title: High prevalence of developmental delay among children under three years of age in poverty-stricken areas of China.
abstract: OBJECTIVE
  Poverty and its associated factors put children at risk for developmental delay. The aim of this study was to describe the neurodevelopment of children under three years of age in poverty-stricken areas of China and explore possible associated factors.
  
  
  METHODS
  A cross-sectional survey was conducted among 2837 children aged 1-35 months in poverty-stricken areas of China.
  
  
  METHODS
  Characteristics of the child, caregiver, and family were collected through face-to-face caregiver interviews. Developmental delay was explored with the five-domain, structured, parent-completed Ages and Stages Questionnaire. The Zung Self-rating Depression Scale was used to assess depressive symptoms of the caregivers. The Chi-squared test and multivariate logistic regression analyses were used to explore associated factors.
  
  
  RESULTS
  Of the children, 39.7% (95% confidence interval, 37.9-41.5) had developmental delay in at least one of the five domains. For the domains of communication, gross motor, fine motor, problem solving, and personal-social skills, the prevalence was 11.5%, 18.5%, 21.4%, 18.4%, and 17.9%, respectively. Significant predictors of increased odds of developmental delay included the child having no toys (odds ratio [OR] = 2.31), the caregiver having depression (OR = 2.24), insufficient learning activities (OR = 1.65), and more children in the family (OR = 1.16).
  
  
  CONCLUSIONS
  The high prevalence of developmental delay in children younger than three years in poverty-stricken areas of China and the presence of risk factors for developmental delay such as inadequate learning resources and activities in the home, caregiver depression, and low family income highlight the need for early identification and interventions.
authors: Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
authors: Q W
authors: QW
authors: Wei
authors: Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
authors: J X
authors: JX
authors: Zhang
authors: UNICEF China Office, 12 Sanlitun Rd, Beijing 100600, China.
authors: R W
authors: RW
authors: Scherpbier
authors: UNICEF China Office, 12 Sanlitun Rd, Beijing 100600, China.
authors: C X
authors: CX
authors: Zhao
authors: Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
authors: S S
authors: SS
authors: Luo
authors: Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China. Electronic address: xlwang@bjmu.edu.cn.
authors: X L
authors: XL
authors: Wang
authors: UNICEF China Office, 12 Sanlitun Rd, Beijing 100600, China.
authors: S F
authors: SF
authors: Guo
mesh_terms: D017028:Caregivers / Q000523:psychology; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011203:Poverty; D011204:Poverty Areas; D015995:Prevalence; D012307:Risk Factors
keywords: Developmental delay; Early childhood development; Family environment; Poverty; Primary caregiver