Early childhood development and parental training interventions in rural China: a systematic review and meta-analysis

Abstract

IntroductionInadequate care during early childhood can lead to long-term deficits in skills. Parenting programmes that encourage investment in young children are a promising tool for improving early development outcomes and long-term opportunities in low-income and middle-income regions, such as rural China.MethodsWe conducted a systematic review and a meta-analysis to investigate the prevalence of early developmental delays and stimulating parenting practices as well as the effect of parental training programmes on child development outcomes in rural China. We obtained data in English from EconPapers, PubMed, PsycARTICLES, Cochrane Library, Web of Science and Scopus (Elsevier) and in Chinese from China National Knowledge Infrastructure, Wanfang Data and VIP Information. We conducted frequentist meta-analyses of aggregate data and estimated random-effects meta-regressions. Certainty of evidence was rated according to the Grading of Recommendations Assessment, Development and Evaluation approach.ResultsWe identified 19 observational studies on the prevalence of developmental delays and stimulating parenting practices for children under 5 years of age (n=19 762) and ten studies on the impact of parental training programmes on early child development (n=13 766). Children’s risk of cognitive, language and social-emotional delays in the rural study sites (covering 14 provinces mostly in Central and Western China) was 45%, 46%, and 36%, respectively. Parental training programmes had a positive impact on child cognition, language and social-emotional development.ConclusionThere is evidence to suggest that early developmental delay and the absence of stimulating parenting practices (ie, reading, storytelling and singing with children) may be prevalent across rural, low-income and middle-income regions in Central and Western China. Results support the effectiveness of parental training programmes to improve early development by encouraging parental engagement.Trial registration numberThis study was registered with PROSPERO (CRD42020218852).

Impact of Parental Beliefs on Child Developmental Outcomes: A Quasi-Experiment in Rural China

“…Research has shown that there are high rates of cognitive and non-cognitive developmental delays in children under the age 5 in rural China [ 1 , 2 , 3 , 4 ]. According to a systematic review by Emmers et al (2021), nearly 45% and 36% children under age 5 have delays in cognitive and social–emotional skills, respectively [ 5 ]. Due to high brain plasticity in the first years of life, the developmental outcomes at this age are critical to the development of more complex cognitive and social–emotional skills in later childhood and even to the levels of educational attainment and employment in adulthood [ 6 , 7 , 8 , 9 ].…”

“…Unfortunately, studies have shown that parenting practices are poor in rural China when children are under the age of 5 [ 1 , 4 , 5 , 21 , 22 ]. According to the research, only 23% of caregivers read books to their children, and only 25% of caregivers tell stories to their children [ 5 ].…”

“…Unfortunately, studies have shown that parenting practices are poor in rural China when children are under the age of 5 [ 1 , 4 , 5 , 21 , 22 ]. According to the research, only 23% of caregivers read books to their children, and only 25% of caregivers tell stories to their children [ 5 ]. Studies have shown that low levels of interaction between caregivers and their children may be one cause of the high rates of developmental delays seen in young children in rural China [ 1 , 4 ].…”

Impact of an Early Childhood Development Intervention on the Mental Health of Female Caregivers: Evidence from a Randomized Controlled Trial

“…Children in rural areas of China aged 0–3 years are seriously lagging in their development [ 7 , 8 , 9 , 10 ]. The percentage of children with at least one lag in their development of cognitive, language, motor, and social-emotional skills is 86% [ 11 ], and the risk of cognitive, language, motor, and social-emotional delays in children is 53%, 60%, 36%, and 40%, respectively [ 12 ].…”

“…Furthermore, caregivers with poor mental health also have negative impacts on their children in terms of cognitive development, language development, social emotions, adaptability, and behavior [ 19 , 24 , 29 , 30 , 31 , 32 , 33 ]. Some 36–46% of children under the age of five are stunted and have slower early cognitive, language, and social-emotional development in low- and middle-income rural areas of West-central China [ 7 ]. These delays are positively correlated with negative parenting behavior [ 16 , 34 ].…”