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Caregiver mental health is associated with early childhood language outcomes and perception bias in rural China
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  • Published: 13 February 2026

Caregiver mental health is associated with early childhood language outcomes and perception bias in rural China

  • Qi Jiang1,
  • Yiwei Qian2,
  • Tianli Feng3,
  • Mengmei Du4,
  • Hanwen Zhang3,
  • Evelyn Zhang3,
  • Sarah-Eve Dill5,
  • Yue Ma3,6 &
  • …
  • Scott Rozelle3 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Health care
  • Psychology

Abstract

Language development and the home language environment during early childhood are critical for long-term child outcomes. Caregiver mental health may influence early language outcomes directly, but it can also introduce perception bias, which refers to the discrepancies between caregiver self-assessments and the actual status of child language outcomes. This study examines the associations between caregivers mental health symptoms and (1) child language development and home language environment, and (2) caregiver perception bias in self-report assessments of child language development and home language environment. The stduy recruited 137 rural Chinese households with children aged 16–24 months. Objective measures of child language development and the home language environment were collected using Language Environment Analysis (LENA) technology. Caregiver perception bias were measured by the descrepency between the objective and caregiver self-report measurements. Results show that caregiver anxiety and stress symptoms were linked to poor child language development, while symptoms of depression and anxiety symptoms were associated with less stimulating home language environment. Caregivers with depressive and anxiety symptoms tended to overestimate their children’s language development, and those with depressive symptoms also overestimated their own verbal inputs. These findings call for caution when implementing self-report assessments of early childhood development.

Data availability

Data and analytic code necessary to reproduce the analyses presented in this paper are available from the first author upon reasonable request. The analyses presented here were not preregistered.

Abbreviations

AWC:

Adult word count

CDI:

MacArthur–Bates Communicative Development Inventory

CTC:

Conversational turn count

CVC:

Child vocalization count

DASS-21:

Depression, Anxiety, and Stress Scale-21

FCI:

Family care indicators

LENA:

Language environment analysis (LENA) technology

LMICs:

Low- and middle-income countries

OLS:

Ordinary least squares

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Acknowledgements

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Funding

This study was supported by private gifts from individual donors. The funders had no role in studydesign, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. School of Public Health, University of California, Berkeley, Berkeley, CA, USA

    Qi Jiang

  2. Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu, Sichuan, China

    Yiwei Qian

  3. Stanford Center on China’s Economy and Institution, Stanford University, Stanford, CA, USA

    Tianli Feng, Hanwen Zhang, Evelyn Zhang, Yue Ma & Scott Rozelle

  4. School of Management and Economics, University of Electronic Science and Technology of China, Chengdu, Sichuan, China

    Mengmei Du

  5. Department of Sociology, Stanford University, Stanford, CA, USA

    Sarah-Eve Dill

  6. Graduate School of Education, Stanford University, Stanford, CA, USA

    Yue Ma

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Contributions

**QJ: ** Conceptualization, Investigation, Methodology, Software, Formal Analysis, Writing- Original draft preparation, Writing- Reviewing and Editing. **YQ: ** Writing- Reviewing and Editing, Methodology, Formal Analysis. **TF** : Investigation. **MD: ** Investigation **. HZ: ** Writing- Reviewing and Editing. **EZ: ** Writing- Original draft preparation. **S-ED: ** Writing- Reviewing and Editing. **YM: ** Conceptualization, Data curation. **SR: ** Conceptualization, Writing- Reviewing and Editing.

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Correspondence to Yiwei Qian.

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The study was approved by the Stanford University Institutional Review Board (Protocol ID 49552). The study was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from the legal guardians or parents prior to data collection. Enumerators introduced the study, allowed time for questions, and used a standardized script in both Mandarin and the Sichuan dialect to obtain consent. Caregivers were made aware that their recordings would be collected and reviewed for research purposes. The caregivers were compensated for their participation in the study with books and educational toys.

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Jiang, Q., Qian, Y., Feng, T. et al. Caregiver mental health is associated with early childhood language outcomes and perception bias in rural China. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39674-2

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  • Received: 20 September 2025

  • Accepted: 06 February 2026

  • Published: 13 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-39674-2

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Keywords

  • Early childhood language development
  • Early childhood language environment
  • Language environment analysis (LENA)
  • Caregiver mental health
  • Rural china
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