Family ecological influences on early childhood development in Shanghai, China: a cross-sectional study.

BACKGROUND

Studies regarding the prevalence of early childhood development (ECD) delays and comprehensive evidence of family ecological influences in urban regions of China are scarce. We aimed to include multilevel factors in Bronfenbrenner's family ecosystem model and examine the effect of each factor on ECD among 1-36-month-old children.

METHODS

A questionnaire was designed to collect demographic characteristics and family ecological factors from the microsystem and exosystem. The questionnaires were distributed online to caregivers in Shanghai from February 6, 2022, to March 29, 2024.

RESULTS

A total of 557 questionnaires were distributed, and 534 valid responses were obtained. In total, 16.7% of children confirmed developmental delay in at least one developmental domain. Boys, children born prematurely with oxygen supplementation, those with fewer child books, parents with lower marital happiness, less frequent parent-child activities, mothers' screen use and associated neglect, and poorer family functioning were risk factors for early developmental delays, particularly affecting language, problem-solving, personal-social, and social-emotional domains.

CONCLUSION

Children aged 1-36 months in Shanghai face a severe risk of ECD delays. The identified family ecological factors, as conceptualized within the family ecosystem theory and the Nurturing Care Framework, are measurable and may represent potential targets for early identification and intervention.