Neurodevelopment under Threat: the Role of Care Dynamics and Food Insecurity in Early Cognitive Risk

Objective This study examined how caregiving dynamics and household food insecurity predict neurodevelopmental risk in children under six in Córdoba, Colombia. The objective was to identify environmental threats to early cognitive development, focusing on prevention in low-resource settings. Method We analyzed cross-sectional data from 1200 children aged 0–6 and their families across 20 municipalities. Key variables included food security status, caregiver responsivity, frequency of cognitive stimulation, maternal education, income, and rural/urban setting. Variables were selected based on relevance to neurodevelopment and early adversity, with guidance from the Nurturing Care Framework. Informal consultation with regional experts supported contextual validity. Results Logistic regression and random forest models were used to predict neurodevelopmental risk based on language, executive function, and socioemotional screening outcomes. Food insecurity and low caregiver responsivity were the strongest predictors, followed by low maternal education and absence of stimulation. The random forest model achieved high accuracy (AUC = 0.86). Spatial mapping revealed clustering of high-risk profiles in rural and low-income zones. Conclusion Food insecurity and poor caregiving practices significantly increase neurodevelopmental vulnerability in early childhood. Findings highlight the need for integrated interventions targeting both nutritional and relational care factors. This evidence supports early identification strategies and neuropsychological prevention efforts in socioeconomically disadvantaged areas.