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[Early childhood development and risk factors in rural China: a cohort study]
1Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an 710119, China.
Insights
Cognitive impairment in rural Chinese children significantly increased with age, with maternal education being a key risk factor. Early childhood development in these areas requires urgent attention, particularly for children of less educated mothers.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Early childhood development is crucial for long-term health and well-being.
- Rural areas in China face unique challenges impacting child development.
- Understanding developmental trajectories and risk factors is essential for targeted interventions.
Purpose of the Study:
- To assess the developmental status of infants and toddlers in rural China.
- To identify risk factors associated with cognitive and psychomotor development.
- To provide data for improving early childhood care in underserved regions.
Main Methods:
- A cohort study involving 603 infants (6-12 months) in rural Shaanxi, China.
- Four phases of data collection (6-30 months) including questionnaires, home visits, lab tests (hemoglobin), and Bayley Scales of Infant and Toddler Development.
- Logistic regression analysis to determine risk factors for developmental impairments.
Main Results:
- Cognitive impairment incidence rose significantly with age, from 13.4% at 6-12 months to 50.4% at 24-30 months.
- Psychomotor impairment incidence decreased with age, from 25.0% at 6-12 months to 11.9% at 24-30 months.
- Maternal education (≤9 years) was a significant risk factor for both cognitive (OR=2.56) and psychomotor (OR=2.64) impairment; growth retardation also impacted psychomotor development (OR=2.95).
Conclusions:
- Early childhood development, particularly cognitive development, is a significant concern in rural Shaanxi.
- Maternal educational background is a critical determinant of child development outcomes.
- Increased attention and targeted interventions are needed for rural Chinese children, especially those from disadvantaged backgrounds.
Abstract:
Objective: To investigate the development status and risk factors of infants and toddlers in rural China. Methods: In this cohort study, 603 infants (6-12 months of age, Phase Ⅰ) in the rural areas of QinLing-Bashan (Qin-Ba) in Shaanxi were recruited in the control group that received no intervention from April 2013 to October 2015. Three follow-up visits were performed every six months (Phase Ⅱ(12-18 months of age), Phase Ⅲ (18-24 months of age) and Phase Ⅳ(24-30 months of age)). In all the 4 phases (Ⅰ-Ⅳ), general data of the children and the families were collected by questionnaires, early childhood growth and development were assessed by door to door visits, children's hemoglobin levels were determined by laboratory tests, and the cognitive and motor development screening was conducted by the Bayley Scales of Infant and Toddler Development. Logistic regression was used to analyze the risk factors affecting the development of infants and toddlers in rural areas and the data were analyzed in terms of risk factors from infants, guardians and family. Results: Phase Ⅱ, Phase Ⅲ and Phase Ⅳ survey recruited 497, 483 and 486 participants respectively. The incidences of cognitive impairment (mental development scores<80) in rural areas of southern Shaanxi were 13.4% (81/603) in Phase Ⅰ(6-12 months), 20.1%(100/497) in PhaseⅡ(12-18 months), 42.9% (207/483) in Phase Ⅲ(18-24 months) and 50.4%(245/486) in Phase Ⅳ(24-30 months) respectively, which showed a significant increase with age (χ(2)=233.40, P<0.01); the incidences of psychomotor impairment (psychomotor development scores<80) of Phase Ⅰ, Phase Ⅱ, Phase Ⅲ and Phase Ⅳ were 25.0% (151/603), 26.8% (133/497), 8.3% (40/483) and 11.9% (58/486), which showed a significant decrease with age (χ(2)=87.08, P<0.01). Multivariate logistic regression analysis showed that the leading risk factor of the cognitive development of 24-30-month-old children was the mothers' poor education background (≤9 years of school education) (OR=2.56, P<0.01), and the main risk factors affecting psychomotor development were the mothers' poor education background (≤9 years of school education) (OR=2.64, P<0.05) and growth retardation (OR=2.95, P=0.07). Conclusions: The early childhood development (especially cognitive development) in the rural areas of Qin-Ba in Shaanxi of China is not optimistic. More attention should be paid to the early childhood development in rural China, especially to the development of children from the mothers with poor education background.
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