hygiene practices, stimulating cognitive and language development, and providing warm and responsive social-emotional support in the early years (Cuartas, 2022). Studies demonstrate that increased years of schooling among mothers positively relate to increased maternal engagement with young children, through more stimulating activities, improved ECE attendance, and reduced use of harsh discipline (Cuartas, 2022; Hasan et. al, 2020). Maternal education has been shown to serve as a mediation pathway through which greater cognitive and verbal stimulation from mother to child occurs, which relates to children’s language skills, social-emotional responsiveness, and later social competence (Huang et al., 2022; Hasan et. al 2020).

Without sufficient knowledge, skills, and mental health supports in place, caregivers in Pakistan are not providing their young children with the early psychosocial stimulation they need to learn and thrive. Everyday activities that support learning in young children include telling stories, singing songs, going outside together, playing, reading books, or naming or counting objects. Rates of adequate early stimulation in Pakistan are lower than the average rate for least developed countries (48 percent) and considerably lower than the average rate for low- and middle-income countries (69 percent) for children aged 2-5 years (Lu et al., 2020). Based on data from the Multiple Indicator Cluster Survey (MICS), among Pakistani children aged 3-5, stimulation rates for the prior three days are just 35 percent in Punjab (2017-18), 45 percent in Sindh (201819), 35 percent in Khyber Pakhtunkhwa (2019), and 23 percent in Balochistan (2010) (Tomlinson et al., forthcoming). Children younger than 3 years old, whose brain development is at its most rapid and sensitive, have equally or even lower odds of experiencing adequate stimulation through responsive interactions, ranging from 26 percent in Punjab, to 29 percent in Khyber Pakhtunkhwa to 45 percent in Sindh (Tomlinson et al., forthcoming).<sup>2</sup> However, more recent data collected in Punjab during the first year of pandemic disruptions indicated higher levels of psychosocial stimulation from caregivers relative to playing (86 percent), looking at a book (90 percent), or telling a story (86 percent) in the prior 15 days (ITA, 2021).

Access to child-oriented learning materials at home is also low. In addition to the critical stimulation that occurs through engaging interactions, children learn through exploration and manipulation of objects such as toys, picture books, dress-up objects, and other playthings. Across provinces and settings, less than 9 percent of 3- to 5-year-olds in Pakistan and less than 2 percent of 0- to 2-year-olds have access to books at home (Tomlinson et al., forthcoming). These low rates of access to learning materials at home contribute further to insufficient opportunities for early learning for too many children, and those living in poverty or experiencing losses in the face of the pandemic are most likely to be left out. The cumulative lack of adequate social-

> 2 Data on caregiver engagement with stimulating activities was not collected for children in Balochistan under the age of 3 in the 2010 MICS survey. The 2019-2020 data in Balochistan is forthcoming, but not yet available.

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