Publications

The literature has shown that cognitive and non-cognitive development before the age of three is associated with children’s levels of development at later ages. However, the extent to which the different pathways of cognitive and non-cognitive development before age three (between 6–12 months and 22–30 months of age) are associated with developmental outcomes at primary school age remains unknown. This study aims to examine this research question using three waves of longitudinal data collected from 1087 children aged 9 to 10 years and their primary caregivers in rural China. Results demonstrated four pathways of cognitive and non-cognitive development between 6–12 months and 22–30 months of age. The four pathways include: “never delayed”, “persistently delayed”, “improving”, or “deteriorating.” Children that experienced either persistently delayed or deteriorating development had lower levels of cognitive and non-cognitive development and performed worse academically than children that were never delayed when they were 9–10 years old. Maternal education attainment, family assets, and whether the child was born prematurely all predicted the child’s entry into different developmental pathways. Findings suggest that early childhood development screening and interventions that aim to facilitate healthy early development among children under three years old are needed for rural China’s young children.

Using a longitudinal data set developed from surveys of 1,285 children (and their families), as well as 683 preschools teachers in 382 preschools in rural western China, we examined the association between preschool quality and the development (cognitive and social-emotional skills) of preschool children. The findings showed that 55 % of the sample children were cognitively delayed, and 49 % of the children were social-emotionally delayed at age 3. The rates of delay decreased to less than 40 % when the children were at preschool age. Although other factors were associated with the decline in development delays, according to the findings, preschool attendance respectively led to an improvement of 0.47 SD (p = 0.001) in child cognitive development (i.e., the fall in delays). More specifically, the global quality and the structural quality of preschools improved child cognitive development by 0.11 SD (p = 0.001) and 0.09 SD (p = 0.004), respectively. The findings of the subgroup analyses suggested that children from disadvantaged backgrounds benefited more from being able to attend quality preschools. Preschool quality also helped to improve developmental outcomes (cognitive abilities and social-emotional skills): for children that were developmentally delayed before age 3, but not for those children that were not delayed when they were 3 years old; for children with lower educated parents, but not for those with more highly educated parents; for children that were from relatively poor families, but not for those that were from relatively rich families; and for children that were attending preschools in rural areas, but not for those who were attending a preschool in an urban area.

Cognitive and social-emotional development in the first three years of life is associated with later skills. However, little is known about the paths of developmental delays in both cognitive and social-emotional skills before age 3 or to what extent these paths predict later developmental outcomes. The aim of this study is to examine the associations between the different paths of developmental delays in both cognitive and social-emotional skills of children before age 3 and the levels of development of the children when they are preschool age. Using a longitudinal data collected at three time points from 1245 children and their caregivers in rural China, we identified four different paths of developmental delays in cognitive and social-emotional before age 3 and examined how these paths are associated with different levels of developmental outcomes at preschool age. We used a non-parametric standardization approach and an ordinary least squares model to perform our analyses. Findings show that rates of developmental delays in either cognitive or social-emotional domain or both domains are high at all different time points, ranging from 20% to 55% for cognitive delays and 42% to 61% for social-emotional delays. Over half of children experienced deteriorating levels of either cognitive or social-emotional development before age 3. A large share of children was found to be persistently delayed in either domain. Only a small share of children raised their levels of development in either domain before age 3. In addition, we identified certain socioeconomic status of the family that are associated with never or deteriorating path of child developmental delays. More importantly, we revealed that different paths of developmental delays before age 3 have predictive power on different levels of developmental outcomes at preschool age. Our results suggest that actions are needed at the earliest times to improve child development when children are still infants or toddlers.

To better understand the impacts of parenting interventions (e.g., parental training of psychosocial stimulating activities) on child developmental outcomes and design effective policies to benefit young children, it is essential to identify the mechanisms through which the interventions work. To this end, this paper presents the results of two randomized controlled trials that offered home visitation, parenting trainings to 435 households (with 527 households as the control group) in 174 villages across three provinces in China. The findings from the randomized controlled trials showed that the interventions significantly improved child cognitive development and had a positive effect on the primary caregivers’ parenting practices and their parenting beliefs. The analysis suggests three possible mechanisms through which the parenting interventions affected child cognitive development: changing the parenting beliefs of the primary caregivers, shifting the parenting practices of the primary caregivers, and improving the primary caregivers’ parenting beliefs, thus fostering better parenting practices.

Background
Poor development of young children is a common issue in developing countries and it is well established that iron deficiency anemia is one of the risk factors. Research has shown that iron deficiency is a common micronutrient deficiency among children in rural China and can result in anemia. A previous paper using data from the same trial as those used in the current study, but conducted when sample children were younger, found that after 6 months of providing caregivers of children 6–11 months of age free access to iron-rich micronutrient powder (MNP) increased the hemoglobin concentrations (Hb) of their children. However, no effects were found 12 and 18 months after the intervention. The current study followed up the children four years after the start of the original intervention (when the children were 4–5 years old) and aims to assess the medium-term impacts of the MNP program on the nutritional status of the sample pre-school-aged children, including their levels of Hb, the prevalence of anemia, and the dietary diversity of the diets of the children.

Methods
At baseline, this study sampled 1,802 children aged 6–11 months in rural Western China. The intervention lasted 18 months. In this medium-term follow-up study that successfully followed 81% (n = 1,464) of children (aged 49–65 months) from the original study population 4 years after the start of the intervention, we used both intention-to-treat (ITT) effect and average treatment on the treated effect (ATT) analyses to assess the medium-term impacts of the MNP distribution program on the nutritional status of sample children.

Results
The ITT analysis shows that the MNP intervention decreased the prevalence of anemia of young children in the medium run by 8% (4 percentage points, p < 0.1). The ATT analysis shows that consuming 100 (out of 540) MNP sachets during the initial intervention led to a decrease in anemia of 4% (2 percentage points, p < 0.1). Among children with moderate anemia at baseline (Hb < 100 g/L), the intervention reduced the probability of anemia by 45% (9 percentage points, p < 0.1), and, for those families that complied by consuming 100 (out of 540) sachets, a 25% (5 percentage points, p < 0.05) reduction in the anemia rate was found. The MNP intervention also led to a persistent increase in dietary diversity among children that were moderately anemic at baseline. The results from the quantile treatment effect analysis demonstrated that children with lower Hb levels at baseline benefited relatively more from the MNP intervention.

Conclusions
The findings of the current study reveal that the MNP intervention has medium-term effects on the nutritional status of children in rural China. The impacts of the MNP program were relatively higher for children that initially had more severe anemia levels. Hence, the implications of this study are that programs that aim to increase caregiver knowledge of nutrition and improve their feeding practices should be encouraged across rural China. Families, policymakers, and China’s society overall need to continue to pay more attention to problems of childhood anemia in rural areas. This is particularly crucial for families with moderately anemic children at an early age as it can significantly contribute to improving the anemia status of children across rural areas of China.

This paper examines the impact of parental beliefs on child development outcomes (for both cognitive and social–emotional skills) based on a three-wave longitudinal survey in rural China. The survey waves were conducted when the sample children were 18–30 months, 22–36 months, and 49–65 months, respectively. A total of 815 children and their primary caregivers who participated in all three wave surveys were enrolled in this study. Using difference-in-differences and propensity score matching approaches, the results indicate that strengthened parental beliefs have a positive and significant impact on child social–emotional development. Specifically, between the periods of the Wave 1 survey (when children were 18–30 months old) and the Wave 3 survey (when children were 49–65 months old), and between the Wave 2 survey (when children were 22–36 months old) and the Wave 3 survey, strengthened parental beliefs were causally associated with more favorable child social–emotional scores by 0.44 SD (p < 0.01) and 0.49 SD (p < 0.01), respectively. No significant impact, however, was found between the period of the Wave 1 survey and the Wave 2 survey. In contrast, weakened parental beliefs had a negative and significant impact on child social–emotional development. Specifically, weakened parental beliefs were causally associated with worse child social–emotional abilities by 0.35 SD (p < 0.01), 0.30 SD (p < 0.01), and 0.22 (p < 0.05) for the time period of the Wave 1 to Wave 2, Wave 1 to Wave 3, and Wave 2 to Wave 3, respectively. No significant impact of parental beliefs, however, was found on child cognitive development. In addition, the findings of the mediation analysis show that only a marginal impact of parental beliefs on child social–emotional development can be indirectly explained by parental beliefs through parenting practices. This study calls on policy makers to improve parental beliefs and parenting practices in the hope that it will lead to better child development in rural China.

Using a three-wave longitudinal survey conducted in 815 households in rural Western China, this study aims to examine the association between parental self-perception and early childhood development and the mediation effect of parental investment on the association between parental self-perception and child development when the sample children are at different ages in the early childhood (18–30, 22–36, and 49–65 months). The results demonstrate that parental self-perception are positively and significantly associated with child social-emotional development in all three ages of childhood (from 18 to 65 months). Positive and significant association between parental self-perception and child cognitive development is found in the ages from 22 to 65 months. In addition, findings of this study show that parental investment plays a mediating role in the association between parental self-perception and child cognitive development. The study calls on policymakers to help to strengthen parental self-perception and parental investment related to early childhood development, which should result in better child development in rural China.

Background: Social-emotional development during the first three years of life is associated with later social-emotional development and cognitive development. In rural China, research has found large shares of children under age three are developmentally delayed, yet little is known about the paths of social-emotional development before age 3 or how developmental paths predict later social-emotional skills and cognitive skills. 

Aims: To investigate the paths of child social-emotional development during ages 0–3 and examine how different paths predict social-emotional development and cognitive development at preschool age. 

Methods: Three waves of longitudinal panel data from 1245 children in rural Western China was collected. Child social-emotional development was measured by the Ages and Stages Questionnaire: Social-Emotional. Child cognitive development was measured by the Bayley Scales of Infant Development and by the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition. Four paths of child social-emotional development were classified: “never” social-emotionally delayed; “persistently” social-emotionally delayed; “improving,” or “deteriorating.” 

Results: 331 (27%) were never social-emotionally delayed; 373 children (30%) were persistently social-emotionally delayed; 149 children (12%) experienced improving social-emotional development; and 392 children (31%) experienced deteriorating social-emotional development. Children who were never social-emotionally delayed or who were on an “improving” path had higher social-emotional development at preschool age (p < .01). Children who were persistently social-emotionally delayed (p < .5) and on a deteriorating path (p < .01) had lower social-emotional development at preschool age. Children on the persistently delay path also were shown to have lower levels of cognitive development at preschool age (p < .01). 

Conclusions: Different paths of child social-emotional development before age 3 are associated with different social-emotional and cognitive development at preschool age.