Early childhood education provisions, interventions, and child outcomes in Malaysia: A 25-year review

Early childhood education provisions, interventions, and child outcomes in Malaysia: A 25-year review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Early childhood education provisions, interventions, and child outcomes in Malaysia: A 25-year review Jean Anne Heng, Alexandra Cheah, Kimberley Kong This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8789362/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Early childhood education (ECE) is widely recognized as foundational to child development, yet evidence from low- and middle-income countries remains limited. This systematic review synthesizes research on ECE provisions, interventions and child developmental outcomes in Malaysia over the past 25 years. Following PRISMA guidelines, we searched multiple databases and identified 28 studies meeting inclusion criteria. Three research questions guided the review: (1) What are the associations between aspects of ECE provision and child developmental outcomes? (2) What types of instructional interventions have been implemented, and what evidence exists for their effectiveness? (3) What methodological gaps exist in the current literature? Findings indicate consistent positive associations between ECE provision and child outcomes across literacy, numeracy, and socioemotional domains. Structural features such as preschool type, enrolment duration, and classroom environment showed meaningful but under-examined associations with developmental outcomes. Instructional interventions, particularly in literacy and mathematics, demonstrated promising effects. However, the evidence base is constrained by significant methodological limitations, including predominance of quasi-experimental designs, short intervention durations, lack of longitudinal follow-up, and limited control for confounding variables. Notably, no studies examined process quality, and few employed integrated assessments across multiple developmental domains. The review identifies critical directions for future research, including the need for rigorous longitudinal designs, measurement of process quality, holistic evaluation frameworks, and attention to ethnic and socioeconomic diversity. Implications for system-level policy and programme-level practice are discussed. These findings have the potential to inform evidence-based decision-making to enhance both ECE access and quality in Malaysia. early childhood provisions intervention Malaysia preschool Figures Figure 1 Figure 2 Figure 3 Introduction Early childhood education (ECE) is widely recognised as a cornerstone for fostering development across cognitive, linguistic, and socio-emotional domains. While increasing access to ECE remains a national and global priority, evidence suggests that access alone does not guarantee positive developmental outcomes. Recent work indicates that factors such as programme quality, classroom experiences, and the implementation of targeted interventions all play critical roles in shaping children’s learning and wellbeing (Egert et al., 2018 ; Perlman et al., 2016 ; Melhuish et al., 2015 ). Concurrently, a broader push for a more globally representative developmental science has motivated greater inclusion of work from diverse contexts (Draper et al., 2022 ). In line with these developments, this review aims to synthesise peer-reviewed evidence on ECE experiences as associated with child outcomes in Malaysia across two key strands: (i) general ECE provisions, including structural and contextual aspects such as preschool type, enrolment duration, and mode of delivery; and (ii) targeted interventions implemented within ECE settings to enhance specific developmental outcomes. By examining both strands, we aim to provide an evidence-informed foundation for further discussion on how Malaysian ECE environments may continue to support children’s development. Early childhood education experiences: A multi-componential, global perspective A robust body of evidence demonstrates that high-quality ECE programs support not only short-term gains in academic performance and social-emotional skills, but also long-term outcomes extending into adulthood (Phillips et al., 2017 ). Multiple mechanisms underlie these relations, for instance, through participation in structured, stimulating, and nurturing environments that promote early learning and emotional regulation. Importantly, the developmental benefits of ECE are not conferred by access alone. In particular, researchers in this area have highlighted the distinct but often interrelated roles of both structural and process quality in shaping ECE outcomes. Structural dimensions such as environmental factors, teacher–child ratios and group sizes, have been linked to more favourable developmental trajectories (Egert et al., 2018 ; Perlman et al., 2016 ), while process quality, characterised by emotionally responsive, reciprocal, and cognitively rich interactions between teachers and children, has emerged as a critical predictor of learning and wellbeing (Melhuish et al., 2015 ). Further to this, type of setting, such as public versus private provision, may also serve as a proxy for quality, with some evidence suggesting variation in developmental outcomes based on institutional characteristics (Blanden et al., 2022 ). Against this backdrop, it is worth examining how multi-dimensional features of ECE provision operate across diverse global contexts. In low- and middle-income countries (LMICs), ECE has been shown to play a vital role in addressing early developmental delays and mitigating educational inequities, particularly for children from underserved communities (Currie, 2001 ; Elango et al., 2016 ; Melhuish et al., 2015 ). Targeted interventions in early childhood have consistently demonstrated greater long-term impact among children from lower socioeconomic backgrounds, suggesting that ECE may function as a levelling force in contexts of structural disadvantage (Barnett, 2011 ). Enriched and predictable learning environments, often more cognitively stimulating than home settings, offer both protective and promotive effects on child development (Conger & Donnellan, 2007 ). Recent meta-analytic evidence points to the value of ECE across global contexts. For example, Schmutz ( 2024 ) synthesised outcomes from high- and low-income countries, concluding that ECE policies generally yield positive impacts on developmental trajectories. Similarly, in a meta-analysis of 250 estimates across 30 studies, Huizen and Plantenga ( 2018 ) found that while effect sizes vary, high-quality, intensive, and publicly provided programs consistently produced more favourable outcomes, particularly for children from disadvantaged backgrounds. Notably, these benefits were not subject to fade-out effects, and age of enrolment appeared to have limited influence on outcomes. Taken together, these findings highlight the importance of evaluating both access and quality in relation to context-specific developmental goals. The present review contributes to this evidence base by focusing on Malaysia - an Official Development Assistance (ODA) country undergoing rapid expansion of its early childhood education sector. Early childhood education systems within the Malaysian landscape In Malaysia, ECE provision is characterized by a mix of public, private, and community-based programs. Children under the age of 4 may be enrolled into nurseries known as TASKA ( Taman Asuhan Kanak-Kanak ), while children between the ages of 4 to 6 will attend preschool (known as tadika in Malay) (Kong, 2023 ; Samuel et al., 2017 ). Preschools consist of two main types: privately-owned and government funded. Government funded preschools can be further divided into a few categories, namely KEMAS (located in rural and semi-rural areas), PERMATA, Tabika Perpaduan (located in urban areas), Islamic preschools, and preschools annexed to national schools (Mohd Nor & Symaco, 2017; Samuel et al., 2017 ; The Malaysian Administrative Modernisation and Management Planning Unit, 2021 ). All preschools in Malaysia are registered with the Ministry of Education (MOE) and subscribe to the National Standard-Based Preschool Curriculum (Kurikulum Standard Prasekolah Kebangsaan; KSPK) (MOE, 2017). This curriculum, developed by Malaysia’s Ministry of Education and most recently revised in 2017, outlines the integration of higher-order thinking skills as a core component of early education. This is in alignment with the Malaysia Education Blueprint (2013–2025), which serves as a national transformation agenda to elevate public education standards in Malaysia by 2025. A key government initiative of the blueprint was to improve Malaysia’s performance in international assessments (i.e., Program for International Student Assessment (PISA) benchmarks). To achieve this, the blueprint outlined a detailed roadmap prioritizing improving educational facilities, enhancing quality, and increasing enrolment rates across all levels of education, including preschools. Together, the overarching aim of the standardised curriculum was to support children’s readiness for primary school by fostering foundational skills, self-confidence, and positive self-concepts within a safe and engaging learning environment (MOE, 2017). The curriculum adopts a child-centred approach, promoting learning through creative and meaningful activities for children in preschool. It is organised into six interrelated learning strands: communication, spirituality and values, social understanding, physical development and aesthetics, science and technology, and personal competence. These strands are designed to support holistic development and are underpinned by an emphasis on critical, creative, and innovative thinking. Also significant in the early childhood education landscape in Malaysia is the National Key Result Area (NKRA) for Education, introduced by the Malaysian government in 2009 (Jabatan Perdana Menteri, 2010 ). This effort focuses on four sub-NKRAs to expand access to quality and affordable education, with preschool education being one of the sub-NKRAs. The Key Performance Indicator (KPI) set for this sub-NKRA is to increase the enrolment rate of children aged four and five, and to enhance the quality of preschool education by incorporating private preschools and other agencies as part of the national education system. The Malaysia Education Blueprint (MEB) 2013–2025 also takes into account the importance of preschool education. Phase 1 of the MEB 2013–2025 outlines the provision of equal access to quality education of an international standard. The target under this shift is to improve the quality of preschools and promote universal enrolment. Despite growing policy attention as described above, persistent structural and contextual challenges continue to affect the effectiveness of early childhood education (ECE) provision in Malaysia. As highlighted in a recent review by Kong et al. ( 2024a ), two key concerns remain central: accessibility and quality. In terms of accessibility, the national gross enrolment rate for preschool children stands at approximately 86%, leaving a significant proportion of children – particularly those in rural and socioeconomically disadvantaged communities, without access to formal early education. This lack of access can place children at a disadvantage upon entry into primary school, as they may lack foundational cognitive and socio-emotional skills. Such early disparities in school readiness are linked to difficulties in adapting to formal learning environments and may compound over time, contributing to wider educational inequalities (Linberg et al., 2020 ). With regard to quality, teacher qualifications in particular represent a persistent issue. A report from the Ministry of Education indicated that only 54% of the ECE workforce hold the minimum required qualification of a diploma in early childhood education, with the number being as low as 18% in private preschools (MOE, 2023). From the perspective of parents, interview-based studies have highlighted concerns around educator quality, including issues such as inadequate teacher training, poor English language proficiency, and limited use of developmentally appropriate play-based practices (Aquino et al., 2017 ). Addressing these disparities is critical to ensuring equitable developmental opportunities for all Malaysian children. However, to do so, a clear outline of the current state of early childhood education provisions and interventions from empirical studies in Malaysia is necessary. Present Review This review synthesises the evidence on early childhood education (ECE) provision and interventions in Malaysia, focusing on how these factors relate to domains of children’s developmental outcomes – including social, emotional and cognitive skills. We examine studies addressing structural aspects of provision (e.g., enrolment duration, preschool type, and mode of delivery) as well as targeted instructional interventions implemented within ECE settings. Together, these strands offer insights into how the Malaysian ECE landscape supports children’s learning, wellbeing, and holistic development across social, emotional, cognitive, and physical domains. Despite growing attention to early education as a national priority, there remains no systematic synthesis of peer-reviewed evidence linking ECE experiences to child developmental outcomes in Malaysia. This review therefore collates and evaluates available studies to identify robust findings, methodological limitations, and directions for future research and policy action. The review is guided by three research questions: RQ1. What are the associations between structural aspects of ECE provision and child developmental outcomes in Malaysia? RQ2. What types of targeted instructional interventions have been implemented, and what evidence exists for their effectiveness in improving child developmental outcomes? RQ3. What methodological gaps and limitations exist in the current literature, and what implications do these have for future research? Methods Search Strategy A comprehensive search was conducted across multiple databases, including PubMed, Scopus, Web of Science, and MyCITE (Malaysian Citation Index). The MyCITE portal is a website providing access to bibliographic as well full-text contents of scholarly journals published in Malaysia in the fields of science, technology, medicine, social sciences and the humanities. Across all databases, keywords were combined using Boolean operators to develop comprehensive search strings, including terms such as “early childhood education,” “preschool,” “child development,” “Malaysia,”, “ECE”, “ taska ”, “ tadika ”. The study was pre-registered on the Open Science Framework. Inclusion of papers published in Bahasa Malaysia To date, an overwhelming number of reviews have cited the exclusion of non-English papers as a main limitation of their findings (e.g., Schmutz, 2024 ; Brunsek et al., 2020 ; Egert et al., 2018 ; van Huizen & Plantenga, 2018 ; Burger, 2010 ; D’Onise et al., 2010 ; Anderson et al., 2003 ). This both reflects and perpetuates an overarching, prevalent issue within global child development research. According to a commentary by Draper et al. ( 2022 ), researchers have found it particularly challenging to publish research from non-Western, Educated, Industrialized, Rich, and Democratic (WEIRD) settings, despite the fact that it represents 90% of the global child population. This is due to several reasons including publication bias, which often favours certain contexts over others regardless of study quality. An exclusive reliance on English-language articles for review and replication further exacerbates this disparity in research representation. In direct response to this, our review includes papers published in Bahasa Malaysia, the national language of Malaysia. Inclusion criteria for papers are thus as follows: (1) Published between 2000–2024, (2) Includes a sample population of Malaysian children between the ages of 0–8, (3) Includes at least one aspect of ECE provision or intervention, (4) Includes at least one aspect of child developmental outcomes. Procedure The screening process was carried out in two stages, in accordance with the PRISMA guidelines. We utilized the Covidence software for both stages. Covidence is a web-based software platform designed to streamline and facilitate the process of conducting systematic reviews and other comprehensive literature reviews ( https://www.covidence.org/ ). In the first stage, reviewers independently assessed the title and abstract of each study for relevance based on the predefined inclusion and exclusion criteria. Studies were included if they met all inclusion criteria, even if certain details (e.g., population characteristics or intervention specifics) were unclear. Studies that clearly failed to meet any one of the criteria were excluded. If uncertainty remained, studies were marked as “Uncertain” in Covidence and flagged for review by the senior author. In the second stage, two reviewers independently assessed the full-text articles of studies that passed the initial screening. Studies were included if they fulfilled all inclusion criteria. Articles were excluded if full texts were unavailable despite efforts to contact the authors or if the criteria were not met. Authors were given a one-month window to respond. Any disagreements were resolved through discussion with the senior author. A PRISMA flow diagram illustrating the screening process is provided in Fig. 1. A total of 28 studies were included in the final review (see Table 1 ). For a more comprehensive table including all study characteristics, see Appendix 1. Each included study underwent a risk of bias assessment using the Mixed Methods Appraisal Tool (MMAT). This tool was selected due to the mixed-methods nature of the current review, which included qualitative, quantitative, and mixed-method studies. Table 1 Study Characteristics Study ID Study design Year Age Sex Ethnicity N Provision/Intervention Duration Outcomes 1 Quasi-experimental, pre-post test 2010 Not specified Not specified Not specified 100 - Experimental group received instruction using the Reading Intervention Module (MIM); control group followed traditional teacher-selected methods without MIM - MIM designed to improve reading achievement through structured, targeted literacy activities - Effectiveness assessed via pre- and post-test comparison using t-test analysis 3 months Reading achievement in Bahasa Malaysia 2 Cross-sectional 2010 Primary 2 465 boys (50.6%) Malay; Chinese; Indian; Others; Migrant 919 Preschool attendance Not applicable Cognitive ability; Raven’s Standard Progressive Matrices 3 Quasi-experimental, pre-post test 2013 5 years 25 girls (62.5%); 15 boys (37.5%) Not specified 40 Animated pedagogical agent 2 days Reading ability for English words and sentences 4 Quasi-experimental, pre-post test 2013 4 years 10 girls (50%); 10 boys (50%) Not specified 20 - Modul Literasi Awal (MULA) - adapted from Get Ready to Read (GRTR) program 5 weeks Early literacy; Ujian Pengesanan Kemahiran Literasi Awal 5 Quasi-experimental, pre-post test 2013 5 to 6 years Not specified in final sample Not specified 50 Reader’s Theater (reading aloud, choral reading, reading robin, paired reading) 5 weeks Translated fluency checklist from the National Assessment of Educational Progress 6 Cross-sectional - direct assessment 2014 5 to 6 years 49 girls (40.5%); 72 boys (59.5%) Not specified 121 Type of preschool (Public vs. private) Not applicable Cognitive ability (McCarthy Scales of Children’s Abilities - MSCA) 7 Quasi-experimental with non-equivalent control group pre test/post-test research design. 2015 5 to 6 years Not specified Not specified 47 Games-based learning (GBL) Not specified Learning behaviour - Learning Behavior Scale (LBS); Prosocial behavior (video recordings and observations using observation table adapted from Weir & Duveen (1981) 8 Quasi-experimental, pre-post test 2016 Not specified Not specified Not specified 6 - Children with learning difficulties (n = 6) were divided into control and experimental groups - Experimental group received syllable instruction via a tablet-based, persuasive-designed multimedia courseware; control group received traditional instruction from a special education teacher - Courseware (newly developed for the study) featured interactive syllable modules with visual and pronunciation discrimination exercises, delivered via mobile tablets 20 minutes Syllable recognition - paper-based pre- and post-test questionnaires (10 Malay syllable items with image-matching tasks) 9 Multi-site, quasi-experimental 2016 4 to 5 years Not specified Not specified 1108 Type of preschool Not applicable Early mathematic achievement 10 Randomized controlled trial (RCT) 2017 3 to 6 years Not specified Not specified 100 - Preschool-based emotional intelligence (EI) module targeting four EI components: identifying, understanding, controlling, and using emotions - Each component addressed through structured activities facilitated by teachers to enhance specific EI skills in children - Intervention implemented by preschool teachers as part of regular teaching activities Six weeks Emotional intelligence: identifying, understanding, controlling, and using emotions (Sullivan Emotional Intelligence Scale for Children [EISC]) 11 Quasi-experimental, pre-post test 2017 4 to 5 years 24 girls (57.1%); 18 boys (42.9%) Chinese; Malay 42 Literature-based intervention using Wallas’ Stage Model to teach creative thinking through ten structured lesson plans Focused on four aspects of creative teaching: person (teacher and child), press (supportive environment), product (creative outputs), and process (children’s creative thinking) Lessons incorporated picture e-books selected or designed to enhance creativity during storytelling sessions 4 weeks Creative thinking abilities Divergent thinking and idea generation (Torrance Test of Creative Thinking) 12 Quasi-experimental, pre-post test 2018 7 years 12 girls (44.4%); 15 boys (55.6%) Not specified 27 - PIL-based science intervention on magnets, structured around four instructional phases - Included multimedia stimuli (images, video) to prompt inquiry and activate prior knowledge about trains and magnetism - Students explored magnetic connectivity in trains, then sketched and constructed model train carriages (engineering in action) - Emphasized hands-on design and iterative thinking through guided exploration and construction tasks Three weeks Students’ interest in learning Science 13 Quasi-experimental, pre-post test, mixed methods 2019 5 years; 6 years 9 girls (60%); 6 boys (40%) Not specified 15 AR mobile-based application with no further specifications Not specified Early literacy skills: reading and writing of basic words and alphabets (custom pre- and post-test) Learning engagement and satisfaction (learning satisfaction questionnaire) 14 Quasi-experimental, mixed-method 2019 6 years Not specified Not specified 37 Self-regulated learning (SRL) intervention 4 months Early writing performance; Self-regulated Strategies for Ealy Writing-Observation Form (SRSEWOF), Early Writing Performance Scale (EWPS) 15 Quasi-experimental, pre-post test 2019 Not specified Not specified Not specified 64 Early literacy intervention (ELI) on Malay language 14 weeks Phonological awareness; Malay Early Literacy Skills Test Battery (MELSTB) − 4 literacy skills test: Malay Early Literacy Phonological Awareness Test (MELPAT); Malay Early Literacy Decoding Test (MELDT); Malay Early Literacy Spelling Test (MELST); Malay Early Literacy Reading Comprehension Test (MELRCT) 16 Quasi experimental method 2019 Not specified Not specified Not specified 1107 Teaching methods: games, number books, worksheet Not specified Early mathematical comprehension and analysis; Test of Mathematics Ability (Ginsburg & Baroody, 2003) 17 Quasi-experimental, random group assignment 2019 5 to 6 years Not specified Not specified 75 Self-regulated learning (SRL) - 10 units tied to early writing process 4 months Self-Regulation Strategies for Early Writing-Observation Form (SRSEWOF) and Self-Efficacy Scale of Early Writing (SESEW); Early Writing Performance Scale (EWPS) - developed based on 3 aspects: content, mechanical writing skills, overall writing quality 18 Survey/Cross-sectional 2020 Not specified (only preschools with 6 years were selected) Not specified Not specified 336 Classroom environment and spatial design Not specified Cognitive school readiness skills; self-regulation 19 Survey/Cross-sectional 2020 6 years Not specified Not specified 378 Classroom environment and spatial design Not specified, monthly follow-ups Cognitive school readiness skills 20 Cross-sectional 2021 Mean: 5.95 ± 0.47 years; Range: 5.08–6.83 years 204 girls (47.0%); 226 boys (52.0%) Gender not reported for 5 children (1.1%) Malay 85.1%; Chinese 6.0%; Indian 2.1%; Orang Asli (indigenous people) 4.0%; Others 2.8% 435 Preschool type (KEMAS vs private) Not applicable Visual-motor integration performance (Beery-Bucktenicka Developmental Test of Visual-Motor Integration) 21 Quasi-experimental, pre-post test 2021 6 years 20 girls (69.0%); 9 boys (31.0%) Not specified 29 - MyNEPs (Malaysian Nature Education in Preschool Program) focused on five nature domains: climate, flora, fauna, insects, and microbes - Delivered through outdoor, hands-on activities designed to engage children with the natural environment - Activities supported by structured worksheets to reinforce learning and observation Not specified (post-test was collected within a month post intervention) Nature-related knowledge 22 Quasi-experimental, pre-post test 2021 5 to 6 years Not specified Not specified 100 Early Mathematics learning module - administered in 65 separate activities in 3 months (5–10 minutes per activity) - one mentor/facilitator per group of 5 preschoolers - 55 teacher trainees as mentors and observers - module not specified 3 months Mathematic performance; Measurement tool: Test of Mathematics Ability (Ginsburd & Barrody, 2003) 23 Non-equivalent two-group pretest-posttest quasi-experimental design 2022 6 years Not specified Not specified 56 Creative play (30–45 mins per activity) 3 weeks Creativity (Fluency, originality, imagination); Torrance’s Thinking Creatively in Action and Movement (TCAM) 24 Teacher-reported survey - Cross-sectional 2023 M = 70.19 (months); SD = 7.94 267 girls (47.9%); 290 boys (52.1%) Primarily Malay/Malay/Chinese/Indian, some Indigenous 557 Locality of preschool (urban vs. rural) Not applicable Behavioural and emotional problems (SDQ) 25 Quasi-experimental, pre-post test 2023 6 years Control group: 16 girls (53.3%); 14 boys (46.7%) Experimental group: 14 girls (46.7%); 16 boys (53.3%) Not specified 60 - Intervention group received English instruction via Integrated Sound Word Method, incorporating early reading games - Control group received early reading instruction without game-based components Delivered 30 minutes/day, 3 times/week, over 4 weeks (total: 6 hours) Early reading proficiency in English 26 Survey/Cross-sectional 2023 21 to > 30 years 74 female teachers (88.1%); 10 male teachers (11.9%) 71 - Chinese 7 - Indian 6 - Malay 84 Outdoor play structural factors 3 months Socio-emotional; health and physical development; academic learning 27 Cross-sectional - direct assessment 2024 4 to 5 years (M = 5.90, SD = 0.58) 80 girls (47.1%); 90 boys (52.9%) Not specified 170 Nature and duration of ECE participation Not applicable Cognitive development Language and literacy skills Socio-emotional development Motor development Health and hygiene knowledge Cultural understanding and learning approaches; East Asia-Pacific Early Childhood Development Scales (Short Form) (Rao et al., 2019) 28 Cross-sectional - direct assessment 2024 4–6 years 398 girls (37.9%); 412 boys (39.2%) Gender not reported for 241 children (22.9%) Not specified 1051 Synchronous or hybrid learning Enrollment or non-enrollment Not applicable Emergent numeracy Emergent literacy Socio-emotional skills Motor skills; International Development and Early Learning Assessment battery (Pisani et al., 2018) Results The majority of included studies reported positive and statistically significant associations (p < .05) between various aspects of ECE provision and child developmental outcomes in Malaysia. Only three studies reported null findings for the variables of interest, suggesting that most research to date points toward meaningful links between ECE provision and developmental outcomes. The findings are organized below according to the three research questions guiding this review. RQ1: What are the associations between structural aspects of ECE provision and child developmental outcomes in Malaysia? A small number of studies examined structural quality in ECE settings, typically defined by features such as preschool type, duration of enrollment, classroom environment, teacher qualifications, and teacher-child ratios. One comparative study (Ompok, 2016 ) found significant differences in mathematics outcomes based on preschool type (KPM vs. KEMAS), though further research is needed to clarify the direction and implications of these differences. Kong et al. ( 2024a ), using the East Asia-Pacific Early Childhood Development Scales (EAP-ECDS) instrument, found that the duration of ECE enrollment among children from low-income families attending KPM preschools was positively associated with language and literacy outcomes. Two studies explored the role of classroom environment and spatial design. Shaari et al. (2020) reported mixed design quality in public preschools: while classrooms showed good circulation and indoor conditions, they scored poorly on spatial layout, which was linked to lower cognitive self-regulation in children. Another study (Shaari et al., 2020b ) found that fair spatial planning, along with strong ratings in safety, site location, and environmental quality, were positively associated with children’s cognitive school readiness. While these findings are promising, they are constrained by notable methodological and conceptual limitations, which are addressed in detail under RQ3 and in the Discussion section. RQ2: What types of targeted instructional interventions have been implemented, and what evidence exists for their effectiveness in improving child developmental outcomes? Most studies with significant findings focused on instructional interventions and their effects on children’s emerging academic skills. These interventions span literacy, numeracy, and socioemotional and creative development. Literacy interventions Ten studies focused on literacy-related outcomes, reporting improvements across multiple skill domains. Several studies reported gains in reading achievement in Bahasa Malaysia (Majzub & Buang., 2010) and English (Abdul Rahman et al., 2023 ; Omar & Mohd Rias, 2013 ), as well as basic reading and writing skills (Mahmud et al., 2019 ). Siew and Md Nor ( 2019a ) and (2019b) found improvements in overall writing performance and self-efficacy, while Mohamed Isa et al. ( 2013 ) reported gains in reading fluency and comprehension. More specialized interventions addressed syllable recognition and phonological awareness in Bahasa Malaysia (Ng et al., 2016 ; Yeo & Ng, 2019 ). All studies reported significant positive effects of interventions on the targeted literacy outcomes. Some studies utilized existing intervention modules or programs, including the Reading Intervention Module (MIM; Majzub & Buang, 2010 ), Modul Literasi Awal (MULA) adapted from the Get Ready to Read (GRTR) program (Bacotang, 2013 ), and Reader’s Theater (Mohamed Isa et al., 2013 ). Others developed ad-hoc intervention strategies grounded in established theoretical frameworks, such as persuasive learning (Ng et al., 2016 ). Mathematics interventions Early mathematical development was examined in three studies. Two intervention studies by Ompok and colleagues (2019; 2021 ) found improvements in early mathematical skills, highlighting the effectiveness of game-based approaches compared to worksheets and number books, though intervention details were limited Socioemotional and creative development A small subset of studies targeted non-academic developmental outcomes. Akmal Rohaizad et al. ( 2017 ) implemented a preschool-based emotional intelligence (EI) module designed to enhance four core components: identifying, understanding, controlling, and using emotions. Each component was addressed through structured teacher-facilitated activities integrated into the regular preschool curriculum. Two studies focused on fostering creativity. Chew and Eau ( 2017 ) developed a literature-based intervention grounded in Wallas’ Stage Model of creativity, delivered through ten structured lesson plans. The program targeted four dimensions of creative teaching: person (teacher and child), press (supportive environment), product (creative outputs), and process (children’s creative thinking), with storytelling sessions built around selected or designed picture books. A more recent study by Tee ( 2022 ) focused on enhancing children’s fluency, originality, and imagination through creative play activities. Instructional delivery methods Kong et al. ( 2024b ) examined different modes of instructional delivery during the COVID-19 pandemic. The study reported that asynchronous instruction, which combined real-time online and offline learning activities, was significantly predictive of refugee children’s academic readiness compared to synchronous instruction delivered purely through live video conferencing. This was assessed using the International Development and Early Learning Assessment (IDELA) tool. Notably, this is the only study that involved refugee children undertaking early childhood education in Malaysia. Intervention characteristics The interventions varied considerably in scope and design. Several studies implemented ad-hoc intervention strategies developed with reference to established theoretical frameworks, including Wallas’ Stage Model (Chew & Eau, 2017 ), Project-Based Inquiry Learning (Safiee et al., 2018 ), and persuasive learning (Ng et al., 2016 ). Child outcomes were assessed primarily through direct measures, with some studies designing their own instruments to capture target skills. Most intervention effects were analyzed using t-tests to compare pretest and posttest scores, except for Abdul Rahman et al. ( 2023 ), Hutagalung et al. ( 2022 ), Ompok and Bacotang ( 2019 ), and Rohaizad et al. ( 2017 ) who employed ANOVAs. The duration of interventions varied widely, ranging from 20 minutes to 6 months. RQ3: What methodological gaps and limitations exist in the current literature, and what implications do these have for future research? Publication trends and study designs Based on Fig. 2, there is an overall upward trend in the number of publications, with fewer publications in Bahasa Malaysia (BM) compared with English-language publications. Studies that met the inclusion criteria were largely published after 2009. Figure 3 indicates the composition of study designs included in the review. The most common study design was quasi-experimental with pre-test post-test designs, followed by cross-sectional studies relying on surveys for child outcomes, and then direct assessments. Just one study utilized a full randomized controlled trial design. Assessment and measurement approaches Child outcomes were assessed primarily through direct measures, with some studies designing ad-hoc instruments to capture target skills. A minority of studies employed standardized tools, such as the EAP-ECDS instrument (Kong et al., 2024a ) and the IDELA tool (Kong et al., 2024b ). The reliance on researcher-designed instruments raises questions about measurement validity and comparability across studies. Analytical approaches Most intervention effects were analysed using t-tests to compare pretest and posttest scores, with limited use of more sophisticated statistical techniques. The predominance of quasi-experimental designs without randomization and the lack of control for confounding variables in many studies limit the ability to make causal inferences. Limited reporting of intervention details A majority of intervention studies provided insufficient detail about implementation procedures, fidelity monitoring, and dosage. For example, Ompok and colleagues’ studies (2019; 2021) on game-based mathematics interventions showed promising results but lacked comprehensive descriptions of the intervention components and implementation processes. Gaps in structural quality research While the studies on classroom environment and spatial design (Shaari et al., 2020a and b ) reported associations with child outcomes, they are constrained by notable methodological and conceptual limitations. These include cross-sectional designs that prevent causal inference, limited control for confounding variables, and inconsistent measurement of structural quality indicators. Discussion The present review included 28 studies that met the inclusion criteria. In what follows, we discuss the findings in response to the three research questions. Finally, we offer suggestions related to future research directions, policy, and practice. Study method and design limit interpretation of positive findings In response to RQ1 and RQ2, our review identified consistent positive associations between aspects of ECE provision and child outcomes in Malaysia. However, the robustness of these findings is challenged by significant methodological concerns (RQ3). The majority of studies employed simple pre-test–post-test designs and relied on p-value testing to infer intervention effectiveness, often without appropriate control groups, adjustment for confounding variables, or adequate follow-up. These approaches limit confidence in the internal validity and sustainability of reported effects. More rigorous methodologies have the potential to provide a more robust foundation for evaluating programme impact and should be considered by Malaysian researchers in future studies. One such example is the Response to Intervention (RTI) framework, which is a multi-tiered approach that begins with universal screening to identify children at risk of poor outcomes, followed by increasingly targeted and intensive interventions (Shapiro & Clemens, 2009 ). Importantly, the effectiveness of these interventions is continuously monitored through data-driven assessments, allowing educators and researchers to make informed decisions about which children need additional support and when. In LMIC settings such as Malaysia, where resources can often be limited and educational disparities more pronounced, RTI thus offers a cost-effective and scalable strategy to strengthen early identification and support systems. Rather than relying on brief, one-off interventions with limited follow-up, as was common in many of the studies reviewed, an RTI approach embeds assessment into the learning process and supports ongoing adaptation of instructional strategies based on children’s progress. This not only increases the precision of educational responses but also helps to differentiate between learning difficulties that arise from inadequate instruction versus those that reflect deeper developmental needs. Further to this, intervention durations varied substantially across studies, ranging from a single 20-minute session to multi-month programmes. This wide variation, along with inconsistency in implementation fidelity and outcome measures across studies, precluded meta-analytic synthesis and complicates our current interpretation of outcomes. These limitations are especially salient for domains such as socio-emotional functioning, where developmental changes may not be immediately observable. For instance, evidence from global early stimulation programmes (e.g., Jamaica, Mauritius) suggests that benefits to externalising behaviours often manifest later in childhood or adolescence, highlighting the need for longer-term evaluation (Tanner et al., 2015 ). The lack of such studies in the Malaysian context represents a critical gap, especially in light of research that has shown potential buffering effects of ECE provision on later social and behavioural issues (McLeod et al., 2017 ). Future research should prioritise longitudinal, theory-driven designs that take into consideration developmental timing and contextually relevant indicators of child outcomes. Structural and process quality remain underexplored Regarding structural aspects of ECE provision (RQ1), our findings suggest meaningful but under-examined associations. The limited number of studies exploring preschool type, enrollment duration, and physical environment indicates this remains a nascent area of inquiry in Malaysia. The mixed findings on classroom spatial design (Shaari et al., 2020b ) and the contrasting effects of enrollment duration on different outcome domains (Kong et al., 2024a ) highlight the complexity of structural influences. While Ompok ( 2016 ) found significant differences between types of preschools (KEMAS versus KPM), the author’s suggestion that differences may be attributed to attention teachers provided to students is merely speculative. Future research should more systematically examine how structural features- including teacher qualifications, class size, and physical resources - interact with instructional quality to shape developmental outcomes. Notably absent from the literature on structural aspects (RQ1) was also examination of process quality in ECEC, defined as children’s actual experience within a preschool setting including, but not limited to, interactions between educators and children. This is important for several reasons. First, it has been reported that children from underserved communities may not benefit equally from ECEC unless educator–child interactions are warm, responsive, and developmentally appropriate (Hall et al., 2013 ). As such, measuring process quality helps assess how fairly quality is distributed, particularly in socioeconomically diverse populations. Second, previous studies with Malaysian parents have highlighted concerns surrounding educators’ skills, which suggest a potential disconnect between structural required credentials (e.g., the requirement of a basic degree) and actual practice. A study by Sharifah and Aliza ( 2016 ) reported that even qualified teachers in Malaysia did not have a full grasp on the conceptual and operational frameworks of child-centred pedagogy (e.g., play-based learning). This lack of understanding has also been demonstrated at scale: a survey study involving more than 1000 TASKA educators in Malaysia showed that some educators were not aware about the national Malaysian preschool curriculum (Mustafa, 2016 ). These studies underscore the urgency of focusing on process quality within ECE research in Malaysia. Such data will allow for a better understanding of whether and how those skills are enacted in the classroom and inform policy and training. Without robust data on process quality, little is known about where and when to target professional development, how to improve practice, or how to ensure that ECEC investments are meaningful beyond just infrastructure on a national scale. Indeed, existing work has suggested that a lack of time as well as limited training pose challenges to teachers’ performances in preschool classrooms (Ann, 2019; Kasdiah et al., 2024 ). As noted in our current review, the studies on structural quality have indicated that existing classroom environments may be conducive, but differing levels of educators’ skills and approaches across preschool systems may lead to disparities in children’s performance (Ompok et al., 2016). Future studies seeking to address this gap may refer to a previously published paper by Ha and colleagues (2024) on assessing process quality, which included a table of existing frameworks within which to further this inquiry. Lack of integrated assessment of child outcomes Addressing RQ1 and RQ2, a key finding of our review is that though papers included cover a wide range of child outcomes and aspects of ECE provision in Malaysia, these domains were largely examined in isolation. The focus of each study broadly aligns with the six interrelated learning strands outlined in Malaysia’s national preschool curriculum: communication, spirituality and values, social understanding, physical development and aesthetics, science and technology, and personal competence. However, few studies considered how these domains may intersect in theory and practice. Integrated assessments of developmental outcomes remain rare, with only two studies in the review examining multiple skill domains concurrently (Kong et al., 2024a ; Kong et al., 2024b ). Notably, one of the studies illustrates the importance of such an approach: the same predictor variable - duration of ECE participation, was associated with contrasting outcomes. While longer ECE attendance was linked to improved language and literacy skills (p = .016), it was also associated with poorer socio-emotional outcomes (p = .004). These findings underscore the need for more holistic evaluation frameworks that reflect the multifaceted aims of early education and avoid over-reliance on narrow indicators of success. Future directions in system-level and programme-level policies The findings on ECE provision (RQ1) have important implications for system-level policy decisions related to access, enrollment, and resource allocation. Currently, approximately 16–18% of children in Malaysia remain unenrolled in any form of early childhood education. We propose that the evidence reviewed here raises several policy-relevant questions, including but not limited to the following considerations: Should enrollment in ECE be made mandatory? Should the duration of preschool participation be extended? While the studies reviewed demonstrate positive associations between structural features, such as preschool type, duration of enrollment, and classroom environment, and child outcomes, overall the evidence base remains limited in terms of scope and methodological rigor. The contrasting effects observed for duration of participation (improved literacy but poorer socio-emotional outcomes; Kong et al., 2024a ) suggest that simply expanding access or extending participation may not be sufficient without concurrent attention to quality. This underscores the need for policy decisions to be grounded in more robust, longitudinal research that accounts for potential consequences of system-level changes. Additionally, policymakers, planners, and administrators ought to consider the intersecting barriers to ECE access and quality in Malaysia’s culturally and religiously diverse context. Reasons for non-enrollment are likely multifaceted, encompassing economic constraints, traditional caregiving practices, and competing family priorities. In families facing socioeconomic disadvantage, fundamental concerns such as food security and physical health may take precedence over formal education. The role of nutrition in early development, as an example, is particularly salient: large-scale studies have reported stunting rates of 16–21% and underweight rates of 10–14% among young children in Malaysia (Lee et al., 2022 ; Institute for Public Health, MOH Malaysia, 2020). Given the well-established links between early nutritional status and long-term cognitive and educational outcomes (Brown & Pollitt, 1996 ; Glewwe et al., 2001 ), ECE policy must be considered within a broader cross-sectoral framework that integrates health, nutrition, and social protection. Monitoring of system-level progress should therefore include broad indicators such as enrollment rates, years of participation, attendance patterns, and access equity, which should then be disaggregated by ethnicity, socioeconomic status, and urban/rural distinctions. Findings on instructional interventions (RQ2) offer some guidance for programme-level improvements, which are primarily the responsibility of curriculum developers, teachers, trainers, and school leaders (Melhuish et al., 2015 ). The evidence reviewed suggests that certain teaching approaches and targeted interventions can meaningfully improve child outcomes, particularly in literacy and early mathematics. Here, we propose key questions for programme design: Which teaching approaches work best in the Malaysian context? Which intervention modules should be scaled up for wider implementation? How should teacher training be upgraded to support high-quality instruction? Should certain targeted interventions, such as phonological awareness training or game-based mathematics activities, be integrated into the national preschool curriculum? The studies reviewed highlight several promising intervention approaches. For literacy, interventions grounded in phonological awareness, structured storytelling, and reading fluency activities consistently demonstrated positive effects. For mathematics, game-based learning approaches showed advantages over traditional worksheet-based instruction. For socioemotional development, structured modules addressing emotional identification, understanding, control, and use showed positive results. However, the variability in intervention design, duration (ranging from 20 minutes to 6 months), and implementation fidelity limits the ability to draw firm conclusions about which specific components are most effective or how they should be adapted for scale. Monitoring of programme-level effectiveness should rely on child-level outcome measures, such as gains in reading scores, mathematical fluency, creativity, and emotional skills, as well as process measures including fidelity of implementation and teacher competence. Importantly, few studies in this review assessed teacher skills or documented how interventions were actually delivered in practice. Future programme evaluations should therefore include measures of both what is being taught and how it is being taught, to better understand the mechanisms through which interventions exert their effects. This may support more targeted professional development, helping to identify where teachers need additional training or resources to implement evidence-based practices effectively. Such challenges - balancing access with quality and expanding provision while maintaining instructional effectiveness - are not unique to Malaysia. Evidence from similar low-resource contexts has shown difficulties in ensuring quality alongside increasing access in ECE settings. For instance, studies have highlighted the potential trade-offs between rapid expansion of access and the maintenance of quality (Yoshikawa & Kabay, 2015 ). Initiatives like the Nurturing Care Framework (WHO, 2018) advocate for integrating health, nutrition, social protection, and parental support into early education, particularly for vulnerable populations. Conclusion The findings of this review highlight several critical directions for future research on early childhood education (ECE) and child outcomes in Malaysia, while outlining areas for policy and programme attention. Regarding structural aspects of provision (RQ1), future studies should examine how features such as preschool type, enrollment duration, classroom environment, and teacher qualifications interact to influence outcomes. Crucially, research on process quality, the actual interactions and experiences children have in ECE settings, remains absent and urgently needed. System-level policy decisions regarding mandatory enrollment, duration of participation, funding allocation, and movement toward universal preschool must be informed by more rigorous evidence that accounts for equity, access, and quality simultaneously. Concerning instructional interventions (RQ2), existing studies demonstrate promising effects across literacy, numeracy, and socioemotional domains. That said, studies would benefit from examining potential mediating and moderating mechanisms that link ECE provision to developmental outcomes, such as caregiver engagement, classroom quality, or child temperament, as these pathways remain underexplored in the current literature. Additionally, more integrated assessments that examine multiple developmental domains concurrently can help avoid over-reliance on narrow indicators of success. Programme-level improvements should be guided by evidence on which teaching approaches are most effective, how teacher training can be upgraded, and which targeted interventions merit integration into the national curriculum. The methodological limitations (RQ3) identified in this review, including a predominance of quasi-experimental designs, short intervention durations, lack of longitudinal follow-up, and limited control for confounding variables, warrants caution for any sort of causal inference. There is an urgent need for more longitudinal research to capture the sustained impact of ECE interventions over time in Malaysia. This is particularly important given evidence of “fade-out effects”, where initial gains from early interventions diminish as children progress through the education system. Future work should prioritise rigorous, theory-driven designs such as the Response to Intervention (RTI) framework, which embeds continuous assessment and allows for data-driven adaptation of support. Finally, few studies systematically account for the role of ethnic and socioeconomic diversity, despite their known influence on access, uptake, and effectiveness of ECE. This is an especially salient perspective in the Malaysian context, which is multi-ethnic and multi-cultural. Future work should therefore prioritise disaggregated analyses to better understand for whom and under what conditions ECE is most beneficial. By addressing these gaps at both the system and programme levels, future research can offer more robust, context-sensitive evidence to inform equitable and effective ECE policy and practice. Declarations Author Contribution J.A.H and A.C. conducted the screening. J.A.H. wrote the main manuscript text. 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A meta-analysis of evidence from natural experiments. Economics of Education Review , 66 , 206–222. https://doi.org/10.1016/j.econedurev.2018.08.001 World Health Organization (WHO) (2018). Nurturing care for early childhood development. https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/child-health/nurturing-care Yeo, K., & Ng, P. (2019). Literacy intervention for preschool children at risk of learning difficulties in Malaysia. Universal Journal of Educational Research , 7 (11), 2501–2506. https://doi.org/10.13189/ujer.2019.071130 Yoshikawa, H., & Kabay, S. (2015). The evidence base on early childhood care and education in global contexts. Paper commissioned for the EFA Global Monitoring Report 2015, Education for All 2000–2015: achievements and challenges. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8789362","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":586998349,"identity":"5fc6ebe3-8df5-46bf-a44b-d8190af123c1","order_by":0,"name":"Jean Anne Heng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAx0lEQVRIiWNgGAWjYBACxgYexgcfKmzgAgbEaGE2nHEmjQQtDAw8bNKcLYdJ0MLcfvaANGPDeXn+aQcYP/xgOGxM2GE9eQnGhTtuG864ncAs2cNw2IywloYcg+SZZ24nMACRNAPDYRvCWvrfGBzmbTuXIA+05TdxWmbkGDbzth1IMLidwAayhQiHzXhjzDjjTLLhxtuJbZY9BumEvW/Yn2P+40OFnbzc7eTDN35UWBs2ENSCUMHYQFxEyhOhZhSMglEwCkY6AABStz1baMR74QAAAABJRU5ErkJggg==","orcid":"","institution":"University of Cambridge","correspondingAuthor":true,"prefix":"","firstName":"Jean","middleName":"Anne","lastName":"Heng","suffix":""},{"id":586998350,"identity":"013fd1a7-02f2-482d-a877-ea70c5cee67c","order_by":1,"name":"Alexandra Cheah","email":"","orcid":"","institution":"Universiti Sains Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Alexandra","middleName":"","lastName":"Cheah","suffix":""},{"id":586998351,"identity":"3c76d257-a51d-4440-9a55-3969e7737f3e","order_by":2,"name":"Kimberley Kong","email":"","orcid":"","institution":"Universiti Sains Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Kimberley","middleName":"","lastName":"Kong","suffix":""}],"badges":[],"createdAt":"2026-02-04 17:54:00","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8789362/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8789362/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104180294,"identity":"fd8e81db-27b5-4483-8b18-03642fa0229c","added_by":"auto","created_at":"2026-03-08 17:12:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":175083,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003ePRISMA Flow Diagram\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8789362/v1/a9cc9ad02075d41bb937c96a.png"},{"id":104180295,"identity":"03344e3e-e4d2-4254-a659-fb9602160b94","added_by":"auto","created_at":"2026-03-08 17:12:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":26136,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStudies published between 2000–2024\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8789362/v1/b68bf210edddaacba74d4649.png"},{"id":104180297,"identity":"b0b234d7-daf8-47cf-b37a-1bc64804cb6f","added_by":"auto","created_at":"2026-03-08 17:12:40","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":18195,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eType of study design in eligible studies\u003c/em\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8789362/v1/92754dc963922248041216cc.png"},{"id":104961384,"identity":"51444b0e-6628-4418-8f0c-9a2250fdb411","added_by":"auto","created_at":"2026-03-19 08:58:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1589290,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8789362/v1/a9b70d02-ca91-437b-b492-244c490ef1c0.pdf"},{"id":104180296,"identity":"e4b990eb-c259-45a3-bfd8-bf810f6ca509","added_by":"auto","created_at":"2026-03-08 17:12:40","extension":"xlsx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":62432,"visible":true,"origin":"","legend":"","description":"","filename":"ECEAppendix1ECE.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-8789362/v1/a4c59c73a2aabe9910170e1b.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Early childhood education provisions, interventions, and child outcomes in Malaysia: A 25-year review ","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEarly childhood education (ECE) is widely recognised as a cornerstone for fostering development across cognitive, linguistic, and socio-emotional domains. While increasing access to ECE remains a national and global priority, evidence suggests that access alone does not guarantee positive developmental outcomes. Recent work indicates that factors such as programme quality, classroom experiences, and the implementation of targeted interventions all play critical roles in shaping children\u0026rsquo;s learning and wellbeing (Egert et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Perlman et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Melhuish et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Concurrently, a broader push for a more globally representative developmental science has motivated greater inclusion of work from diverse contexts (Draper et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In line with these developments, this review aims to synthesise peer-reviewed evidence on ECE experiences as associated with child outcomes in Malaysia across two key strands: (i) general ECE provisions, including structural and contextual aspects such as preschool type, enrolment duration, and mode of delivery; and (ii) targeted interventions implemented within ECE settings to enhance specific developmental outcomes. By examining both strands, we aim to provide an evidence-informed foundation for further discussion on how Malaysian ECE environments may continue to support children\u0026rsquo;s development.\u003c/p\u003e\n\u003ch3\u003eEarly childhood education experiences: A multi-componential, global perspective\u003c/h3\u003e\n\u003cp\u003eA robust body of evidence demonstrates that high-quality ECE programs support not only short-term gains in academic performance and social-emotional skills, but also long-term outcomes extending into adulthood (Phillips et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Multiple mechanisms underlie these relations, for instance, through participation in structured, stimulating, and nurturing environments that promote early learning and emotional regulation. Importantly, the developmental benefits of ECE are not conferred by access alone. In particular, researchers in this area have highlighted the distinct but often interrelated roles of both \u003cem\u003estructural\u003c/em\u003e and \u003cem\u003eprocess\u003c/em\u003e quality in shaping ECE outcomes. Structural dimensions such as environmental factors, teacher\u0026ndash;child ratios and group sizes, have been linked to more favourable developmental trajectories (Egert et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Perlman et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), while process quality, characterised by emotionally responsive, reciprocal, and cognitively rich interactions between teachers and children, has emerged as a critical predictor of learning and wellbeing (Melhuish et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Further to this, type of setting, such as public versus private provision, may also serve as a proxy for quality, with some evidence suggesting variation in developmental outcomes based on institutional characteristics (Blanden et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAgainst this backdrop, it is worth examining how multi-dimensional features of ECE provision operate across diverse global contexts. In low- and middle-income countries (LMICs), ECE has been shown to play a vital role in addressing early developmental delays and mitigating educational inequities, particularly for children from underserved communities (Currie, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2001\u003c/span\u003e; Elango et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Melhuish et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Targeted interventions in early childhood have consistently demonstrated greater long-term impact among children from lower socioeconomic backgrounds, suggesting that ECE may function as a levelling force in contexts of structural disadvantage (Barnett, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Enriched and predictable learning environments, often more cognitively stimulating than home settings, offer both protective and promotive effects on child development (Conger \u0026amp; Donnellan, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRecent meta-analytic evidence points to the value of ECE across global contexts. For example, Schmutz (\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) synthesised outcomes from high- and low-income countries, concluding that ECE policies generally yield positive impacts on developmental trajectories. Similarly, in a meta-analysis of 250 estimates across 30 studies, Huizen and Plantenga (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) found that while effect sizes vary, high-quality, intensive, and publicly provided programs consistently produced more favourable outcomes, particularly for children from disadvantaged backgrounds. Notably, these benefits were not subject to fade-out effects, and age of enrolment appeared to have limited influence on outcomes. Taken together, these findings highlight the importance of evaluating both access and quality in relation to context-specific developmental goals. The present review contributes to this evidence base by focusing on Malaysia - an Official Development Assistance (ODA) country undergoing rapid expansion of its early childhood education sector.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEarly childhood education systems within the Malaysian landscape\u003c/h2\u003e \u003cp\u003eIn Malaysia, ECE provision is characterized by a mix of public, private, and community-based programs. Children under the age of 4 may be enrolled into nurseries known as TASKA (\u003cem\u003eTaman Asuhan Kanak-Kanak\u003c/em\u003e), while children between the ages of 4 to 6 will attend preschool (known as \u003cem\u003etadika\u003c/em\u003e in Malay) (Kong, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Samuel et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Preschools consist of two main types: privately-owned and government funded. Government funded preschools can be further divided into a few categories, namely KEMAS (located in rural and semi-rural areas), PERMATA, Tabika Perpaduan (located in urban areas), Islamic preschools, and preschools annexed to national schools (Mohd Nor \u0026amp; Symaco, 2017; Samuel et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; The Malaysian Administrative Modernisation and Management Planning Unit, \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). All preschools in Malaysia are registered with the Ministry of Education (MOE) and subscribe to the National Standard-Based Preschool Curriculum (Kurikulum Standard Prasekolah Kebangsaan; KSPK) (MOE, 2017).\u003c/p\u003e \u003cp\u003eThis curriculum, developed by Malaysia\u0026rsquo;s Ministry of Education and most recently revised in 2017, outlines the integration of higher-order thinking skills as a core component of early education. This is in alignment with the Malaysia Education Blueprint (2013\u0026ndash;2025), which serves as a national transformation agenda to elevate public education standards in Malaysia by 2025. A key government initiative of the blueprint was to improve Malaysia\u0026rsquo;s performance in international assessments (i.e., Program for International Student Assessment (PISA) benchmarks). To achieve this, the blueprint outlined a detailed roadmap prioritizing improving educational facilities, enhancing quality, and increasing enrolment rates across all levels of education, including preschools. Together, the overarching aim of the standardised curriculum was to support children\u0026rsquo;s readiness for primary school by fostering foundational skills, self-confidence, and positive self-concepts within a safe and engaging learning environment (MOE, 2017). The curriculum adopts a child-centred approach, promoting learning through creative and meaningful activities for children in preschool. It is organised into six interrelated learning strands: communication, spirituality and values, social understanding, physical development and aesthetics, science and technology, and personal competence. These strands are designed to support holistic development and are underpinned by an emphasis on critical, creative, and innovative thinking.\u003c/p\u003e \u003cp\u003eAlso significant in the early childhood education landscape in Malaysia is the National Key Result Area (NKRA) for Education, introduced by the Malaysian government in 2009 (Jabatan Perdana Menteri, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). This effort focuses on four sub-NKRAs to expand access to quality and affordable education, with preschool education being one of the sub-NKRAs. The Key Performance Indicator (KPI) set for this sub-NKRA is to increase the enrolment rate of children aged four and five, and to enhance the quality of preschool education by incorporating private preschools and other agencies as part of the national education system. The Malaysia Education Blueprint (MEB) 2013\u0026ndash;2025 also takes into account the importance of preschool education. Phase 1 of the MEB 2013\u0026ndash;2025 outlines the provision of equal access to quality education of an international standard. The target under this shift is to improve the quality of preschools and promote universal enrolment.\u003c/p\u003e \u003cp\u003eDespite growing policy attention as described above, persistent structural and contextual challenges continue to affect the effectiveness of early childhood education (ECE) provision in Malaysia. As highlighted in a recent review by Kong et al. (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024a\u003c/span\u003e), two key concerns remain central: accessibility and quality. In terms of accessibility, the national gross enrolment rate for preschool children stands at approximately 86%, leaving a significant proportion of children \u0026ndash; particularly those in rural and socioeconomically disadvantaged communities, without access to formal early education. This lack of access can place children at a disadvantage upon entry into primary school, as they may lack foundational cognitive and socio-emotional skills. Such early disparities in school readiness are linked to difficulties in adapting to formal learning environments and may compound over time, contributing to wider educational inequalities (Linberg et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWith regard to quality, teacher qualifications in particular represent a persistent issue. A report from the Ministry of Education indicated that only 54% of the ECE workforce hold the minimum required qualification of a diploma in early childhood education, with the number being as low as 18% in private preschools (MOE, 2023). From the perspective of parents, interview-based studies have highlighted concerns around educator quality, including issues such as inadequate teacher training, poor English language proficiency, and limited use of developmentally appropriate play-based practices (Aquino et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Addressing these disparities is critical to ensuring equitable developmental opportunities for all Malaysian children. However, to do so, a clear outline of the current state of early childhood education provisions and interventions from empirical studies in Malaysia is necessary.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePresent Review\u003c/h3\u003e\n\u003cp\u003eThis review synthesises the evidence on early childhood education (ECE) provision and interventions in Malaysia, focusing on how these factors relate to domains of children\u0026rsquo;s developmental outcomes \u0026ndash; including social, emotional and cognitive skills. We examine studies addressing structural aspects of provision (e.g., enrolment duration, preschool type, and mode of delivery) as well as targeted instructional interventions implemented within ECE settings. Together, these strands offer insights into how the Malaysian ECE landscape supports children\u0026rsquo;s learning, wellbeing, and holistic development across social, emotional, cognitive, and physical domains. Despite growing attention to early education as a national priority, there remains no systematic synthesis of peer-reviewed evidence linking ECE experiences to child developmental outcomes in Malaysia. This review therefore collates and evaluates available studies to identify robust findings, methodological limitations, and directions for future research and policy action.\u003c/p\u003e \u003cp\u003eThe review is guided by three research questions:\u003c/p\u003e \u003cp\u003e \u003cb\u003eRQ1.\u003c/b\u003e What are the associations between structural aspects of ECE provision and child developmental outcomes in Malaysia?\u003c/p\u003e \u003cp\u003e \u003cb\u003eRQ2.\u003c/b\u003e What types of targeted instructional interventions have been implemented, and what evidence exists for their effectiveness in improving child developmental outcomes?\u003c/p\u003e \u003cp\u003e \u003cb\u003eRQ3.\u003c/b\u003e What methodological gaps and limitations exist in the current literature, and what implications do these have for future research?\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSearch Strategy\u003c/h2\u003e \u003cp\u003eA comprehensive search was conducted across multiple databases, including PubMed, Scopus, Web of Science, and MyCITE (Malaysian Citation Index). The MyCITE portal is a website providing access to bibliographic as well full-text contents of scholarly journals published in Malaysia in the fields of science, technology, medicine, social sciences and the humanities. Across all databases, keywords were combined using Boolean operators to develop comprehensive search strings, including terms such as \u0026ldquo;early childhood education,\u0026rdquo; \u0026ldquo;preschool,\u0026rdquo; \u0026ldquo;child development,\u0026rdquo; \u0026ldquo;Malaysia,\u0026rdquo;, \u0026ldquo;ECE\u0026rdquo;, \u0026ldquo;\u003cem\u003etaska\u003c/em\u003e\u0026rdquo;, \u0026ldquo;\u003cem\u003etadika\u003c/em\u003e\u0026rdquo;. The study was pre-registered on the Open Science Framework.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInclusion of papers published in Bahasa Malaysia\u003c/h3\u003e\n\u003cp\u003eTo date, an overwhelming number of reviews have cited the exclusion of non-English papers as a main limitation of their findings (e.g., Schmutz, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Brunsek et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Egert et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; van Huizen \u0026amp; Plantenga, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Burger, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; D\u0026rsquo;Onise et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Anderson et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). This both reflects and perpetuates an overarching, prevalent issue within global child development research. According to a commentary by Draper et al. (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), researchers have found it particularly challenging to publish research from non-Western, Educated, Industrialized, Rich, and Democratic (WEIRD) settings, despite the fact that it represents 90% of the global child population. This is due to several reasons including publication bias, which often favours certain contexts over others regardless of study quality. An exclusive reliance on English-language articles for review and replication further exacerbates this disparity in research representation. In direct response to this, our review includes papers published in Bahasa Malaysia, the national language of Malaysia. Inclusion criteria for papers are thus as follows: (1) Published between 2000\u0026ndash;2024, (2) Includes a sample population of Malaysian children between the ages of 0\u0026ndash;8, (3) Includes at least one aspect of ECE provision or intervention, (4) Includes at least one aspect of child developmental outcomes.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eProcedure\u003c/h2\u003e \u003cp\u003eThe screening process was carried out in two stages, in accordance with the PRISMA guidelines. We utilized the Covidence software for both stages. Covidence is a web-based software platform designed to streamline and facilitate the process of conducting systematic reviews and other comprehensive literature reviews (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.covidence.org/\u003c/span\u003e\u003cspan address=\"https://www.covidence.org/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e).\u003c/span\u003e In the first stage, reviewers independently assessed the title and abstract of each study for relevance based on the predefined inclusion and exclusion criteria. Studies were included if they met all inclusion criteria, even if certain details (e.g., population characteristics or intervention specifics) were unclear. Studies that clearly failed to meet any one of the criteria were excluded. If uncertainty remained, studies were marked as \u0026ldquo;Uncertain\u0026rdquo; in Covidence and flagged for review by the senior author. In the second stage, two reviewers independently assessed the full-text articles of studies that passed the initial screening. Studies were included if they fulfilled all inclusion criteria. Articles were excluded if full texts were unavailable despite efforts to contact the authors or if the criteria were not met. Authors were given a one-month window to respond. Any disagreements were resolved through discussion with the senior author. A PRISMA flow diagram illustrating the screening process is provided in Fig.\u0026nbsp;1. A total of 28 studies were included in the final review (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). For a more comprehensive table including all study characteristics, see Appendix 1. Each included study underwent a risk of bias assessment using the Mixed Methods Appraisal Tool (MMAT). This tool was selected due to the mixed-methods nature of the current review, which included qualitative, quantitative, and mixed-method studies.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eStudy Characteristics\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy ID\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudy design\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYear\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEthnicity\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eProvision/Intervention\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDuration\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eOutcomes\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e- Experimental group received instruction using the Reading Intervention Module (MIM); control group followed traditional teacher-selected methods without MIM\u003c/p\u003e \u003cp\u003e - MIM designed to improve reading achievement through structured, targeted literacy activities\u003c/p\u003e \u003cp\u003e - Effectiveness assessed via pre- and post-test comparison using t-test analysis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eReading achievement in Bahasa Malaysia\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e465 boys (50.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMalay; \u003c/p\u003e \u003cp\u003eChinese; \u003c/p\u003e \u003cp\u003eIndian; \u003c/p\u003e \u003cp\u003eOthers; \u003c/p\u003e \u003cp\u003eMigrant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e919\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePreschool attendance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCognitive ability; Raven\u0026rsquo;s Standard Progressive Matrices\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 girls (62.5%); 15 boys (37.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAnimated pedagogical agent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eReading ability for English words and sentences\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 girls (50%); 10 boys (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e- Modul Literasi Awal (MULA) - adapted from Get Ready to Read (GRTR) program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEarly literacy; Ujian Pengesanan Kemahiran Literasi Awal\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 to 6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified in final sample\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eReader\u0026rsquo;s Theater (reading aloud, choral reading, reading robin, paired reading)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eTranslated fluency checklist from the National Assessment of Educational Progress\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCross-sectional - direct assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 to 6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49 girls (40.5%); 72 boys (59.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eType of preschool (Public vs. private)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCognitive ability (McCarthy Scales of Children\u0026rsquo;s Abilities - MSCA)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental with non-equivalent control group pre test/post-test research design.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 to 6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eGames-based learning (GBL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eLearning behaviour - Learning Behavior Scale (LBS); Prosocial behavior (video recordings and observations using observation table adapted from Weir \u0026amp; Duveen (1981)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e- Children with learning difficulties (n\u0026thinsp;=\u0026thinsp;6) were divided into control and experimental groups \u003c/p\u003e \u003cp\u003e - Experimental group received syllable instruction via a tablet-based, persuasive-designed multimedia courseware; control group received traditional instruction from a special education teacher \u003c/p\u003e \u003cp\u003e - Courseware (newly developed for the study) featured interactive syllable modules with visual and pronunciation discrimination exercises, delivered via mobile tablets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e20 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSyllable recognition - paper-based pre- and post-test questionnaires (10 Malay syllable items with image-matching tasks)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMulti-site, quasi-experimental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 to 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eType of preschool\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEarly mathematic achievement\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRandomized controlled trial (RCT)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 to 6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e- Preschool-based emotional intelligence (EI) module targeting four EI components: identifying, understanding, controlling, and using emotions\u003c/p\u003e \u003cp\u003e - Each component addressed through structured activities facilitated by teachers to enhance specific EI skills in children\u003c/p\u003e \u003cp\u003e - Intervention implemented by preschool teachers as part of regular teaching activities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSix weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEmotional intelligence: identifying, understanding, controlling, and using emotions (Sullivan Emotional Intelligence Scale for Children [EISC])\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 to 5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 girls (57.1%); 18 boys (42.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eChinese; Malay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLiterature-based intervention using Wallas\u0026rsquo; Stage Model to teach creative thinking through ten structured lesson plans\u003c/p\u003e \u003cp\u003eFocused on four aspects of creative teaching: person (teacher and child), press (supportive environment), product (creative outputs), and process (children\u0026rsquo;s creative thinking)\u003c/p\u003e \u003cp\u003eLessons incorporated picture e-books selected or designed to enhance creativity during storytelling sessions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCreative thinking abilities\u003c/p\u003e \u003cp\u003eDivergent thinking and idea generation (Torrance Test of Creative Thinking)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 girls (44.4%); 15 boys (55.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e- PIL-based science intervention on magnets, structured around four instructional phases\u003c/p\u003e \u003cp\u003e - Included multimedia stimuli (images, video) to prompt inquiry and activate prior knowledge about trains and magnetism\u003c/p\u003e \u003cp\u003e - Students explored magnetic connectivity in trains, then sketched and constructed model train carriages (engineering in action)\u003c/p\u003e \u003cp\u003e - Emphasized hands-on design and iterative thinking through guided exploration and construction tasks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eThree weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eStudents\u0026rsquo; interest in learning Science\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test, mixed methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 years; 6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 girls (60%); 6 boys (40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAR mobile-based application with no further specifications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEarly literacy skills: reading and writing of basic words and alphabets (custom pre- and post-test)\u003c/p\u003e \u003cp\u003eLearning engagement and satisfaction (learning satisfaction questionnaire)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, mixed-method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSelf-regulated learning (SRL) intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEarly writing performance; Self-regulated Strategies for Ealy Writing-Observation Form (SRSEWOF), Early Writing Performance Scale (EWPS)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEarly literacy intervention (ELI) on Malay language\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e14 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003ePhonological awareness; Malay Early Literacy Skills Test Battery (MELSTB)\u0026thinsp;\u0026minus;\u0026thinsp;4 literacy skills test: Malay Early Literacy Phonological Awareness Test (MELPAT); Malay Early Literacy Decoding Test (MELDT); Malay Early Literacy Spelling Test (MELST); Malay Early Literacy Reading Comprehension Test (MELRCT)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi experimental method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eTeaching methods: games, number books, worksheet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEarly mathematical comprehension and analysis; Test of Mathematics Ability (Ginsburg \u0026amp; Baroody, 2003)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, random group assignment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 to 6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSelf-regulated learning (SRL)\u003c/p\u003e \u003cp\u003e- 10 units tied to early writing process\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSelf-Regulation Strategies for Early Writing-Observation Form (SRSEWOF) and Self-Efficacy Scale of Early Writing (SESEW); Early Writing Performance Scale (EWPS) - developed based on 3 aspects: content, mechanical writing skills, overall writing quality\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurvey/Cross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot specified (only preschools with 6 years were selected)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eClassroom environment and spatial design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCognitive school readiness skills; self-regulation\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurvey/Cross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eClassroom environment and spatial design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot specified, monthly follow-ups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCognitive school readiness skills\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean: 5.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47 years; Range: 5.08\u0026ndash;6.83 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e204 girls (47.0%); 226 boys (52.0%)\u003c/p\u003e \u003cp\u003eGender not reported for 5 children (1.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMalay 85.1%; Chinese 6.0%; Indian 2.1%; Orang Asli (indigenous people) 4.0%; Others 2.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePreschool type (KEMAS vs private)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eVisual-motor integration performance (Beery-Bucktenicka Developmental Test of\u003c/p\u003e \u003cp\u003eVisual-Motor Integration)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20 girls (69.0%); 9 boys (31.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e- MyNEPs (Malaysian Nature Education in Preschool Program) focused on five nature domains: climate, flora, fauna, insects, and microbes\u003c/p\u003e \u003cp\u003e - Delivered through outdoor, hands-on activities designed to engage children with the natural environment\u003c/p\u003e \u003cp\u003e - Activities supported by structured worksheets to reinforce learning and observation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot specified (post-test was collected within a month post intervention)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNature-related knowledge\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 to 6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEarly Mathematics learning module\u003c/p\u003e \u003cp\u003e- administered in 65 separate activities in 3 months (5\u0026ndash;10 minutes per activity)\u003c/p\u003e \u003cp\u003e- one mentor/facilitator per group of 5 preschoolers\u003c/p\u003e \u003cp\u003e- 55 teacher trainees as mentors and observers - module not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eMathematic performance; Measurement tool: Test of Mathematics Ability (Ginsburd \u0026amp; Barrody, 2003)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-equivalent two-group pretest-posttest quasi-experimental design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eCreative play (30\u0026ndash;45 mins per activity)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCreativity (Fluency, originality, imagination); Torrance\u0026rsquo;s Thinking Creatively in Action and Movement (TCAM)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTeacher-reported survey - Cross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eM\u0026thinsp;=\u0026thinsp;70.19 (months); SD\u0026thinsp;=\u0026thinsp;7.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e267 girls (47.9%); 290 boys (52.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePrimarily Malay/Malay/Chinese/Indian, some Indigenous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e557\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLocality of preschool (urban vs. rural)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eBehavioural and emotional problems (SDQ)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuasi-experimental, pre-post test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eControl group: 16 girls (53.3%); 14 boys (46.7%)\u003c/p\u003e \u003cp\u003eExperimental group: 14 girls (46.7%); 16 boys (53.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e- Intervention group received English instruction via Integrated Sound Word Method, incorporating early reading games\u003c/p\u003e \u003cp\u003e - Control group received early reading instruction without game-based components\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDelivered 30 minutes/day, 3 times/week, over 4 weeks (total: 6 hours)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEarly reading proficiency in English\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurvey/Cross-sectional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 to \u0026gt;\u0026thinsp;30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74 female teachers (88.1%); 10 male teachers (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e71 - Chinese\u003c/p\u003e \u003cp\u003e7 - Indian\u003c/p\u003e \u003cp\u003e6 - Malay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eOutdoor play structural factors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSocio-emotional; health and physical development; academic learning\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCross-sectional - direct assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 to 5 years (M\u0026thinsp;=\u0026thinsp;5.90, SD\u0026thinsp;=\u0026thinsp;0.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e80 girls (47.1%); 90 boys (52.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNature and duration of ECE participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCognitive development\u003c/p\u003e \u003cp\u003eLanguage and literacy skills\u003c/p\u003e \u003cp\u003eSocio-emotional development\u003c/p\u003e \u003cp\u003eMotor development\u003c/p\u003e \u003cp\u003eHealth and hygiene knowledge\u003c/p\u003e \u003cp\u003eCultural understanding and learning approaches; East Asia-Pacific Early Childhood Development Scales (Short Form) (Rao et al., 2019)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCross-sectional - direct assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u0026ndash;6 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e398 girls (37.9%); 412 boys (39.2%)\u003c/p\u003e \u003cp\u003eGender not reported for 241 children (22.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSynchronous or hybrid learning\u003c/p\u003e \u003cp\u003eEnrollment or non-enrollment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eEmergent numeracy\u003c/p\u003e \u003cp\u003eEmergent literacy\u003c/p\u003e \u003cp\u003eSocio-emotional skills\u003c/p\u003e \u003cp\u003eMotor skills; International Development and Early Learning Assessment battery (Pisani et al., 2018)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Results","content":"\u003cp\u003eThe majority of included studies reported positive and statistically significant associations (p \u0026lt; .05) between various aspects of ECE provision and child developmental outcomes in Malaysia. Only three studies reported null findings for the variables of interest, suggesting that most research to date points toward meaningful links between ECE provision and developmental outcomes. The findings are organized below according to the three research questions guiding this review.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRQ1: What are the associations between structural aspects of ECE provision and child developmental outcomes in Malaysia?\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA small number of studies examined structural quality in ECE settings, typically defined by features such as preschool type, duration of enrollment, classroom environment, teacher qualifications, and teacher-child ratios. One comparative study (Ompok, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) found significant differences in mathematics outcomes based on preschool type (KPM vs. KEMAS), though further research is needed to clarify the direction and implications of these differences. Kong et al. (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024a\u003c/span\u003e), using the East Asia-Pacific Early Childhood Development Scales (EAP-ECDS) instrument, found that the duration of ECE enrollment among children from low-income families attending KPM preschools was positively associated with language and literacy outcomes. Two studies explored the role of classroom environment and spatial design. Shaari et al. (2020) reported mixed design quality in public preschools: while classrooms showed good circulation and indoor conditions, they scored poorly on spatial layout, which was linked to lower cognitive self-regulation in children. Another study (Shaari et al., \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2020b\u003c/span\u003e) found that fair spatial planning, along with strong ratings in safety, site location, and environmental quality, were positively associated with children\u0026rsquo;s cognitive school readiness. While these findings are promising, they are constrained by notable methodological and conceptual limitations, which are addressed in detail under RQ3 and in the Discussion section.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRQ2: What types of targeted instructional interventions have been implemented, and what evidence exists for their effectiveness in improving child developmental outcomes?\u003c/b\u003e \u003c/p\u003e \u003cp\u003eMost studies with significant findings focused on instructional interventions and their effects on children\u0026rsquo;s emerging academic skills. These interventions span literacy, numeracy, and socioemotional and creative development.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eLiteracy interventions\u003c/h2\u003e \u003cp\u003eTen studies focused on literacy-related outcomes, reporting improvements across multiple skill domains. Several studies reported gains in reading achievement in Bahasa Malaysia (Majzub \u0026amp; Buang., 2010) and English (Abdul Rahman et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Omar \u0026amp; Mohd Rias, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), as well as basic reading and writing skills (Mahmud et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Siew and Md Nor (\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2019a\u003c/span\u003e) and (2019b) found improvements in overall writing performance and self-efficacy, while Mohamed Isa et al. (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) reported gains in reading fluency and comprehension. More specialized interventions addressed syllable recognition and phonological awareness in Bahasa Malaysia (Ng et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Yeo \u0026amp; Ng, \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). All studies reported significant positive effects of interventions on the targeted literacy outcomes. Some studies utilized existing intervention modules or programs, including the Reading Intervention Module (MIM; Majzub \u0026amp; Buang, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), Modul Literasi Awal (MULA) adapted from the Get Ready to Read (GRTR) program (Bacotang, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), and Reader\u0026rsquo;s Theater (Mohamed Isa et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Others developed ad-hoc intervention strategies grounded in established theoretical frameworks, such as persuasive learning (Ng et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eMathematics interventions\u003c/h2\u003e \u003cp\u003eEarly mathematical development was examined in three studies. Two intervention studies by Ompok and colleagues (2019; \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found improvements in early mathematical skills, highlighting the effectiveness of game-based approaches compared to worksheets and number books, though intervention details were limited\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSocioemotional and creative development\u003c/h2\u003e \u003cp\u003eA small subset of studies targeted non-academic developmental outcomes. Akmal Rohaizad et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) implemented a preschool-based emotional intelligence (EI) module designed to enhance four core components: identifying, understanding, controlling, and using emotions. Each component was addressed through structured teacher-facilitated activities integrated into the regular preschool curriculum. Two studies focused on fostering creativity. Chew and Eau (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) developed a literature-based intervention grounded in Wallas\u0026rsquo; Stage Model of creativity, delivered through ten structured lesson plans. The program targeted four dimensions of creative teaching: person (teacher and child), press (supportive environment), product (creative outputs), and process (children\u0026rsquo;s creative thinking), with storytelling sessions built around selected or designed picture books. A more recent study by Tee (\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) focused on enhancing children\u0026rsquo;s fluency, originality, and imagination through creative play activities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eInstructional delivery methods\u003c/h2\u003e \u003cp\u003eKong et al. (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2024b\u003c/span\u003e) examined different modes of instructional delivery during the COVID-19 pandemic. The study reported that asynchronous instruction, which combined real-time online and offline learning activities, was significantly predictive of refugee children\u0026rsquo;s academic readiness compared to synchronous instruction delivered purely through live video conferencing. This was assessed using the International Development and Early Learning Assessment (IDELA) tool. Notably, this is the only study that involved refugee children undertaking early childhood education in Malaysia.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eIntervention characteristics\u003c/h2\u003e \u003cp\u003eThe interventions varied considerably in scope and design. Several studies implemented ad-hoc intervention strategies developed with reference to established theoretical frameworks, including Wallas\u0026rsquo; Stage Model (Chew \u0026amp; Eau, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), Project-Based Inquiry Learning (Safiee et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), and persuasive learning (Ng et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Child outcomes were assessed primarily through direct measures, with some studies designing their own instruments to capture target skills. Most intervention effects were analyzed using t-tests to compare pretest and posttest scores, except for Abdul Rahman et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), Hutagalung et al. (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), Ompok and Bacotang (\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), and Rohaizad et al. (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) who employed ANOVAs. The duration of interventions varied widely, ranging from 20 minutes to 6 months.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRQ3: What methodological gaps and limitations exist in the current literature, and what implications do these have for future research?\u003c/b\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePublication trends and study designs\u003c/h2\u003e \u003cp\u003eBased on Fig.\u0026nbsp;2, there is an overall upward trend in the number of publications, with fewer publications in Bahasa Malaysia (BM) compared with English-language publications. Studies that met the inclusion criteria were largely published after 2009. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e3\u003c/span\u003e indicates the composition of study designs included in the review. The most common study design was quasi-experimental with pre-test post-test designs, followed by cross-sectional studies relying on surveys for child outcomes, and then direct assessments. Just one study utilized a full randomized controlled trial design.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eAssessment and measurement approaches\u003c/h2\u003e \u003cp\u003eChild outcomes were assessed primarily through direct measures, with some studies designing ad-hoc instruments to capture target skills. A minority of studies employed standardized tools, such as the EAP-ECDS instrument (Kong et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024a\u003c/span\u003e) and the IDELA tool (Kong et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2024b\u003c/span\u003e). The reliance on researcher-designed instruments raises questions about measurement validity and comparability across studies.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eAnalytical approaches\u003c/h2\u003e \u003cp\u003eMost intervention effects were analysed using t-tests to compare pretest and posttest scores, with limited use of more sophisticated statistical techniques. The predominance of quasi-experimental designs without randomization and the lack of control for confounding variables in many studies limit the ability to make causal inferences.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eLimited reporting of intervention details\u003c/h2\u003e \u003cp\u003eA majority of intervention studies provided insufficient detail about implementation procedures, fidelity monitoring, and dosage. For example, Ompok and colleagues\u0026rsquo; studies (2019; 2021) on game-based mathematics interventions showed promising results but lacked comprehensive descriptions of the intervention components and implementation processes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eGaps in structural quality research\u003c/h2\u003e \u003cp\u003eWhile the studies on classroom environment and spatial design (Shaari et al., \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2020a\u003c/span\u003e and \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003eb\u003c/span\u003e) reported associations with child outcomes, they are constrained by notable methodological and conceptual limitations. These include cross-sectional designs that prevent causal inference, limited control for confounding variables, and inconsistent measurement of structural quality indicators.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present review included 28 studies that met the inclusion criteria. In what follows, we discuss the findings in response to the three research questions. Finally, we offer suggestions related to future research directions, policy, and practice.\u003c/p\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eStudy method and design limit interpretation of positive findings\u003c/h2\u003e \u003cp\u003eIn response to RQ1 and RQ2, our review identified consistent positive associations between aspects of ECE provision and child outcomes in Malaysia. However, the robustness of these findings is challenged by significant methodological concerns (RQ3). The majority of studies employed simple pre-test\u0026ndash;post-test designs and relied on p-value testing to infer intervention effectiveness, often without appropriate control groups, adjustment for confounding variables, or adequate follow-up. These approaches limit confidence in the internal validity and sustainability of reported effects. More rigorous methodologies have the potential to provide a more robust foundation for evaluating programme impact and should be considered by Malaysian researchers in future studies. One such example is the Response to Intervention (RTI) framework, which is a multi-tiered approach that begins with universal screening to identify children at risk of poor outcomes, followed by increasingly targeted and intensive interventions (Shapiro \u0026amp; Clemens, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). Importantly, the effectiveness of these interventions is continuously monitored through data-driven assessments, allowing educators and researchers to make informed decisions about which children need additional support and when. In LMIC settings such as Malaysia, where resources can often be limited and educational disparities more pronounced, RTI thus offers a cost-effective and scalable strategy to strengthen early identification and support systems. Rather than relying on brief, one-off interventions with limited follow-up, as was common in many of the studies reviewed, an RTI approach embeds assessment into the learning process and supports ongoing adaptation of instructional strategies based on children\u0026rsquo;s progress. This not only increases the precision of educational responses but also helps to differentiate between learning difficulties that arise from inadequate instruction versus those that reflect deeper developmental needs.\u003c/p\u003e \u003cp\u003eFurther to this, intervention durations varied substantially across studies, ranging from a single 20-minute session to multi-month programmes. This wide variation, along with inconsistency in implementation fidelity and outcome measures across studies, precluded meta-analytic synthesis and complicates our current interpretation of outcomes. These limitations are especially salient for domains such as socio-emotional functioning, where developmental changes may not be immediately observable. For instance, evidence from global early stimulation programmes (e.g., Jamaica, Mauritius) suggests that benefits to externalising behaviours often manifest later in childhood or adolescence, highlighting the need for longer-term evaluation (Tanner et al., \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The lack of such studies in the Malaysian context represents a critical gap, especially in light of research that has shown potential buffering effects of ECE provision on later social and behavioural issues (McLeod et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Future research should prioritise longitudinal, theory-driven designs that take into consideration developmental timing and contextually relevant indicators of child outcomes.\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eStructural and process quality remain underexplored\u003c/h2\u003e \u003cp\u003eRegarding structural aspects of ECE provision (RQ1), our findings suggest meaningful but under-examined associations. The limited number of studies exploring preschool type, enrollment duration, and physical environment indicates this remains a nascent area of inquiry in Malaysia. The mixed findings on classroom spatial design (Shaari et al., \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2020b\u003c/span\u003e) and the contrasting effects of enrollment duration on different outcome domains (Kong et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024a\u003c/span\u003e) highlight the complexity of structural influences. While Ompok (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) found significant differences between types of preschools (KEMAS versus KPM), the author\u0026rsquo;s suggestion that differences may be attributed to attention teachers provided to students is merely speculative. Future research should more systematically examine how structural features- including teacher qualifications, class size, and physical resources - interact with instructional quality to shape developmental outcomes.\u003c/p\u003e \u003cp\u003eNotably absent from the literature on structural aspects (RQ1) was also examination of process quality in ECEC, defined as children\u0026rsquo;s actual experience within a preschool setting including, but not limited to, interactions between educators and children. This is important for several reasons. First, it has been reported that children from underserved communities may not benefit equally from ECEC unless educator\u0026ndash;child interactions are warm, responsive, and developmentally appropriate (Hall et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). As such, measuring process quality helps assess how fairly quality is distributed, particularly in socioeconomically diverse populations. Second, previous studies with Malaysian parents have highlighted concerns surrounding educators\u0026rsquo; skills, which suggest a potential disconnect between structural required credentials (e.g., the requirement of a basic degree) and actual practice. A study by Sharifah and Aliza (\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) reported that even qualified teachers in Malaysia did not have a full grasp on the conceptual and operational frameworks of child-centred pedagogy (e.g., play-based learning). This lack of understanding has also been demonstrated at scale: a survey study involving more than 1000 TASKA educators in Malaysia showed that some educators were not aware about the national Malaysian preschool curriculum (Mustafa, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThese studies underscore the urgency of focusing on process quality within ECE research in Malaysia. Such data will allow for a better understanding of whether and how those skills are enacted in the classroom and inform policy and training. Without robust data on process quality, little is known about where and when to target professional development, how to improve practice, or how to ensure that ECEC investments are meaningful beyond just infrastructure on a national scale. Indeed, existing work has suggested that a lack of time as well as limited training pose challenges to teachers\u0026rsquo; performances in preschool classrooms (Ann, 2019; Kasdiah et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs noted in our current review, the studies on structural quality have indicated that existing classroom environments may be conducive, but differing levels of educators\u0026rsquo; skills and approaches across preschool systems may lead to disparities in children\u0026rsquo;s performance (Ompok et al., 2016). Future studies seeking to address this gap may refer to a previously published paper by Ha and colleagues (2024) on assessing process quality, which included a table of existing frameworks within which to further this inquiry.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eLack of integrated assessment of child outcomes\u003c/h2\u003e \u003cp\u003eAddressing RQ1 and RQ2, a key finding of our review is that though papers included cover a wide range of child outcomes and aspects of ECE provision in Malaysia, these domains were largely examined in isolation. The focus of each study broadly aligns with the six interrelated learning strands outlined in Malaysia\u0026rsquo;s national preschool curriculum: communication, spirituality and values, social understanding, physical development and aesthetics, science and technology, and personal competence. However, few studies considered how these domains may intersect in theory and practice. Integrated assessments of developmental outcomes remain rare, with only two studies in the review examining multiple skill domains concurrently (Kong et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024a\u003c/span\u003e; Kong et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2024b\u003c/span\u003e). Notably, one of the studies illustrates the importance of such an approach: the same predictor variable - duration of ECE participation, was associated with contrasting outcomes. While longer ECE attendance was linked to improved language and literacy skills (p = .016), it was also associated with poorer socio-emotional outcomes (p = .004). These findings underscore the need for more holistic evaluation frameworks that reflect the multifaceted aims of early education and avoid over-reliance on narrow indicators of success.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section3\"\u003e \u003ch2\u003eFuture directions in system-level and programme-level policies\u003c/h2\u003e \u003cp\u003eThe findings on ECE provision (RQ1) have important implications for system-level policy decisions related to access, enrollment, and resource allocation. Currently, approximately 16\u0026ndash;18% of children in Malaysia remain unenrolled in any form of early childhood education. We propose that the evidence reviewed here raises several policy-relevant questions, including but not limited to the following considerations: Should enrollment in ECE be made mandatory? Should the duration of preschool participation be extended?\u003c/p\u003e \u003cp\u003eWhile the studies reviewed demonstrate positive associations between structural features, such as preschool type, duration of enrollment, and classroom environment, and child outcomes, overall the evidence base remains limited in terms of scope and methodological rigor. The contrasting effects observed for duration of participation (improved literacy but poorer socio-emotional outcomes; Kong et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024a\u003c/span\u003e) suggest that simply expanding access or extending participation may not be sufficient without concurrent attention to quality. This underscores the need for policy decisions to be grounded in more robust, longitudinal research that accounts for potential consequences of system-level changes.\u003c/p\u003e \u003cp\u003eAdditionally, policymakers, planners, and administrators ought to consider the intersecting barriers to ECE access and quality in Malaysia\u0026rsquo;s culturally and religiously diverse context. Reasons for non-enrollment are likely multifaceted, encompassing economic constraints, traditional caregiving practices, and competing family priorities. In families facing socioeconomic disadvantage, fundamental concerns such as food security and physical health may take precedence over formal education. The role of nutrition in early development, as an example, is particularly salient: large-scale studies have reported stunting rates of 16\u0026ndash;21% and underweight rates of 10\u0026ndash;14% among young children in Malaysia (Lee et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Institute for Public Health, MOH Malaysia, 2020). Given the well-established links between early nutritional status and long-term cognitive and educational outcomes (Brown \u0026amp; Pollitt, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e1996\u003c/span\u003e; Glewwe et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2001\u003c/span\u003e), ECE policy must be considered within a broader cross-sectoral framework that integrates health, nutrition, and social protection. Monitoring of system-level progress should therefore include broad indicators such as enrollment rates, years of participation, attendance patterns, and access equity, which should then be disaggregated by ethnicity, socioeconomic status, and urban/rural distinctions.\u003c/p\u003e \u003cp\u003eFindings on instructional interventions (RQ2) offer some guidance for programme-level improvements, which are primarily the responsibility of curriculum developers, teachers, trainers, and school leaders (Melhuish et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The evidence reviewed suggests that certain teaching approaches and targeted interventions can meaningfully improve child outcomes, particularly in literacy and early mathematics. Here, we propose key questions for programme design: Which teaching approaches work best in the Malaysian context? Which intervention modules should be scaled up for wider implementation? How should teacher training be upgraded to support high-quality instruction? Should certain targeted interventions, such as phonological awareness training or game-based mathematics activities, be integrated into the national preschool curriculum?\u003c/p\u003e \u003cp\u003eThe studies reviewed highlight several promising intervention approaches. For literacy, interventions grounded in phonological awareness, structured storytelling, and reading fluency activities consistently demonstrated positive effects. For mathematics, game-based learning approaches showed advantages over traditional worksheet-based instruction. For socioemotional development, structured modules addressing emotional identification, understanding, control, and use showed positive results. However, the variability in intervention design, duration (ranging from 20 minutes to 6 months), and implementation fidelity limits the ability to draw firm conclusions about which specific components are most effective or how they should be adapted for scale.\u003c/p\u003e \u003cp\u003eMonitoring of programme-level effectiveness should rely on child-level outcome measures, such as gains in reading scores, mathematical fluency, creativity, and emotional skills, as well as process measures including fidelity of implementation and teacher competence. Importantly, few studies in this review assessed teacher skills or documented how interventions were actually delivered in practice. Future programme evaluations should therefore include measures of both \u003cem\u003ewhat\u003c/em\u003e is being taught and \u003cem\u003ehow\u003c/em\u003e it is being taught, to better understand the mechanisms through which interventions exert their effects. This may support more targeted professional development, helping to identify where teachers need additional training or resources to implement evidence-based practices effectively.\u003c/p\u003e \u003cp\u003eSuch challenges - balancing access with quality and expanding provision while maintaining instructional effectiveness - are not unique to Malaysia. Evidence from similar low-resource contexts has shown difficulties in ensuring quality alongside increasing access in ECE settings. For instance, studies have highlighted the potential trade-offs between rapid expansion of access and the maintenance of quality (Yoshikawa \u0026amp; Kabay, \u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Initiatives like the Nurturing Care Framework (WHO, 2018) advocate for integrating health, nutrition, social protection, and parental support into early education, particularly for vulnerable populations.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings of this review highlight several critical directions for future research on early childhood education (ECE) and child outcomes in Malaysia, while outlining areas for policy and programme attention. Regarding structural aspects of provision (RQ1), future studies should examine how features such as preschool type, enrollment duration, classroom environment, and teacher qualifications interact to influence outcomes. Crucially, research on process quality, the actual interactions and experiences children have in ECE settings, remains absent and urgently needed. System-level policy decisions regarding mandatory enrollment, duration of participation, funding allocation, and movement toward universal preschool must be informed by more rigorous evidence that accounts for equity, access, and quality simultaneously.\u003c/p\u003e \u003cp\u003eConcerning instructional interventions (RQ2), existing studies demonstrate promising effects across literacy, numeracy, and socioemotional domains. That said, studies would benefit from examining potential mediating and moderating mechanisms that link ECE provision to developmental outcomes, such as caregiver engagement, classroom quality, or child temperament, as these pathways remain underexplored in the current literature. Additionally, more integrated assessments that examine multiple developmental domains concurrently can help avoid over-reliance on narrow indicators of success. Programme-level improvements should be guided by evidence on which teaching approaches are most effective, how teacher training can be upgraded, and which targeted interventions merit integration into the national curriculum.\u003c/p\u003e \u003cp\u003eThe methodological limitations (RQ3) identified in this review, including a predominance of quasi-experimental designs, short intervention durations, lack of longitudinal follow-up, and limited control for confounding variables, warrants caution for any sort of causal inference. There is an urgent need for more longitudinal research to capture the sustained impact of ECE interventions over time in Malaysia. This is particularly important given evidence of \u0026ldquo;fade-out effects\u0026rdquo;, where initial gains from early interventions diminish as children progress through the education system. Future work should prioritise rigorous, theory-driven designs such as the Response to Intervention (RTI) framework, which embeds continuous assessment and allows for data-driven adaptation of support.\u003c/p\u003e \u003cp\u003eFinally, few studies systematically account for the role of ethnic and socioeconomic diversity, despite their known influence on access, uptake, and effectiveness of ECE. This is an especially salient perspective in the Malaysian context, which is multi-ethnic and multi-cultural. Future work should therefore prioritise disaggregated analyses to better understand for whom and under what conditions ECE is most beneficial. By addressing these gaps at both the system and programme levels, future research can offer more robust, context-sensitive evidence to inform equitable and effective ECE policy and practice.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJ.A.H and A.C. conducted the screening. J.A.H. wrote the main manuscript text. A.C. finalised supplementary materials and provided editing and reviewing. K.K. assisted with conceptualisation and final reviewing. All authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbd Rahim, M. H., Ibrahim, M. I., Ab Rahman, A., Yaacob, N. M., Hashim, \u0026amp; N.S.F. (2023). Emotional and bahavioral problems among preschool children in Northeast Peninsular Malaysia: Parent report version. \u003cem\u003eHealthcare\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e, 1828. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/https://doi.org/10.3390/healthcare11131828\u003c/span\u003e\u003cspan address=\"10.3390/healthcare11131828\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdul Rahman, M., Tham, K., \u0026amp; Liu, C. (2023). 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Paper commissioned for the EFA Global Monitoring Report 2015, Education for All 2000\u0026ndash;2015: achievements and challenges.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"early childhood provisions, intervention, Malaysia, preschool","lastPublishedDoi":"10.21203/rs.3.rs-8789362/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8789362/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Early childhood education (ECE) is widely recognized as foundational to child development, yet evidence from low- and middle-income countries remains limited. This systematic review synthesizes research on ECE provisions, interventions and child developmental outcomes in Malaysia over the past 25 years. Following PRISMA guidelines, we searched multiple databases and identified 28 studies meeting inclusion criteria. Three research questions guided the review: (1) What are the associations between aspects of ECE provision and child developmental outcomes? (2) What types of instructional interventions have been implemented, and what evidence exists for their effectiveness? (3) What methodological gaps exist in the current literature? Findings indicate consistent positive associations between ECE provision and child outcomes across literacy, numeracy, and socioemotional domains. Structural features such as preschool type, enrolment duration, and classroom environment showed meaningful but under-examined associations with developmental outcomes. Instructional interventions, particularly in literacy and mathematics, demonstrated promising effects. However, the evidence base is constrained by significant methodological limitations, including predominance of quasi-experimental designs, short intervention durations, lack of longitudinal follow-up, and limited control for confounding variables. Notably, no studies examined process quality, and few employed integrated assessments across multiple developmental domains. The review identifies critical directions for future research, including the need for rigorous longitudinal designs, measurement of process quality, holistic evaluation frameworks, and attention to ethnic and socioeconomic diversity. Implications for system-level policy and programme-level practice are discussed. These findings have the potential to inform evidence-based decision-making to enhance both ECE access and quality in Malaysia.","manuscriptTitle":"Early childhood education provisions, interventions, and child outcomes in Malaysia: A 25-year review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-08 17:12:33","doi":"10.21203/rs.3.rs-8789362/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"16acd65d-3ebb-431c-b827-3385ed5dd2ae","owner":[],"postedDate":"March 8th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-19T08:55:36+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-08 17:12:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8789362","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8789362","identity":"rs-8789362","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}