Early stimulation and responsive care: A mediator of caregivers' depression on the suspected developmental delay of left-behind children in China

Gege Ma; Mengshi Li; Huifeng Shi; Chang Tan; Chunxia Zhao; Yan Dou; Xiaoqian Duan; Xiaoli Wang; Jingxu Zhang

doi:10.1016/j.jad.2023.08.118

Early stimulation and responsive care: A mediator of caregivers' depression on the suspected developmental delay of left-behind children in China

J Affect Disord. 2023 Nov 15:341:88-95. doi: 10.1016/j.jad.2023.08.118. Epub 2023 Aug 24.

Authors

Gege Ma¹, Mengshi Li¹, Huifeng Shi², Chang Tan¹, Chunxia Zhao³, Yan Dou¹, Xiaoqian Duan¹, Xiaoli Wang⁴, Jingxu Zhang⁵

Affiliations

¹ Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, PR China.
² Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, PR China; Department of Obstetrics and Gynecology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, PR China.
³ Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, PR China; Child Development Research Center, China Development Research Foundation, 136 Andingmenwai Street, Dongcheng District, Beijing 100010, PR China.
⁴ Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, PR China; Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing 100191, PR China.
⁵ Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, PR China; Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing 100191, PR China. Electronic address: jxzhang@bjmu.edu.cn.

PMID: 37633525
DOI: 10.1016/j.jad.2023.08.118

Abstract

Background: Due to multiple factors, left-behind children in rural areas suffer from neurodevelopment delay and their caregivers suffer from depressive symptoms. This study aimed to analyze the effect of caregivers' depressive symptoms on left-behind children's neurodevelopment, with early stimulation and responsive care mediating.

Methods: We conducted a cross-sectional survey in five counties in China. A total of 904 left-behind children aged 0-3 and their primary caregivers were enrolled. The Zung Self-rating Depression Scale (ZSDS) was used to measure caregivers' depressive symptoms. The Ages and Stages questionnaires-third edition (ASQ-3), which contains five domains: communication (CM), gross motor (GM), fine motor (FM), problem-solving (CG), and personal social (PS), was used to screen children for suspected developmental delay (SDD).

Results: 31.4 % of left-behind children suffered from SDD, while 39.7 % of left-behind children's caregivers experienced depressive symptoms. Caregivers' ZSDS scores were positively correlated with the SDD on four domains (FM, GM, CG, and PS), while Early stimulation and responsive care was negatively correlated with the SDD on four domains (CM, FM, CG, and PS).

Limitations: The cross-sectional design limited the ability to ascertain causal relations. Besides, the findings may not be generalized to all regions of China due to the heterogeneity of the study population.

Conclusions: Left-behind children under three years old in rural China were at high risk of SDD, while a substantial proportion of their caregivers had depressive symptoms. Caregivers' depressive symptoms may negatively affect the SDD of left-behind children through caregivers providing less early stimulation and responsive care.

Keywords: Caregivers' depressive symptoms; Early childhood development; Early stimulation and responsive care; Left-behind children; Suspected developmental delay (SDD).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Caregivers*
Child
Child, Preschool
China
Communication
Cross-Sectional Studies
Depression*
Humans