better development of spatial abilities. However, this occurs in adolescence, given that the lateralization of higher functions occurs earlier in females, with less brain asymmetry than males(30). In addition, females tend to have faster and earlier physical and psychological development than males(31), therefore, the results obtained are compatible with what has been reported in specialized literature.(32)
There was also evidence of superiority of bilingual boys and girls over their monolingual peers in expressive language and spatial structuring, which is consistent with studies on bilingualism(5). It is evident then, that mastering a second language promotes the development of expressive language(33). Following the Vygotskyan hypothesis, it is feasible to think that these linguistic abilities would have an important effect on other cognitive functions, favoring the overall development of the child.(22,34)
Regarding the comparison of neuropsychological maturity based on place of residence, we concluded that boys and girls living in urban areas obtained higher levels on the scales that assess rhythm, oral fluency, attention, reading, writing, non-verbal development and overall development scores; in spite of the fact that a very large effect size was only recorded for pacing, verbal fluency, attention, and writing. It is known that these abilities are lateralized in the left hemisphere and are closely related to specific learning difficulties(20). That is to say, that the lower achievement in learning that has been registered among students in rural areas in Peru(35), as well as the limitations to read and understand texts(9), could be explained by a lack of maturity of the neuropsychological functions. These lower levels of neuropsychological maturity in rural children may be due to several factors, such as the lack of economic resources, which impacts the satisfaction of basic needs related to food, clothing, education, recreation, etc.(11,36) In this sense, although not all people experience poverty in the same way, belonging to minority ethnic groups and living in rural contexts is associated with lower cognitive and neuropsychological performance.(37)
Another important factor that would explain the scores obtained in the psychological functions studied in children from rural areas, would be the lack of parental support and the quality of the home environment(38). In this sense, parental support is vital for childrens psychological development and school performance(39), given that learning through social interaction between family members is a powerful stimulator(40). Furthermore, the educational level of the mother determines the quality of interactions, so children who interact the most with their mother develop better language and cognitive skills(41). The studies by González Moreyra(5) reported that mothers in rural areas do not interact very much with their children because they are more dedicated to housework and agricultural work. This has a negative impact on children´s psycholinguistic development. Since socioeconomic conditions remain unfavorable for people living in rural areas(10), interactions with parents might have a negative effect on children, as it has been proven in children from urban areas of the city of Arequipa.(40)
Finally, an important factor that could also explain our results is altitude. The rural area is located above 3,600 masl compared to the urban area which is located at 2,335 masl. Altitude could affect the neuropsychological development of children, given that at a higher altitude the amount of oxygen is lower and might have a negative effect on the development children´s nervous system and the metabolic functions of the brain(41). However, in a recent study, León reported that, although damage to complex cognitive ability occurs at high altitudes, it only affects people who are not adapted to it.(42)
Thus, we can conclude that the most relevant differences in neuropsychological maturity of the boys and girls studied, are due to the area of residence; favoring those who come from urban areas, specifically in skills such as verbal fluency, reading and writing. Hence, it would be necessary to develop neuropsychological intervention programs to stimulate the neurocognitive development of children in rural areas; especially in reading and writing skills, since they have a significant impact on school performance(43). On the other hand, it is necessary to implement early neuropsychological development intervention strategies, in charge of health departments located in rural areas. These measures should be integrated into national health policies.(44)
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