Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Child Care Health Dev. 2024 Jan;50(1):e13145. doi: 10.1111/cch.13145. Epub 2023 Jun 14.
This study aimed to understand the early development and nurturing care environment of children aged 0-6 years in rural China and to evaluate the sex- and age-specific associations of nurturing care environment with child developmental outcomes.
A cross-sectional survey involving 2078 children aged 0-6 years was conducted using a stratified cluster sampling strategy. We used face-to-face interviews to collect information on child, family and nurturing care. The Ages & Stages Questionnaires-Chinese version and ASQ: Social-Emotional were applied to assess children's neuro- and social-emotional development, respectively. Lower neurodevelopmental scores indicate an increased risk for neurodevelopmental delay, and higher social-emotional scores are indicative to a risk of social-emotional problems. The multiple linear regression model examined the associations of nurturing care environments with childhood development.
Among the investigated children, the average age was (42.9 ± 19.8) months and 55.8% were boys; 67.9% of the children had absent fathers because of labour migration and 54.0% had limited access to books and toys. Overall, boys had a lower total neurodevelopmental score than girls; similar gender patterns were also found in the domains of communication, fine motor, problem-solving and person-social. Concurrent absent fathers and limited access to books and toys were significantly associated with reduced neurodevelopmental scores [β - 11.44, 95% CI (-18.20, -4.68)] and increased social-emotional developmental scores [β 5.88, 95%CI (1.35, 10.41)] after controlling for confounding factors. Sex-specific analysis only echoed the results in boys. Additionally, having an absent father and limited access to books and toys was associated with lower neurodevelopmental scores [β - 14.58, 95%CI (-25.41, -3.75)] in children under 3 years of age and higher social-emotional developmental scores among children aged 3-6 years [β 10.66, 95%CI (5.09, 16.24)].
Children, especially boys, with absent fathers due to labour migration have poorer neuro- and social-emotional development. Limited access to books and toys and father absence are linked to the children's developmental delay, especially for those under 3 years of age. Our findings suggest that intervention programs in resource-constrained rural areas are desirable; more importantly, such programs should begin before 3 years of age to achieve a benefit-cost outcome.
本研究旨在了解中国农村 0-6 岁儿童的早期发展和养育环境，并评估养育环境与儿童发展结果的性别和年龄特异性关联。
采用分层聚类抽样策略，对 2078 名 0-6 岁儿童进行了横断面调查。我们使用面对面访谈收集了儿童、家庭和养育方面的信息。采用《年龄与阶段问卷-中文版本》和 ASQ：社会情绪评估儿童的神经和社会情绪发展，神经发育得分越低表示神经发育迟缓的风险增加，社会情绪得分越高表示社会情绪问题的风险增加。多线性回归模型检验了养育环境与儿童发育的关系。
在所调查的儿童中，平均年龄为（42.9±19.8）个月，55.8%为男孩；67.9%的儿童因劳动力迁移而没有父亲，54.0%的儿童很少有机会接触书籍和玩具。总的来说，男孩的总神经发育评分低于女孩；在沟通、精细运动、解决问题和人际交往领域也存在类似的性别模式。在控制了混杂因素后，同时缺失父亲和很少有机会接触书籍和玩具与神经发育评分降低[β-11.44，95%CI（-18.20，-4.68）]和社会情绪发育评分升高[β5.88，95%CI（1.35，10.41）]显著相关。性别特异性分析仅在男孩中反映了这一结果。此外，3 岁以下儿童中父亲缺失和很少有机会接触书籍和玩具与神经发育评分较低[β-14.58，95%CI（-25.41，-3.75）]有关，而 3-6 岁儿童中社会情绪发育评分较高[β 10.66，95%CI（5.09，16.24）]。
由于劳动力迁移而缺失父亲的儿童，尤其是男孩，其神经和社会情绪发育较差。很少有机会接触书籍和玩具以及父亲缺失与儿童发育迟缓有关，尤其是 3 岁以下儿童。我们的研究结果表明，资源有限的农村地区需要开展干预项目；更重要的是，这些项目应在 3 岁之前开始实施，以实现成本效益。
