Early Childhood Development
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Parental investment in the home language environment during the earliest years is a critical predictor of early language development. Because most studies investigating the home language environment and child language development have been conducted in Western, high-income, and developed settings, less is known about such environments in low- or middle-income settings. This study was conducted in a peri-urban area in Southwestern China in a sample of 81 rural migrant and urbanized farmer families with children aged 18-24 months. The home language environment was measured using Language Environment Analysis (LENA) recorders and software, while early language development was measured using the MacArthur-Bates Communicative Developmental Inventories expressive vocabulary scale. Findings reveal large and substantial variation in the sample's home language environments and a strong association between the home language environment and child language development. Certain demographic characteristics, such as household resources, maternal employment, and gender, are associated with the home language environment. These findings highlight the needs for interventions specifically targeting the home language environment to improve early language development of young children and for more research on early childhood development in peri-urban China.

Journal Publisher
Early Childhood Research Quarterly
Authors
Tianli Feng
Scott Rozelle
Yue Ma
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Background
Mothers’ perception of infant hunger cues is a critical content of responsive feeding, which is central to the promotion of early childhood development. However, only a few studies have examined responsive feeding in China, especially lacking the studies on perceptions of infant hunger cues. Consider the cultural differences, the aim of this study was to describe the perceptions of infant hunger cues of Chinese mothers for infants aged 3 months, and explore the relationship between maternal perceptions of infant hunger cues and different feeding methods.

Methods
A cross-sectional study was conducted with a sample of 326 mothers of healthy 3-month-old infants, including 188 exclusive breastfeeding (EBF) mothers and 138 formula feeding (FF) mothers. It was implemented in four provincial and municipal maternal and child health hospitals. The mothers’ perceptions of infant hunger cues were surveyed by self-reporting questionnaires. Chi-square tests and logistic analysis were applied to analyze the differences in maternal perceptions of infant hunger cues, including the number of hunger cues and the specific cues, between EBF group and FF group by controlling sociodemographic variables and the daily nursing indicators.

Results
We found that a higher proportion of EBF mothers could perceive multiple hunger cues (≥ 2) than FF mothers (66.5% vs.55.1%). For specific cues, the EBF mothers had higher perceptions of infant’s “hand sucking” (67.6% vs. 53.6%) and “moving head frantically from side to side” (34.6% vs. 23.9%), all p < 0.05. Regression analysis revealed that EBF might support mothers to perceive infant hunger cues than FF mothers, with the number of infant hunger cues (OR = 1.70, 95% CI: 1.01–2.85), “hand sucking” (OR = 1.72, 95% CI: 1.04–2.87), “moving head frantically from side to side” (OR = 2.07, 95% CI: 1.19–3.62). The number of infant hunger cues perceived by mothers was also associated with their educational level and family structure.

Conclusion
EBF mothers of 3-month-old infants may be more likely to perceive infant hunger cues than FF mothers in China. It is necessary to increase the health education about infant hunger and satiety cues to caregivers in China, especially among mothers with lower education levels, mothers living in nuclear families, and FF mothers.

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BMC Public Health
Authors
Scott Rozelle
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Using premier Language Environment Analysis technology to measure and analyze the home language environment, this observational study aims to describe the home language environment and child language ability, drawing on empirical data from 77 households with children aged 18–24 months from rural China. The results show large variation in measures of the home language environment and early language ability, similar to other rural Chinese samples. Results also demonstrate significant correlations between child age and the home language environment, maternal employment and the home language environment, father’s educational attainment and the home language environment, adult–child conversations and early language ability, and child vocalizations and early language ability.

Journal Publisher
Frontiers in Psychology
Authors
Yue Ma
Tianli Feng
Scott Rozelle
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Background
A rich language environment is an important element of a nurturing home environment. Despite their proven importance, vocabulary and conversation have been shown to vary widely across households—even within the same socio-economic class. One significant gap in the existing literature is its nearly exclusive geographic focus on Western and developed settings, with little attention given to poorer communities in lower/middle income countries. The purpose of this study was to empirically illustrate the characteristics of the home language environment in the low SES, non-Western cultural setting of rural China.

Methods
Using Language Environment Analysis (LENA) automated language-analysis system, this study measured the home language environment of 38 children aged 20-27 months in Northwest rural China. Our primary measures of the home language environment were Adult Word Count (AWC), Conversational Turn Count (CTC) and Child Vocalization Count (CVC). Multivariate linear regression models were used to examine the association between home language environment and family/child characteristics, and language skills (Measured by MacArthur-Bates Communicative Developmental Inventory score).

Results
In this paper, by comparison, we found that the home language environment of our rural sample fell far behind that of urban households. We also identify significant, positive correlations between language skills and both AWC and CTC. Our analysis finds no significant correlations between home language environment and family/child characteristics.

Conclusion
In this paper, we present the first ever findings using the LENA system to measure the home language environment of young children from poor rural communities in China. We found that the home language environment of lower-SES household was significantly worse than high-SES households, and demonstrated the importance of the home language environment to language skills, pointing to a need for more high-quality studies of the home language environment in rural China to better understand possible mechanisms behind low levels of parent-child language engagement and ways to improve the home language environment.

Journal Publisher
BMC Public Health
Authors
Yue Ma
Alexis Medina
Scott Rozelle
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Research suggests that elements of the family environment may have significant associations with cognitive and language development outcomes. Less is known, however, about the family environment in peri-urban China, where rates of cognitive and language delay in children aged 0-3 years are as high as 51% and 54%, respectively. Using data collected from 81 peri-urban households with toddlers aged 18-24 months in Southwestern China, this study examines the associations between stimulating parenting practices, the home language environment, and parental self-efficacy, with cognitive and language development. The results indicate that stimulating parenting practices was significantly associated with cognitive development, the home language environment was significantly associated with language development, and parental self-efficacy was significantly associated with cognitive development. The implications of such findings reveal several mechanisms for supporting healthy cognitive and language development among toddlers from peri-urban China.

Journal Publisher
Applied Developmental Science
Authors
Yue Ma
Tianli Feng
Scott Rozelle
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Introduction Millions of young rural children in China still suffer from poor health and malnutrition, partly due to a lack of knowledge about optimal perinatal and child care among rural mothers and caregivers. Meanwhile, there is an urgent need to improve maternal mental health in rural communities. Comprehensive home visiting programmes delivered by community health workers (CHWs) can bridge the caregiver knowledge gap and improve child health and maternal well-being in low-resource settings, but the effectiveness of this approach is unknown in rural China. Additionally, grandmothers play important roles in child care and family decision-making in rural China, suggesting the importance of engaging multiple caregivers in interventions. The Healthy Future programme seeks to improve child health and maternal well-being by developing a staged-based curriculum that CHWs deliver to mothers and caregivers of young children through home visits with the assistance of a tablet-based mHealth system. This protocol describes the design and evaluation plan for this programme.

Methods and analysis We designed a cluster-randomised controlled trial among 119 rural townships in four nationally designated poverty counties in Southwestern China. We will compare the outcomes between three arms: one standard arm with only primary caregivers participating in the intervention, one encouragement arm engaging primary and secondary caregivers and one control arm with no intervention. Families with pregnant women or infants under 6 months of age are invited to enrol in the 12-month study. Primary outcomes include children’s haemoglobin levels, exclusive breastfeeding rates and dietary diversity in complementary feeding. Secondary outcomes include a combination of health, behavioural and intermediate outcomes.

Journal Publisher
BMJ Open
Authors
Alexis Medina
Gary Darmstadt
Huan Wang
Scott Rozelle
Paragraphs

Nearly 120 million children in 37 countries are at risk of missing their measlescontaining vaccine (MCV) shots this year, as preventive and public health campaigns take a back seat to policies put in place to contain coronavirus disease 2019 (COVID-19). In March, the World Health Organization (WHO) issued guidelines indicating that mass vaccination campaigns should be put on hold to maintain physical distancing and minimize COVID-19 transmission. The disruption of immunization services, even for short periods, will lead to more susceptible individuals, more communities with less than the 95% MCV coverage needed for herd immunity, and therefore more measles outbreaks globally. A mere 15% decrease in routine measles vaccinations—a plausible result of lockdowns and disruption of health services—could raise the burden of childhood deaths by nearly a quarter of a million in poorer countries. Solutions for COVID-19, especially among the global poor, cannot include forgoing vaccinations.

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Science Magazine
Authors
Eran Bendavid
Number
2020
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There is general consensus among experts that K-12 schools should aim to reopen for in-person classes during the 2020-2021 school year. Globally, children constitute a low proportion of coronavirus disease 2019 (COVID-19) cases and are far less likely than adults to experience serious illness. Yet, prolonged school closure can exacerbate socioeconomic disparities, amplify existing educational inequalities, and aggravate food insecurity, domestic violence, and mental health disorders. The American Academy of Pediatrics (AAP) recently published its guidance on K-12 school reentry. However, as many school districts face budgetary constraints, schools must evaluate their options and identify measures that are particularly important and feasible for their communities.

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JAMA Pediatrics
Authors
C. Jason Wang
Number
2020
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Background: There is a substantial body of evidence supporting the association between maternal active smoking during pregnancy and child development, but the association between prenatal exposure to environmental tobaccos smoke (ETS) and early child development has not been well documented. This cross-sectional study examines the association between prenatal exposure to ETS and the development of children in their first two years of life. 

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International Journal of Environmental Research and Public Health
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