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Understanding, Expressing, and Regulating Emotions: A Systematic Scoping Review of Interventions for Young Children with Autism Spectrum Disorder
Abstract
Emotional competence, comprising the interconnected domains of emotional understanding, expression, and regulation, is a critical developmental construct that is often disrupted in young children with autism spectrum disorder (ASD), who frequently experience difficulties recognizing, expressing, and managing emotions. This scoping review systematically maps intervention studies targeting emotional competence in young children (ages 036) with or at risk for ASD. Following PRISMA 2020 guidelines, four databases (APA PsycINFO, ERIC, Medline, PubMed) were searched for peer-reviewed studies published from 2000 to 2023. Included studies targeted emotional understanding, expression, or regulation and reported quantifiable child outcomes. Studies were screened and coded by multiple reviewers using standardized procedures. Thirty-two studies met inclusion criteria. Emotional understanding was most frequently targeted (21 studies), followed by regulation (6); no studies focused solely on expression. One study addressed both understanding and regulation, and three targeted all three domains. Intervention types varied and primarily included discrete trial training, video modeling, cognitive behavioral therapy, and caregiver-mediated programs. Demographic reporting was limited: only 15 studies reported race/ethnicity and 5 reported socioeconomic indicators. Outcome measures varied by domain, with direct assessments common for emotional understanding and caregiver reports for regulation. Notable gaps include the absence of standalone expression interventions, inconsistent demographic reporting, and variability in measurement approaches. Future directions are discussed.
Emotional competence represents a foundational set of skills that emerge in early childhood, encompassing the ability to understand, express, and regulate emotions in socially appropriate and effective ways (Denham, 2023). Emotional understanding involves recognizing and interpreting one9s own emotions and those of others. Emotional expression refers to conveying emotions clearly and appropriately through verbal and nonverbal means. Emotional regulation is the ability to manage emotional arousal and adjust emotional responses to meet personal goals and social expectations (Denham, 2023). Emotional competence consists of three distinct but interconnected domains, understanding, expression, and regulation, that develop in tandem rather than in isolation.
This construct develops through bidirectional interactions between children’s characteristics (i.e., cognition, temperament, language abilities) and their social environments, and particularly their relationships with caregivers, teachers, and peers (Castro et al., 2015; Klein et al., 2018). Research has consistently demonstrated that early emotional competence serves as a foundation for developing and maintaining social relationships, academic success, and overall adaptive functioning, with children who exhibit stronger emotional competence showing enhanced social skills, better peer relationships, and more positive academic trajectories (Curby et al., 2015; Jahtomi et al., 2021; Moffitt et al., 2011; Denham & Brown, 2010). Indeed, longitudinal studies reveal that early emotional competence predicts later social adjustment, academic achievement, and behavioral outcomes such as improved vocabulary, literacy skills, emotional understanding, competent social problem solving, and positive social behavior (Nix et al., 2013; Sallquist et al., 2009).
Children with autism spectrum disorder (ASD) often face significant challenges in developing emotional competence, placing them at increased risk for broader developmental difficulties (Vacas et al., 2021). These challenges stem from differences in emotional information processing, emotional regulation, and reciprocal social interaction (Morris et al., 2013; Strain & Schwartz, 2001). Children with ASD often show difficulties in how they perceive and interpret emotional expressions, struggle with managing emotional responses in challenging situations, and face challenges expressing emotions in ways that others can understand (Denham et al., 2012; Rubin et al., 1995; Denham et al., 2001). These challenges create cascading effects across development, impacting social relationships, classroom participation, and academic achievement (Moore et al., 2015; Blandon et al., 2010).
The early years represent a critical period for supporting emotional competence development in children with ASD, with research suggesting that early intervention can promote better developmental outcomes (Webster-Stratton & Reid, 2004; Hemmeter et al., 2006). The complex nature of emotional competence development, combined with the specific challenges faced by children with ASD, suggests the need for targeted intervention approaches within natural developmental contexts (Laible et al., 2014; Walton & Hibbard, 2019).
The goal of the present systematic scoping review is to provide an overview and synthesis of the existing evidence base on emotional competence interventions for young children (0-6 years old) with or at risk for ASD. Specifically, the review seeks to examine which domains of emotional competence (understanding, expression, and regulation) are addressed by current interventions, and identify potential gaps in intervention approaches. This review seeks to provide greater conceptual clarity around emotional competence interventions and help identify which skills are most frequently targeted, and which are underrepresented, in existing interventions. In addition to synthesizing intervention content and outcomes, understanding the participant characteristics represented in the current literature is essential for evaluating the generalizability and equity of emotional competence interventions. Descriptive information such as age, race, ethnicity, socioeconomic status, parental education, and autism severity or presentation can illuminate which populations are being reached by current interventions4and which may be underrepresented. By examining these characteristics, this review aims to identify gaps in sample diversity and inform the development of more inclusive and developmentally appropriate intervention practices. The present review aims to guide future research and practice by highlighting areas in need of development, promoting more comprehensive and developmentally appropriate support for young children with or at risk for ASD.
Overarching Research Question
What is the current state of the evidence on interventions targeting emotional competence (understanding, expression, and regulation) in young children (ages 036) with or at risk for autism spectrum disorder (ASD)?
Specific Research Question
Which emotional competence domains are most and least frequently addressed? What intervention strategies and evidence-based practices are used to support emotional competence in this population? What are the common characteristics of included studies in terms of participant demographics, reporting practices, outcome measurement methods?
Method
Search and Selection Strategy
The systematic scoping review was conducted according to PRISMA 2020 guidelines. A comprehensive search strategy was implemented across four electronic databases: APA PsycINFO, ERIC, Medline, and PubMed. The search terms were organized into two conceptual categories connected by Boolean operators. The first category encompassed emotion-related terms: “emotion,” “emotion regulation,” “emotion understanding,” “emotional competence,” “emotion-learning,” “tacting emotions,” “SEL,” and “Social-Emot.” The second category utilized the truncated term ”autis” to capture autism-related terminology. The search was limited to peer-reviewed articles published in English from 2000 to present.
The screening process was conducted using Covidence systematic review software. The primary researcher, a doctoral student in Special Education, completed the full screening process, while an additional researcher, a doctoral student in Behavior Analysis, independently screened 100% of the records to establish inter-rater reliability. The selection process involved two phases: initial screening of titles and abstracts, followed by full-text review of potentially eligible studies. Any disagreements between reviewers within the reliability sample were resolved through discussion until consensus was reached. Prior to formal screening, both reviewers completed training by collaboratively coding a small sample of articles using the predefined inclusion criteria and emotional competence domain definitions. When discrepancies emerged, they were discussed and resolved through consensus. Full screening did not proceed until the reviewers achieved 100% agreement on the practice set, ensuring consistency and shared understanding of key constructs.
Inclusion and Exclusion Criteria
Studies were evaluated for inclusion based on several predefined criteria aligned with the research objectives. Regarding population characteristics, studies were required to focus on children ages 0-6 years with diagnosed or at-risk status for ASD. For studies with age ranges marginally outside these parameters, full-text examination was conducted to evaluate the sample’s mean age, with inclusion determined by whether this mean fell within the target range.
Intervention eligibility required explicit targeting of emotional understanding, emotional regulation, or emotional expressiveness. The review included experimental intervention studies employing randomized controlled trials, quasi-experimental designs, or single-case research designs. Studies involving typically developing children were considered eligible only when they incorporated children with ASD in the sample as well. Studies were required to report quantifiable child outcomes specifically related to changes in the targeted emotional domains.
The review excluded non-experimental studies, including surveys, observational studies, case studies, and theoretical papers. Studies focusing exclusively on other developmental disorders without including ASD were excluded, as were those lacking measurable child outcomes or those reporting outcomes unrelated to emotional domains.
Data Extraction Process
A standardized data extraction form was developed to systematically collect information from eligible studies. To ensure inter-rater reliability, each article was independently coded by two reviewers. The primary researcher extracted data from all included studies, and two additional researchers, one faculty and one doctoral student in Special Education, independently reviewed and coded the full set of articles, each coding a subset such that every study was coded twice. The extraction protocol captured intervention characteristics, methodological features, participant demographics, outcome measures, and implementation details. Specific information coded during the full-text review included: the intervention practices employed in the interventions; the emotional learning domains addressed (i.e., emotional understanding,regulation, or expressiveness); and participant demographics, including age, race, and ethnicity. Additionally, researchers documented the severity, presentation, and profile of participants9 ASD, including the tools or scales used to assess ASD (e.g., ADOS, CARS). Outcome measures were also categorized based on whether they involved direct assessment or caregiver reports. Socioeconomic factors, such as parental education levels and income, were noted when available.
Results
A total of 32 studies met inclusion criteria and were analyzed to address the review9s research questions. Findings are organized by emotional competence domain (understanding, expression, and regulation) and include summaries of intervention characteristics, participant demographics, and outcome patterns. This section also highlights trends in intervention focus, methodological rigor, and gaps in the current evidence base. Figure 1 presents the PRISMA 2020 flowchart summarizing the study selection process.
Emotional Competence Domains Targeted
The included studies varied in the emotional competence domains they targeted. Twenty-one studies focused on emotional understanding, making it the most commonly addressed domain across the review (Lyu et al., 2024; Williams et al., 2012; Golan et al., 2010; Gev et al., 2017; Yan et al., 2018; Giangiacoma et al., 2022; Zhang et al., 2019; Yun et al., 2017; Marino et al., 2020; Conallen and Reed, 2017; Baron-Cohen et al., 2009; Lopata et al., 2018; Young and Posselt, 2012; Matsuda and Yamamato, 2014; Intepe-Tingir, 2023; Wang et al., 2023; Wan et al., 2022; Persicke et al., 2022; Chan et al., 2023).
One study targeted emotional expression as a standalone domain (Gepner et al., 2022). Six studies focused on emotional regulation, which was the second most frequently targeted 8 domain (Rispoli et al., 2019; Gulsrud et al., 2009; Mahoney and Perales, 2003; Scarpa et al., 2011; Salter et al., 2016; Marzouki et al., 2022). One study targeted two domains, specifically emotional understanding and emotional regulation (Factor et al., 2019). Three studies addressed all three emotional domains4emotional understanding, expression, and regulation4through comprehensive interventions (Swain et al., 2019; Ros-Demarize et al., 2021; Bartroli et al., 2024).
Intervention Approaches Used
The included studies used a range of intervention approaches depending on the emotional competence domain being targeted. For studies focused on emotional understanding, interventions included discrete trial training (DTT) (Lyu et al., 2024; Yun et al., 2017), The Transporters DVD or app to teach emotion recognition (which we coded as emotional understaning) (Williams et al., 2012; Golan et al., 2010; Gev et al., 2017; Yan et al., 2018; Baron-Cohen et al., 2009; Young and Posselt, 2012; Chan et al., 2024; Wang et al., 2023), Neuro-Psychomotor Therapy (Giangiacoma et al., 2022), a curriculum incorporating multiple EBPs such as DTT and PRT (Zhang et al., 2019), CBT with REBT principles (Marino et al., 2020), teaching conversations about emotions (Conallen and Reed, 2017), a summer psychosocial group program (Lopata et al., 2018), computer-based MTS training (Matsuda & Yamamato, 2014), repeated reading of storybooks (Intepe-Tingir, 2023), a visual-behavioral intervention combining VBI and The Transporters (Wang et al., 2023), the Facial Emotion Cognition and Training System based on Baron-Cohen9s theory (Wan et al., 2022), a DVD-based emotional recognition tool (Williams et al., 2012), and a multi-component package including modeling and reinforcement (Persicke et al., 2022). One study targeting used a slowed-input speech-language approach called “slowness therapy” (Gepner et al., 2022). Zero studies explicitly targeted emotional expression.
Studies targeting emotional regulation used a variety of approaches, including the RELACS caregiver support model (Rispoli et al., 2019), joint engagement-focused early intervention (Gulsrud et al., 2009), responsive teaching during daily routines (Mahoney and Perales, 2003), cognitive behavioral therapy (CBT) (Scarpa et al., 2011), child-centered play therapy (Salter et al., 2016), and aquatic-based physical activity training (Marzouki et al., 2022). The one study addressing two domains, emotional understanding and regulation, used an adapted CBT program called the STAMP program (Factor et al., 2019). The STAMP intervention directly targets emotional understanding by teaching young children to identify and label both positive emotions (e.g., happiness, relaxation) and negative emotions (e.g., anger, anxiety) through structured group sessions and parent-supported generalization. Emotional regulation is addressed through explicit instruction and practice of coping strategies, including physical calming tools, cognitive reframing techniques, and social support strategies. The strongest measurable impact in the study was a significant reduction in lability and negativity, as captured by the ERC-L/N subscale, indicating decreased emotional reactivity (Factor et al., 2019).
The three studies targeting all three domains used comprehensive models, including cognitive behavioral therapy (Swain et al., 2019), the Summer Treatment Program for PreK (Ros-Demarize et al., 2021), and a universal preschool curriculum for emotional education titled <1,2,3,emoció!=, which was implemented across a school year in Barcelona preschools (Bartroli et al., 2024).
Descriptive Characteristics of Included Studies
Of the 32 studies included in this review, 15 reported participants9 race. The most commonly reported racial groups were White (11 studies), Asian (including participants described broadly as Asian or from Asian subgroups; 9 studies), and Black (1 study). Some studies referenced participants using broad or unclear terms such as <ethnic minority= or <other,= without further detail. Latino and Hispanic identities were reported in three studies each, though race and ethnicity were often conflated or inconsistently defined across studies.
Socioeconomic status (SES) or parental education level was reported in 5 of the 32 studies. Reporting formats varied. For instance, detailing family income ranging from $14,400 to $250,000 (M = $82,894.44) and noting that most parents had completed postsecondary education (Factor et al., 2019). Reporting an income range between $35,000 and $50,000 (Ros-Demarize et al., 2021). Reporting parental education as a mean number of years (15.1 years) (Marino et al., 2020) and (16.17 years) (Lopata et al., 2018). Or providing only a general descriptor, stating participants were from a <medium socioeconomic level.= (Marzouki et al., 2022) No other studies reported SES or parent education in meaningful detail.
Although this review focused on children aged 0 to 6 years, studies were included if the mean participant age fell within this range, even when individual participants were slightly older. Most participants across studies were between four and nine years old.
Of the 32 studies included in this review, 27 provided information about autism diagnosis, severity, or participant presentation, though the specificity and consistency of reporting varied. Several studies used standardized diagnostic tools to confirm autism diagnoses. For example, the Autism Diagnostic Observation Schedule (ADOS) was used in multiple studies (Factor et al., 2019; Williams et al., 2012), and the combination of the Autism Diagnostic Interview-Revised (ADI-R) and the Childhood Autism Spectrum Test (CAST) was used in another (Golan et al., 2010). Some studies described participants using qualitative indicators without formal severity scores. For instance, one study referred to children as higher functioning based on verbal fluency and ability to follow instructions (Swain et al., 2019), while another categorized children as high or low functioning based on IQ and core symptoms (Lyu, Chen et al., 2024). In other cases, diagnoses were confirmed through school or clinical records without specification of the tools used (Ros-Demarize et al., 2021).
Outcome Measures
For studies focused solely on emotional understanding, outcome measures typically included direct assessment of the participants ability to recognize, label, or match emotional content. For instance, several studies used emotion vocabulary tasks, requiring participants to define emotion words and provide examples (Golan et al., 2010; Gev et al., 2017; Yan et al., 2018). Other studies used emotion identification and matching tasks to evaluate comprehension of emotional facial expressions or scenarios (Williams et al., 2012). A different study used DTT task scores to assess participants’ progress in understanding emotional content during intervention sessions (Lyu et al., 2024).
For studies that targeted multiple domains, such as combinations of emotional understanding, expression, and regulation researchers often used caregiver reports. For example, one study used the Emotion Regulation Checklist (ERC) to assess regulatory ability and the Strengths and Difficulties Questionnaire (SDQ) for behavioral symptoms (Factor et al., 2019). Another study targeting all three domains used both the Social Responsiveness Scale (SRS) and the ERC, combining standardized caregiver-report tools to capture a broad picture of social-emotional functioning (Swain et al., 2019).
Discussion
The findings of this systematic literature review highlight several important trends in the current emotional competence intervention landscape for young children with or at risk for ASD. These include which emotional domains are most frequently targeted, the types of interventions used, the demographic and diagnostic characteristics of study samples, and the outcome measures employed to assess emotional competence.
Most studies focused on building emotional understanding, with fewer targeting emotional regulation or expression. This trend aligns with the historical emphasis in ASD research on observable behaviors and emotional recognition rather than the complex processes underlying emotional regulation (Mazefsky et al., 2012). A previous systematic review found that most parent-mediated interventions for young children with ASD targeted challenging behaviors rather than explicitly supporting emotional regulation skills (Hendrix et al., 2022). Although emotional understanding is a foundational skill, the underrepresentation of interventions focused on regulation and expression, targeted in only six studies and one study, respectively, suggests a potential gap in supporting the full spectrum of emotional competence needed for adaptive functioning (Shields et al., 2001; Kwon et al., 2017).
Among the interventions reviewed, The Transporters emerged as the most frequently used approach. The Transporters is a video-based intervention that uses animated vehicles with real human faces to teach emotional understanding skills to children with autism through structured, narrative-driven scenarios. Although effectiveness was not evaluated in the current review, effects reported across the eight studies in this review which utilized The Transporters intervention suggest that this could be a promising program. For example, these studies suggest that The Transporters intervention is effective for improving emotional recognition (which we coded in the emotional understanding domain) in children with ASD who demonstrate higher cognitive functioning. Across five of these studies, participants showed significant gains in identifying basic emotions such as happiness, sadness, and anger, with positive results reported in controlled evaluations (Golan et al., 2009; Golan et al., 2010; Gev et al., 2017; Chan et al., 2023; Wan et al., 2022). Two studies reported that improvements generalized to new contexts or characters, especially when the intervention was delivered through app-based or home-supported formats (Gev et al., 2017; Chan et al., 2023). However, findings on the maintenance of these skills were mixed. Two studies reported retention of gains in recognizing specific emotions like anger, and others noted limited long-term progress, particularly among children with lower verbal or cognitive abilities (Wan et al., 2022; Golan et al., 2010). One randomized controlled trial comparing The Transporters with and without parental support found minimal differences in emotional understanding outcomes, suggesting that while caregiver involvement may support generalization, it may not be essential for initial skill acquisition (Gev et al., 2017). These findings suggest that while The Transporters can be an effective and accessible tool for building skills in the emotional understanding domain, it appears to work best for high-functioning children with autism.
This review suggests that there is a need for more diverse and individualized programs that address the heterogeneity of ASD. Research consistently demonstrates substantial variability in cognitive, language, and behavioral profiles among children with ASD. For example, one study identified three distinct subgroups of preschoolers with ASD based on differences in cognitive abilities, language skills, and autism symptoms (Zheng et al., 2020). Another study observed significant heterogeneity in cognitive and socio-emotional development among children with ASD and intellectual disability, noting consistently lower language and vocal imitation skills (Paulais et al., 2019). Similarly, uneven cognitive-social development and distinct communicative function profiles have been reported in autistic children relative to typically developing peers (Wetherby & Prutting, 1984). These findings emphasize that one-size-fits-all interventions may be insufficient. Future intervention development would benefit from flexible, modular programs that can be adapted to individual profiles while maintaining fidelity to evidence-based practices.
Given the heterogeneity of ASD and the documented variability in how children respond to intervention (Kasari et al., 2018), adaptive interventions (AIs) offer a promising direction for future research and practice. AIs use predefined decision rules to systematically tailor the type, dosage, or delivery of interventions based on a participant9s ongoing response (Nahum-Shani & Almirall, 2019; Murphy, 2005). Rather than applying a one-size-fits-all model, this approach enables timely modifications that optimize outcomes while reducing unnecessary burden. In the context of ASD, where strengths and needs vary widely (Mottron & Bzdok, 2020), AIs offer a replicable yet flexible framework for personalizing intervention. By allowing clinicians and educators to make informed, real-time adjustments, AIs have the potential to improve social-emotional learning outcomes and support more equitable, scalable, and effective programming for young children with autism.
Another important finding was the limited integration across emotional domains. Just one study addressed two domains, and only three studies targeted all three core areas of emotional competence, and, indicating that comprehensive programming remains uncommon. Whether this is problematic depends on the developmental needs of children with ASD. On the one hand, targeted interventions may offer measurable gains and be developmentally appropriate for young children or those with significant language delays. On the other hand, comprehensive models that integrate multiple emotional domains may better reflect the interconnected nature of emotional development and prepare children for the complex social demands of school and community life. Given the interdependence of emotional skills (Denham, 2023), there is a strong rationale for designing interventions that scaffold across understanding, expression, and regulation, particularly for children nearing school entry.
In examining outcome measurement patterns, this review identified meaningful distinctions. Emotional understanding was most often assessed through direct measures, while emotional regulation relied heavily on caregiver reports. This is consistent with prior research; for instance, a systematic review found that 75% of studies on emotional regulation in ASD employed only one method of assessment (Weiss et al., 2014). In contrast, emotional expression was evaluated using a relatively balanced mix of direct and indirect approaches. These patterns suggest a tendency to use observable, structured tasks for isolated skills (e.g., labeling emotions), and caregiver reports for more internalized, context-dependent abilities (e.g., regulating emotional arousal).
The findings of the present study regarding the diversity of assessment strategies support the recommendation that emotional competence research should incorporate multiple methods within each study, rather than relying solely on direct assessments or caregiver reports, to better capture the complexity of the emotional competence domains in young children. Multiple assessment methods, such as standardized instruments, caregiver interviews, and observations, yield complementary insights into child development (Doderer & Miyahara, 2013). Triangulation of data is essential in accurately evaluating emotional competence, particularly in young children with developmental differences. Utilizing direct observation only may be insufficient as research consistently demonstrates atypical behavioral markers in people with ASD can lead to misinterpretations of emotional states (Zwaigenbaum et al., 2005; Brewer et al., 2017; Eack et al., 2015; Samad et al., 2018). Although caregiver reports offer valuable insight into a child’s skills, deficits, or behavior, mothers have been found to often overestimate their children’s developmental abilities (Bagnato, 1984). Therefore, relying on a single source may not capture the full complexity of emotional development. Instead, researchers should integrate multiple assessment methods to strengthen the validity of their findings. For example, Doctoroff & Arnold (2004) found that although each assessment method contributes unique information about child behavior over time, it is the convergence of structured parent interviews, teacher ratings, and classroom observations that provide the most robust picture of preschool children9s behavior over time. This highlights the value of combining data sources to more accurately track growth or identify areas of concern in emotional competence.
Despite growing emphasis on culturally and contextually responsive practices in intervention research, relatively few studies reported participant race, ethnicity, or socioeconomic status (SES). Only 15 studies reported participants9 race, and just five reported SES or parent education, typically using broad indicators such as household income or highest level of education. This lack of demographic reporting limits the field9s ability to evaluate the generalizability of findings or adapt interventions for diverse populations. Emotional competence is socially and culturally mediated, and interventions developed in one context may not generalize effectively without deliberate adaptation (Denham, 2023). The omission of SES data is especially notable, given the documented impact of socioeconomic factors on access to early intervention and educational opportunities. Children from disadvantaged backgrounds remain underrepresented in quality early childhood education and care programs (Archambault et al., 2019). Future research must prioritize demographic reporting and investigate intervention outcomes across racially, ethnically, and socioeconomically diverse populations.
Recommendations for Future Research and Practice
Based on the findings of this review, several recommendations emerge. First, future intervention research should prioritize the development and evaluation of comprehensive programs that integrate emotional understanding, expression, and regulation. Although targeted interventions have value, comprehensive models may more accurately reflect the interconnected nature of emotional development and better prepare children for complex social and academic environments. Second, in response to the substantial heterogeneity observed across autistic children9s cognitive, language, and emotional profiles, as well as the variability in how children respond to existing interventions, future research should invest in the development and application of AIs. These approaches allow for real-time, evidence-based adjustments in intervention type, dosage, or delivery based on individual response, offering a promising framework for tailoring supports to meet diverse needs. Third, researchers must improve demographic reporting practices and systematically examine intervention outcomes across racially, ethnically, and socioeconomically diverse groups to support equitable and generalizable application of findings. Finally, rather than prioritizing one assessment approach over another, future studies should incorporate multiple methods, such as direct observation, standardized tools, and caregiver reports, to more accurately and reliably assess children’s emotional development. Advancing these areas will be essential for supporting the holistic emotional development of young children with ASD in culturally and contextually meaningful ways.
Conclusion
This review highlights both the progress and limitations in current emotion-focused interventions for young children with or at risk for ASD. Although many studies target foundational skills like emotional understanding, far fewer address regulation or expression, or integrate multiple domains in a cohesive framework. By advancing more inclusive, adaptive, and rigorously assessed interventions researchers and practitioners can move toward more effective, equitable approaches to supporting emotional development in early childhood.
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