ABSTRACT
Background
Early childhood development (ECD) is critical for lifelong outcomes, especially in low- and middle-income countries. The home environment plays a vital role, with high-quality caregiving practices such as reading, storytelling and interactive play strongly linked to developmental outcomes. The family care indicator (FCI) scale, although widely used to assess caregiving quality, may be outdated due to shifts from traditional print materials to digital media in recent years. This study explores how home environment components, especially reading materials and screen usage, affect ECD in rural China and why the FCI may need to be revised in the near future.
Methods
Data were collected from 581 children aged 6–24 months in rural Zhejiang Province in 2024. Child development outcomes were measured using the Bayley Scales of Infant Development, Third Edition, and the home environment was assessed via the FCI, supplemented by questions on caregiver and child screen use and caregivers’ self-efficacy in accessing online parenting resources.
Results
Results show that 40% of children exhibited cognitive delays and 42% language delays, whereas 74% of households lacked magazines or newspapers, and nearly half of caregivers never read books at home. Children were exposed to screens for an average of 22 min per day (SD = 45). The FCI reading material subscale was not significantly associated with developmental outcomes, but when caregivers used educational screen content together with their children, it was positively associated with language development (p < 0.05) and cognitive development (p < 0.10). Caregivers’ own screen use for parenting knowledge showed no significant association, likely due to low self-efficacy in navigating online resources.
Conclusion
Traditional FCI items on books and newspapers have limited predictive value, whereas educationally oriented screen use appears beneficial, suggesting the FCI should be updated to reflect evolving caregiving practices in the digital age.