Effects of Home Caregiving Quality on the Psychological and Behavioral Development of Vulnerable Children Aged 0-3 Years.

Objective To explore the short-term and long-term effects of caregiving quality on the psychological and behavioral development among children aged 0-3 years. Methods A prospective study design was adopted，and 220 vulnerable children aged 0-3 years and their primary caregivers were recruited from child care facilities and community healthcare service centers in two districts of Shanghai by stratified cluster sampling.Baseline and one-year follow-up surveys were conducted.Chi-square tests and multivariate Logistic regression analyses were conducted to examine the effects of responsive caregiving and parenting behaviors on the psychological and behavioral development of children. Results Children whose caregivers with poorer respect for children's autonomy （OR=0.869，95%CI=0.583-0.920，P=0.031） and poorer caregiving support （OR=0.779，95%CI=0.464-0.912，P=0.020） at baseline had a higher risk of developmental delay in the problem-solving domain.In addition，reduced social stimulation in caregiving was linked to a higher risk of developmental delay in the communication domain （OR=0.885，95%CI=0.852-0.963，P=0.032）.Insufficient caregiving support received by parents increased the risk of fine-motor developmental delay in children （OR=0.794，95%CI=0.653-0.952，P=0.043）.Children who already exhibited developmental delay in communication，fine motor，problem-solving，or personal-social domain at baseline were more likely to experience delay in the same domain at the one-year follow-up （communication：OR=5.988，95%CI=2.344-14.502，P<0.001；fine motor：OR=5.618，95%CI=1.690-22.241，P<0.01；problem-solving：OR=15.152，95%CI=1.854-44.841，P=0.004；personal-social：OR=2.525，95%CI=1.041-6.340，P=0.041）.In contrast，children with normal development at baseline demonstrated substantially lower risks of subsequent developmental delay. Conclusions Early caregiving quality has an immediate effect on children's psychological and behavioral development，and it continues to influence later development through affecting developmental outcomes.