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

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 caregiver 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 study 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 biases were measured by the discrepancies 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 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.