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Stimulation and Early Child Development in China

Caregiving at Arm's Length

Yue, Ai PhD*; Shi, Yaojiang PhD*; Luo, Renfu PhD†,‡; Wang, Boya MS*; Weber, Ann PhD§; Medina, Alexis MA; Kotb, Sarah BA; Rozelle, Scott PhD

Journal of Developmental & Behavioral Pediatrics: May 16, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/DBP.0000000000000678
Original Article: PDF Only

Objective: To provide an empirical overview of the parenting landscape in rural China, focusing on 18- to 30-month-old children and their caregivers in rural Shaanxi province.

Methods: We collected unique data on 1442 caregiver-toddler dyads in rural areas of Shaanxi province and examined caregiver attitudes toward parenting, sources of information about parenting, and interactive parenting practices, and how each of these differed across generations. We measured how parenting attitudes and sources of information informed parenting practices. Finally, we measured levels of child development in our sample and the association between parenting practices and children's developmental outcomes.

Results: Most of the caregivers did not engage with children in a way that encouraged early development. Caregivers rarely told stories, sang, or used toys to play with their children. Grandmothers were more stressed by the children in their care and engaged significantly less than mothers did in the 3 stimulating interactions. Professional sources of information about parenting were underutilized by all caregivers. We found high rates of developmental delay in our sample and showed that these delays were associated with the lack of caregiver engagement.

Conclusion: Our findings suggest that the major economic and social shifts occurring in rural China have not led to a widespread prevalence of stimulative parenting practices. Although caregivers report positive attitudes toward child-rearing, reliable sources of scientific information are lacking. Our results show a troubling generational disconnect between the information-seeking behaviors and parenting practices of rural caregivers.

*Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Xi'an, China;

Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China;

Center for Chinese Agricultural Policy (CCAP), Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China;

§Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA;

Rural Education Action Program (REAP), Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.

Address for reprints: Ai Yue, PhD, CEEE, Shaanxi Normal University, Xi'an 710119, China; e-mail:

The authors acknowledge financial assistance from the 111 project (Grant number: B16031), the National Science Foundation of China (Grant number: 71703083), International Initiative for Impact Evaluation (3ie), and UBS Optimus Foundation.

Disclosure: The authors declare no conflict of interest.

Received June 12, 2018

Accepted March 12, 2019

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