Factors influencing developmental delay among young children in poor rural China: a latent variable approach

OBJECTIVES: The aims of the study were to determine the prevalence of suspected developmental delay in children living in poor areas of rural China and to investigate factors influencing child developmental delay. DESIGN: A community-based, cross-sectional survey was conducted. Eighty-three villages in Shanxi and Guizhou Provinces, China. PARTICIPANTS: A total of 2514 children aged 6–35 months and their primary caregivers. OUTCOME MEASURES: Suspected child developmental delay was evaluated using the Ages & Stages Questionnaires-Chinese version. Caregivers’ education and age, wealth index, child feeding index, parent-child interaction, number of books and Zung Self-Rating Depression Scale were reported by the primary caregivers. Haemoglobin levels were measured using a calibrated, automated analyser. Birth weight was obtained from medical records. RESULTS: Overall, 35.7% of the surveyed children aged 6–35 months demonstrated suspected developmental delay. The prevalence of suspected developmental delay was inversely associated with age, with the prevalence among young children aged 6–11 months being almost double that of children aged 30–35 months (48.0% and 22.8%, respectively). Using a structural equation model, it was demonstrated that caregiver’s care and stimulus factors and child’s haemoglobin level were directly correlated, while caregiver’s sociodemographic factors were indirectly associated with suspected developmental delay. CONCLUSIONS: The prevalence of suspected developmental delay is high in poor rural areas of China, and appropriate interventions to improve child development are needed.