Early Childhood Development
Authors
Heather Rahimi
Hanwen Zhang
News Type
News
Date
Paragraphs

On March 27–29, 2026, researchers, policymakers, and practitioners from across China, the United States, and Europe gathered at the Irish College Leuven for the third annual International Symposium on Early Childhood Development in Rural China. Co-sponsored by KU Leuven and the Stanford Rural Education Action Program (REAP), the three-day event brought together leading voices in early childhood development (ECD) to cultivate connections, share evidence, exchange perspectives, and explore pathways for scaling effective interventions to improve child development in rural communities.

Presentations and discussions over the two days coalesced around several interconnected themes: reaching families through China's existing primary healthcare infrastructure, supporting the caregivers at the heart of child development, scaling proven interventions through technology and implementation science, and translating research into meaningful policy action.

Reaching Families Through Primary Healthcare


China's primary healthcare system is both far-reaching and well-structured, and a growing body of research suggests it represents one of the most promising vehicles for delivering ECD interventions to families in rural areas. A central thread running through the symposium was that the infrastructure already exists; the challenge lies in making better use of it. This view was echoed by local pediatricians and preventative care representatives among the attendees, who brought frontline perspectives to the conversation.

Presentations from researchers at Shanghai Jiao Tong University explored how caregiver training group activities can be embedded within routine primary child healthcare services, and how digital technologies can be deployed within clinic settings to extend the reach and consistency of ECD support. Research from Zhejiang University complemented this by examining how child growth monitoring, a standard feature of preventive care, can be strengthened as both an evidence base and a practical touchpoint for developmental support.

Not only are preventive care and early intervention more cost-effective than reactive approaches in the long run, but they also provide better safeguards for the wellbeing of mothers and children. China's existing primary care infrastructure has the potential to deliver such preventive care at scale.

Supporting Children by Supporting Caregivers


Another strong theme presented was the importance of directing attention and resources toward caregivers themselves, not only the children in their care. This focus is central to REAP's own intervention work, and it was reflected throughout the symposium's presentations and discussions. Multiple speakers highlighted that the wellbeing, knowledge, and confidence of parents and other caregivers are among the most important determinants of early childhood outcomes.

Importantly, conversations went beyond training primary caregivers of children, who in Chinese households are typically mothers or grandmothers . Speakers discussed how to help different caregivers work together more effectively, and how to bring other family members — especially fathers and other male relatives — more meaningfully into the picture. This broader conception of caregiver support recognizes that child development happens within families and households, not just in the hands of a primary caregiver.

Several presentations underscored the need for integrated approaches that treat caregiver mental health and wellbeing as a core component of ECD programming rather than an afterthought, with evidence suggesting that well-designed interventions can produce durable changes in caregiver behavior and child outcomes. Research on complementary feeding practices added a further dimension, demonstrating how behavioral nudge approaches can shift caregiving practices around infant nutrition. The consistent message across these sessions was that investing in caregivers is investing in children.

Scaling What Works: The Role of Technology and Implementation Science


Perhaps the most forward-looking dimension of the symposium concerned the question of scale. A recurring challenge in ECD research is the gap between what works in controlled settings and what can be sustained and expanded across vast, heterogeneous rural populations. In a country as large as China, even the most cost-effective intervention will fall short of its potential without government funding and commitment to sustain it. Several presentations tackled this challenge directly, with a shared understanding that the responsibility of researchers is not only to develop effective programs, but to build the evidence base that demonstrates their value to policymakers.

Researchers from Stanford University presented findings from  two randomized controlled trials, examining how digital support tools and group parenting models can help upscale parenting interventions while retaining their effectiveness. A presentation from Sean Sylvia at the University of North Carolina, Chapel Hill introduced the Healthy Future Platform, which uses AI-enhanced curriculum delivery to support community health workers. The researchers share the vision that technology can deliver behavioral interventions more consistently and better tailor them to the needs of individuals.

Implementation science featured prominently too, with researchers presenting a framework for evaluating ECD programs not just on their outcomes but on the conditions that enable real-world adoption. Complementing this, cost-effectiveness analysis from researchers at Shanghai Jiao Tong University offered policymakers a concrete basis for prioritizing investments in primary-level ECD support — an increasingly important contribution as the field makes its case for government-backed scale-up.

Policy Dialogue: Building Bridges Between Evidence and Action


The symposium brought together not only academics but analysts from China's National Health Commission and other implementing organizations. This mix of voices gave the event a practical orientation that went beyond the research findings themselves. The participation of government representatives was itself a meaningful signal, reflecting both the importance China places on ECD and a genuine openness to hearing what scientists have to say about how to improve outcomes for young children and their families.

Discussions returned repeatedly to the question of how evidence generated in research settings can be translated into durable government policy and frontline practice. The presence of international participants underscored the global relevance of the questions being asked, and the value of cross-national dialogue in shaping the field.

Looking Ahead


The formal program of the symposium closed on March 28, but conversations continued on March 29 as participants strengthened old friendships and formed new connections on the group visit to Brussels. These conversations reflected a shared recognition that the challenges ahead — scaling proven interventions, sustaining political commitment, and bridging research and practice — require not just strong evidence, but strong networks of people committed to acting on it.



About the Organizers


The Stanford Rural Education Action Program (REAP) conducts research aimed at improving the lives of rural residents in China, with a particular focus on education, health, and early childhood development. KU Leuven is one of Europe's leading research universities and a longstanding partner in international development research.

Hero Image
A group of conference attendees pose in a courtyard raising hand signs that indication 0 to 3. International Symposium on Early Childhood Development in Rural China
All News button
1
Subtitle

The symposium brought together leading voices in early childhood development from across the world to cultivate connections, share evidence, exchange perspectives, and explore pathways for scaling effective interventions to improve child development in rural China.

Date Label
Display Hero Image Wide (1320px)
No
All Publications button
1
Publication Type
Journal Articles
Publication Date
Subtitle

Language development and the home language environment during early childhood are critical for long-term child outcomes. Caregiver mental health may influence early language outcomes directly, but it can also introduce perception bias, which refers to the discrepancies between caregiver self-assessments and the actual status of child language outcomes. This study examines the associations between caregiver mental health symptoms and (1) child language development and home language environment, and (2) caregiver perception bias in self-report assessments of child language development and home language environment. The study recruited 137 rural Chinese households with children aged 16–24 months. Objective measures of child language development and the home language environment were collected using Language Environment Analysis (LENA) technology. Caregiver perception biases were measured by the discrepancies between the objective and caregiver self-report measurements. Results show that caregiver anxiety and stress symptoms were linked to poor child language development, while symptoms of depression and anxiety were associated with less stimulating home language environment. Caregivers with depressive and anxiety symptoms tended to overestimate their children’s language development, and those with depressive symptoms also overestimated their own verbal inputs. These findings call for caution when implementing self-report assessments of early childhood development.

Journal Publisher
Scientific Reports
Authors
Tianli Feng
Hanwen Zhang
Scott Rozelle
All Publications button
1
Publication Type
Journal Articles
Publication Date
Subtitle

The massive flow of migrants from rural to urban areas in China over the past decades has sparked concerns about the development of left-behind children. Drawing on a six-round, longitudinal cohort survey in rural China from 2013 to 2023 that follows children from 6 months to 11 years of age, we analyse the effects of two maternal migration patterns – persistent migration (migration without return) and return migration (migration followed by return) – on the cognitive development and nutrition of left-behind children from infancy to early adolescence. The results show that persistent maternal migration has adverse effects on the cognitive development and increased the BMI of left-behind children. In contrast, maternal migration had no significant effect on either cognitive development or any indicator of nutrition when the mother later returned. Persistent maternal migration had a strong, long-term negative effect on the cognitive development of left-behind children especially when mothers migrate within one or one and a half years after childbirth; maternal migration also had a short-term, negative effect on cognitive development when mothers migrate when the child is between 2 and 3 years old. These effects are likely driven by the lower levels of stimulating parenting practices and dietary diversity provided by the stand-in primary caregivers of left-behind children.

Journal Publisher
World Development
Authors
Scott Rozelle
All Publications button
1
Publication Type
Journal Articles
Publication Date
Subtitle

Purpose: Previous research has found an association between with early childhood development (ECD) and paternal beliefs and evidence suggests that paternal beliefs about their own role in child rearing might affect parental involvement. However, there has been no such empirical study in rural China. This study examines the interrelationships among paternal beliefs, parental involvement and ECD among rural Chinese children.

Design/methodology/approach: Data used for this study were collected from 6-to-42-month-old children and their primary caregivers in southwestern China in 2020. ECD was assessed by the Bayley Scales of Infant and Toddler Development-III. Paternal beliefs were assessed with the Role of the Father Questionnaire. The non-parametric regression methods were used to construct the factor scores of ECD. The ordinary least squares models, the mediation models and the bootstrapping approach were employed to investigate the interrelationships of paternal beliefs, parental involvement and ECD.

Findings: A large share of the sample children displayed delays in cognitive, language and social-emotional development. Paternal involvement significantly mediated the link between paternal beliefs and child cognitive and social-emotional development, while maternal involvement mediated the associations between paternal beliefs and child language and social-emotional development.

Originality/value: This study provides a unique contribution by utilizing unique data fathers' beliefs and their involvement in parenting to investigate the underlying mechanisms of how the role of fathers in parenting can lead to the improvement of early child developmental outcomes. This study also provides the first empirical evidence on the role of paternal beliefs in fostering human capital formation during the early stages of life in rural China. This study suggests that shifting paternal beliefs and improving parental involvement are effective pathways to benefit rural children in their early development.

Journal Publisher
China Agricultural Economic Review
Authors
Scott Rozelle
All Publications button
1
Publication Type
Journal Articles
Publication Date
Subtitle

Background: Poor mental health affects caregivers' parenting practices and threatens the early development of children under 2 years old. This study examined the correlations between caregivers' mental health and parenting practices among 5- to 24-month-old children in rural China.

Methods: Data were collected in two cohorts (October 2022 and March 2023) from 948 households randomly sampled from 120 villages. Dependent variable: parenting practices measured by the Family Care Indicators (FCI). Independent variables: caregiver mental health (DASS-21), perceived social support (MSPSS) and socioeconomic status (SES; household asset index, caregiver education). Models adjusted for child age, child sex, caregiver age and household size, with standard errors clustered at the village level.

Results: Although caregivers provided more play materials for their children compared to previous research, the variety of play materials did not improve. Depressive symptoms among caregivers were associated with inadequate parenting practices, particularly with providing a lower variety of play materials. Both lower SES and more severe caregiver depressive symptoms were linked to less stimulating parenting, whereas higher perceived social support was associated with more stimulating practices and partially attenuated these SES- and mental health–related disparities.

Conclusion: Although rural Chinese caregivers now supply more play materials, limited diversity and widespread caregiver mental health risks persist. Strengthening caregiver mental health and social support could enrich home stimulation and improve early childhood development.

Journal Publisher
Child: care, health and development
Authors
Hanwen Zhang
Scott Rozelle
All Publications button
1
Publication Type
Journal Articles
Publication Date
Subtitle

China’s urbanization has created growing peri-urban communities, where children face challenges to early childhood development (ECD) despite proximity to developed urban areas. Little is known about how the environmental factors of ECD differ between rural migrants and new urban residents. To address this, we sampled 77 peri-urban households with 18–24-month-old Han Chinese children to examine the associations between early cognitive and language development, parental self-efficacy, stimulating parenting practices, and the home language environment measured with Language Environment Analysis (LENA). We find that rural migrants and new urban residents exhibited no significant difference in any child or household characteristic except parental residency. There was no significant difference in the family environment factors or early cognitive or language development, either. However, parental self-efficacy and stimulating parenting practices both predicted better cognitive and language development in rural migrant households, whereas only conversation turn counts predicted better language development in new urban resident households.

Journal Publisher
Applied Developmental Science
Authors
Hanwen Zhang
Scott Rozelle
All Publications button
1
Publication Type
Journal Articles
Publication Date
Subtitle

Background
The quality of parenting can affect the developmental outcomes of young children. This study aims to investigate the associations between parenting quality and the early childhood development of children under age 3 across four major rural subpopulations in China.

Methods
Using a stratified cluster sampling method, 760 children aged 6–36 months and their primary caregivers in four rural subpopulations from four provinces and a metropolis in China were surveyed. Child development was assessed by the Third Edition of the Bayley Scales of Infant and Toddler Development. Parenting quality was measured using the Family Care Indicators. Data were analyzed using descriptive statistics, t-tests, multivariable regression analysis, and linear regression analysis.

Results
Across the four subpopulations, prevalences of delays of the sample children in four domains — cognition, language, social-emotional, and motor development are 52%, 45%, 52%, and 19%, respectively. The proportion of children with any type of delay is 82%, while over half (53%) have delays in at least two areas, and 27% have delays in three or more areas. Child’s mother as the primary caregiver, maternal education levels, and family asset values are all positively associated with the quality of parenting. Notably, low levels of parenting quality in rural China are linked to high rates of developmental delays.

Conclusions
This study demonstrates that the level of parenting quality is significantly associated with early childhood developmental outcomes. Results highlight the need for raising investments in family care to improve early childhood development in different rural subpopulations in China.

Journal Publisher
BMC Psychology
Authors
Scott Rozelle
Authors
Heather Rahimi
News Type
News
Date
Paragraphs

For years the Rural Education Action Program (REAP) has been working to improve early childhood development outcomes across rural China. One of the most impactful programs has been the development and implementation of  REAP’s parenting curriculum and parenting centers. The centers expand upon our parenting curriculum by providing free and accessible spaces where caregivers and their young children can read, play, and explore together using developmentally appropriate toys and books that promote cognitive development. REAP has now supported the development of over 150 centers at county, township, and village levels across multiple provinces. 

Recently, REAP helped establish a parenting center at the Zhengzhou Foxconn Facility serving migrant factory employees and their families. Since opening, the center has already hosted over 10,000 child visits and supported over 350 families. Following the REAP model, this parenting center combines a research-based curriculum for early childhood development with local needs. The new center has received positive media attention across several outlets in China, including Henan DailyGlobal Times, and Zhenggang News. The success of this parenting center introduces new opportunities for future parenting center collaborations that better serve manufacturing communities across China. 
 


Discover more REAP research projects on early childhood development (ECD).

Read More

Scott Rozelle huddles together with two young children around a table looking at a phone screen and pointing to something on the table.
News

Beyond the Ivory Tower: Scott Rozelle Seeks Perspectives on the Ground

Stanford Daily reporter Kayla Chan spotlights Scott Rozelle, REAP Program Director, and the research he has conducted over his 40 years studying agriculture and development in China.
Beyond the Ivory Tower: Scott Rozelle Seeks Perspectives on the Ground
Parents hold two babies while caretaker reads to them.
News

REAP Convenes Second International Symposium on Early Childhood Development

"Advancing Development with 'Children First' Strategy", the second International Symposium on Early Childhood Development, was held in Hangzhou, China on March 27-29, 2025. The symposium gathered over 100 experts from China and abroad to discuss cutting-edge developments, research topics, and practical approaches in early childhood development.
REAP Convenes Second International Symposium on Early Childhood Development
Graphic drawing of children stepping up a rendering of a bar chart projected from a cell phone.
News

Piloting to Policy: REAP Receives Support from the Stanford Impact Labs

With support from the Stanford Impact Labs, the Rural Education Action Program is developing an app-based integrated early childhood development program for rural China.
Piloting to Policy: REAP Receives Support from the Stanford Impact Labs
All News button
1
Subtitle

REAP helped establish a parenting center at the Zhengzhou Foxconn Facility serving migrant factory employees and their families. The center implements a research-based curriculum for early childhood development to better meet local needs. The new center has recently received positive media attention across several outlets in China.

Date Label
All Publications button
1
Publication Type
Journal Articles
Publication Date
Subtitle

The number of acutely food insecure people worldwide has doubled since 2017, increasing demand for early warning systems (EWS) that can predict food emergencies. Advances in computational methods, and the growing availability of near-real time remote sensing data, suggest that big data approaches might help meet this need. But such models have thus far exhibited low predictive skill with respect to subpopulation-level acute malnutrition indicators. We explore whether updating training data with high frequency monitoring of the predictand can help improve machine learning models’ predictive performance with respect to child acute malnutrition by directly learning the dynamic determinants of rapidly evolving acute malnutrition crises. We combine supervised machine learning methods and remotely sensed feature sets with time series child anthropometric data from EWS’ sentinel sites to generate accurate forecasts of acute malnutrition at operationally meaningful time horizons. These advances can enhance intertemporal and geographic targeting of humanitarian response to impending food emergencies that otherwise have unacceptably high case fatality rates.

Journal Publisher
Proceedings of the National Academy of Sciences (PNAS)
Authors
Yanyan Liu
Authors
News Type
News
Date
Paragraphs

This article was published by Stanford Daily. Please click below to read the full article.

All News button
1
Subtitle

Stanford Daily reporter Kayla Chan spotlights Scott Rozelle, REAP Program Director, and the research he has conducted over his 40 years studying agriculture and development in China.

Date Label
Subscribe to Early Childhood Development