Associations of father absence and limited access to books and toys with early childhood development among children aged 0–6 years in a rural county lifted out of poverty in China.

Objectives: This study aimed to understand the early development and nurturing care environment of children aged 0–6 years in rural China and to evaluate the sex‐ and age‐specific associations of nurturing care environment with child developmental outcomes. Methods: A cross‐sectional survey involving 2078 children aged 0–6 years was conducted using a stratified cluster sampling strategy. We used face‐to‐face interviews to collect information on child, family and nurturing care. The Ages & Stages Questionnaires‐Chinese version and ASQ: Social‐Emotional were applied to assess children's neuro‐ and social–emotional development, respectively. Lower neurodevelopmental scores indicate an increased risk for neurodevelopmental delay, and higher social–emotional scores are indicative to a risk of social–emotional problems. The multiple linear regression model examined the associations of nurturing care environments with childhood development. Results: Among the investigated children, the average age was (42.9 ± 19.8) months and 55.8% were boys; 67.9% of the children had absent fathers because of labour migration and 54.0% had limited access to books and toys. Overall, boys had a lower total neurodevelopmental score than girls; similar gender patterns were also found in the domains of communication, fine motor, problem‐solving and person‐social. Concurrent absent fathers and limited access to books and toys were significantly associated with reduced neurodevelopmental scores [β − 11.44, 95% CI (−18.20, −4.68)] and increased social–emotional developmental scores [β 5.88, 95%CI (1.35, 10.41)] after controlling for confounding factors. Sex‐specific analysis only echoed the results in boys. Additionally, having an absent father and limited access to books and toys was associated with lower neurodevelopmental scores [β − 14.58, 95%CI (−25.41, −3.75)] in children under 3 years of age and higher social–emotional developmental scores among children aged 3–6 years [β 10.66, 95%CI (5.09, 16.24)]. Conclusions: Children, especially boys, with absent fathers due to labour migration have poorer neuro‐ and social–emotional development. Limited access to books and toys and father absence are linked to the children's developmental delay, especially for those under 3 years of age. Our findings suggest that intervention programs in resource‐constrained rural areas are desirable; more importantly, such programs should begin before 3 years of age to achieve a benefit–cost outcome. [ABSTRACT FROM AUTHOR]