Publications

Abstract

Background: Positive parental interactions may buffer maltreated children from poor psychosocial outcomes. The study aims to evaluate the associations between various types of maltreatment and psychosocial outcomes in early childhood, and examine the moderating effect of positive parent-child interactions on them.

Methods: Data were from a representative Chinese 6-year-old children sample (n = 17,088). Caregivers reported the history of child maltreatment perpetrated by any individuals, completed the Strengths and Difficulties Questionnaire as a proxy for psychosocial well-being, and reported the frequency of their interactions with children by the Chinese Parent-Child Interaction Scale.

Results: Physical abuse, emotional abuse, neglect, and sexual abuse were all associated with higher odds of psychosocial problems (aOR = 1.90 [95% CI: 1.57-2.29], aOR = 1.92 [95% CI: 1.75-2.10], aOR = 1.64 [95% CI: 1.17-2.30], aOR = 2.03 [95% CI: 1.30-3.17]). Positive parent-child interactions were associated with lower odds of psychosocial problems after accounting for different types of maltreatment. The moderating effect of frequent parent-child interactions was found only in the association between occasional only physical abuse and psychosocial outcomes (interaction term: aOR = 0.34, 95% CI: 0.15-0.77).

Conclusions: Maltreatment and positive parent-child interactions have impacts on psychosocial well-being in early childhood. Positive parent-child interactions could only buffer the adverse effect of occasional physical abuse on psychosocial outcomes. More frequent parent-child interactions may be an important intervention opportunity among some children.

Impact: It provides the first data on the prevalence of different single types and combinations of maltreatment in early childhood in Shanghai, China by drawing on a city-level population-representative sample. It adds to evidence that different forms and degrees of maltreatment were all associated with a higher risk of psychosocial problems in early childhood. Among them, sexual abuse posed the highest risk, followed by emotional abuse. It innovatively found that higher frequencies of parent-child interactions may provide buffering effects only to children who are exposed to occasional physical abuse. It provides a potential intervention opportunity, especially for physically abused children.

Abstract

Background: Developmental language disorder (DLD) is a condition that significantly affects children's achievement but has been understudied. We aim to estimate the prevalence of DLD in Shanghai, compare the co-occurrence of difficulties between children with DLD and those with typical development (TD), and investigate the early risk factors for DLD.

Methods: We estimated DLD prevalence using data from a population-based survey with a cluster random sampling design in Shanghai, China. A subsample of children (aged 5-6 years) received an onsite evaluation, and each child was categorized as TD or DLD. The proportions of children with socio-emotional behavior (SEB) difficulties, low non-verbal IQ (NVIQ), and poor school readiness were calculated among children with TD and DLD. We used multiple imputation to address the missing values of risk factors. Univariate and multivariate regression models adjusted with sampling weights were used to estimate the correlation of each risk factor with DLD.

Findings: Of 1082 children who were approached for the onsite evaluation, 974 (90.0%) completed the language ability assessments, of whom 74 met the criteria for DLD, resulting in a prevalence of 8.5% (95% CI 6.3-11.5) when adjusted with sampling weights. Compared with TD children, children with DLD had higher rates of concurrent difficulties, including SEB (total difficulties score at-risk: 156 [17.3%] of 900 TD vs. 28 [37.8%] of 74 DLD, p < 0.0001), low NVIQ (3 [0.3%] of 900 TD vs. 8 [10.8%] of 74 DLD, p < 0.0001), and poor school readiness (71 [7.9%] of 900 TD vs. 13 [17.6%] of 74 DLD, p = 0.0040). After accounting for all other risk factors, a higher risk of DLD was associated with a lack of parent-child interaction diversity (adjusted odds ratio [aOR] = 3.08, 95% CI = 1.29-7.37; p = 0.012) and lower kindergarten levels (compared to demonstration and first level: third level (aOR = 6.15, 95% CI = 1.92-19.63; p = 0.0020)).

Interpretation: The prevalence of DLD and its co-occurrence with other difficulties suggest the need for further attention. Family and kindergarten factors were found to contribute to DLD, suggesting that multi-sector coordinated efforts are needed to better identify and serve DLD populations at home, in schools, and in clinical settings.

Funding: The study was supported by Shanghai Municipal Education Commission (No. 2022you1-2, D1502), the Innovative Research Team of High-level Local Universities in Shanghai (No. SHSMU-ZDCX20211900), Shanghai Municipal Health Commission (No.GWV-10.1-XK07), and the National Key Research and Development Program of China (No. 2022YFC2705201).

Abstract

Background: The current study aims to investigate the association between the presence of a sibling and early childhood development (ECD). (2) Methods: Data were obtained from a large-scale population-based cohort in Shanghai. Children were followed from three to six years old. Based on birth order, the sample was divided into four groups: single child, younger child, elder child, and single-elder transfer (transfer from single-child to elder-child). Psychosocial well-being and school readiness were assessed with the total difficulties score from the Strengths and Difficulties Questionnaire (SDQ) and the overall development score from the early Human Capability Index (eHCI), respectively. A multilevel model was conducted to evaluate the main effect of each sibling group and the group × age interaction effect on psychosocial well-being and school readiness. (3) Results: Across all measures, children in the younger child group presented with lower psychosocial problems (β = −0.96, 95% CI: −1.44, −0.48, p < 0.001) and higher school readiness scores (β = 1.56, 95% CI: 0.61, 2.51, p = 0.001). No significant difference, or marginally significant difference, was found between the elder group and the single-child group. Compared to the single-child group, the single-elder transfer group presented with slower development on both psychosocial well-being (Age × Group: β = 0.37, 95% CI: 0.18, 0.56, p < 0.001) and school readiness (Age × Group: β = −0.75, 95% CI: −1.10, −0.40, p < 0.001). The sibling-ECD effects did not differ between children from families of low versus high socioeconomic status. (4) Conclusion: The current study suggested the presence of a sibling was not associated with worse development outcomes in general. Rather, children with an elder sibling are more likely to present with better ECD.

Abstract

Importance: Screen time has become an integral part of children's daily lives. Nevertheless, the developmental consequences of screen exposure in young children remain unclear.

Objective: To investigate the screen time trajectory from 6 to 72 months of age and its association with children's development at age 72 months in a prospective birth cohort.

Design, setting, and participants: Women in Shanghai, China, who were at 34 to 36 gestational weeks and had an expected delivery date between May 2012 and July 2013 were recruited for this cohort study. Their children were followed up at 6, 9, 12, 18, 24, 36, 48, and 72 months of age. Children's screen time was classified into 3 groups at age 6 months: continued low (ie, stable amount of screen time), late increasing (ie, sharp increase in screen time at age 36 months), and early increasing (ie, large amount of screen time in early stages that remained stable after age 36 months). Cognitive development was assessed by specially trained research staff in a research clinic. Of 262 eligible mother-offspring pairs, 152 dyads had complete data regarding all variables of interest and were included in the analyses. Data were analyzed from September 2019 to November 2021.

Exposures: Mothers reported screen times of children at 6, 9, 12, 18, 24, 36, 48, and 72 months of age.

Main outcomes and measures: The cognitive development of children was evaluated using the Wechsler Intelligence Scale for Children, 4th edition, at age 72 months. Social-emotional development was measured by the Strengths and Difficulties Questionnaire, which was completed by the child's mother. The study described demographic characteristics, maternal mental health, child's temperament at age 6 months, and mental development at age 12 months by subgroups clustered by a group-based trajectory model. Group difference was examined by analysis of variance.

Results: A total of 152 mother-offspring dyads were included in this study, including 77 girls (50.7%) and 75 boys (49.3%) (mean [SD] age of the mothers was 29.7 [3.3] years). Children's screen time trajectory from age 6 to 72 months was classified into 3 groups: continued low (110 [72.4%]), late increasing (17 [11.2%]), and early increasing (25 [16.4%]). Compared with the continued low group, the late increasing group had lower scores on the Full-Scale Intelligence Quotient (β coefficient, -8.23; 95% CI, -15.16 to -1.30; P < .05) and the General Ability Index (β coefficient, -6.42; 95% CI, -13.70 to 0.86; P = .08); the early increasing group presented with lower scores on the Full-Scale Intelligence Quotient (β coefficient, -6.68; 95% CI, -12.35 to -1.02; P < .05) and the Cognitive Proficiency Index (β coefficient, -10.56; 95% CI, -17.23 to -3.90; P < .01) and a higher total difficulties score (β coefficient, 2.62; 95% CI, 0.49-4.76; P < .05).

Conclusions and relevance: This cohort study found that excessive screen time in early years was associated with poor cognitive and social-emotional development. This finding may be helpful in encouraging awareness among parents of the importance of onset and duration of children's screen time.

Abstract

Previous fNIRS studies have suggested that adult-child cooperation is accompanied by increased inter-brain synchrony. However, its reflection in the electrophysiological synchrony remains unclear. In this study, we designed a naturalistic and well-controlled adult-child interaction paradigm using a tangram solving video game, and recorded dual-EEG from child and adult dyads during cooperative and individual conditions. By calculating the directed inter-brain connectivity in the theta and alpha bands, we found that the inter-brain frontal network was more densely connected and stronger in strength during the cooperative than the individual condition when the adult was watching the child playing. Moreover, the inter-brain network across different dyads shared more common information flows from the player to the observer during cooperation, but was more individually different in solo play. The results suggest an enhancement in inter-brain EEG interactions during adult-child cooperation. However, the enhancement was evident in all cooperative cases but partly depended on the role of participants.