مقاله انگلیسی عوامل متعادل کننده ارتباط میان مراقبت غیر والدینی اوایل دوران کودکی
ABSTRACT
1. Introduction
2. Materials and methods
3. Results
4. Discussion
5. Limitations
Declarations
References
Abstract
Introduction
There is little known about the association between non-parental care in early childhood and attention-deficit/hyperactivity disorder (ADHD) symptoms in preschoolers. Therefore, we examined the association between childcare from grandparents/babysitters during infancy/preschool and ADHD symptoms in preschoolers.
Methods
Using stratified random sampling, we developed a sample comprising 1597 parents of children aged 1.6–7 years who were enrolled in preschool in rural and urban areas of China. Parental reports of ADHD symptoms were assessed using the preschool version of the ADHD Rating scale-IV. A regression analysis was used to examine the association between childcare from grandparents/babysitters and ADHD symptoms.
Results
Childcare from grandparents during infancy was associated with ADHD symptoms in childhood (β = 1.03, P < 0.0001). Significant associations between grandparental care and ADHD symptoms were also observed in children from families with more than one child (β = 0.64, P = 0.0035) and children living in rural areas (β = -0.78, P = 0.0032). A babysitter as the primary child caregiver in preschool was especially strongly correlated with ADHD symptoms in girls (β = 7.95, P = 0.0042). Moreover, region was strong factor associated with ADHD symptoms without adjustment for the non-parental caregivers’ age and education, whereas family income was not strongly associated with ADHD symptoms.
Conclusion
Non-parental caregiving (i.e., from grandparents or babysitters) in early childhood was associated with more ADHD symptoms in children. Certain characteristics in children, such as female gender and the existence of siblings, were stronger moderating factors than were family income and region.
1. Introduction
Attention-deficit/hyperactivity disorder (ADHD), one of the most common childhood brain disorders, is characterized by a persistent pattern of inattention, and impulsivity and hyperactivity [[1]]. The disorder affects approximately 7% of children worldwide [[2]], and the prevalence in preschoolers ranges from 3.3% to 5.4% [[3], [4], [5]]. Both genetic and environmental factors are believed to contribute to ADHD. Among the contributing environmental factors, multiple indicators of psychosocial adversity have been implicated, including poor parenting quality, a poor general home environment, and a low socioeconomic status (SES) [[6], [7], [8]].
Negative early childcare experiences are a risk and a likely causal risk factor for the development of ADHD [[10]]. A hospital-based case-control study conducted in South Africa found that early traumatic life events and non-maternal childcare, included care received at daycare centers and from grandparents, were associated with ADHD symptoms [[11]]. Quasi-experimental studies (based in orphanages) suggested that extreme forms of early deprivation can result in ADHD-type symptoms as well as autism-like symptoms among English and Romanian adoptees [[12], [13], [14]]. However, it remains unclear whether more common types of early experiences, such as non-parental childcare during infancy, are associated with a risk of developing ADHD symptoms.
The non-parental childcare in the present study was narrowly focused on grandparental care and babysitter care at children's personal homes, which are the most common childcare arrangements due to the absence of early childcare systems in China. Our argument of the effect of non-parental care on children's development focused on types of care, quality and quantity of non-parental care, and on the exposure period in early childhood. The present study sought to examine the associations between grandparental/babysitter care in different periods of early childhood and ADHD symptoms.