The association between parental risks and childhood development: findings from a community-based survey in East China

Abstract

Abstract Background: Nurturing care is necessary for optimal early childhood development. This study aimed to investigate the prevalence of parental risks in rural East China and assess its impacts on the early neurodevelopment of children younger than 3 years old. Methods: A community-based cross-sectional survey was conducted from December 2019 to January 2020 among children aged 0 to 3 years old and their caregivers in four counties of Zhejiang Province, who participated the Early Childhood Development Program (ECD) of China. Face-to-face interviews with the major caregivers were conducted by local child health care providers. Demographic information of the child and caregiver were collected by questionnaire. Parental risk screening was performed for each child through Parental Risk Checklist designed by ECD programme. The Ages and Stages Questionnaire (ASQ) was used to identify children with potential developmental delays. Multinomial logistic regression model and linear trend test were applied to assess the association between parental risks and suspected developmental delays. Results:Among 3852 children surveyed, the percentage of children identified with at least one parental risk was 46.70%. Prevalence of children with at least one domain suspected developmental delays was 9.01% according to ASQ. Parental risk was statistically significantly associated with the overall suspected developmental delay of children aged 0-3 years old (Odd Ratio (OR): 1.36; 95% confidence interval (CI): 1.08, 1.72; P=0.010) after adjusting potential confounders. Respectively, children exposed to 3 or more parental risks had 2.59, 5.76, 3.95, and 2.84 times higher risk of the suspected developmental delay in overall ASQ, communication, problem-solving and personal-social domain than children without any parental risk (P values <0.05). The linear trend tests found that the more parental risk factors, the higher possibility of developmental delay (P values <0.05). Conclusions: Parental risks for children under age 3 are still existing and prevalent in rural East China, which may increase children’s risk of developmental delays. The parental risk screening can be used to recognize poor nurturing care in primary health care settings. Targeted interventions are warranted to improve the nurturing care for optimal early childhood development.