Impact of Parent and Child Factors on Behavioural Problems of Children from Low-income Chinese Families

Abstract

Background: Children from low-income families are at increased risk of behavioral problems. However, factors contributing to such problems were not well understood. Objectives: To determine associated parent and child factors on behavioural problems of children from low-income families in Hong Kong. Methods: A cross-sectional study was conducted on 217 parent-child pairs recruited from 2 less affluent districts in Hong Kong between March 2016 and October 2017. The parents were invited to complete a face-to-face questionnaire, which collected: 1) Their child’s behavioural problems using Strength-and-Difficulties-Questionnaire(SDQ), physical health and special education needs; 2) Their own physical and mental health, stress experience using Depression-Anxiety-Stress-Scale(DASS)-21-Stress-subscale, family harmony using Family-Harmony-Scale–5(FHS–5), parenting style using Parenting-Styles-and-Dimensions-Questionnaire(PSDQ), use of physical punishment using Conflict-Tactics-Scale-for-Parent-and-Child(CTSPC)-physical assault subscale and neglect potential using CTSPC-neglect subscale; 3) Socio-demographic factors including household income, marital and employment status of the parents. Multivariable linear regression with backward selection method was adopted to identify the parental and child factors associated child behavior. Results: Among the 217 recruited families, 114(53%) lived in poverty while 49(23%) were single-parent. 114(53%) children were boy, mean age was 10.7 years (standard deviation (SD)=2.0). The mean total-difficulty-score (TDS) measured by SDQ was 10.4(SD=6.0). After adjusting for parental and child factor, younger age of the child (p<0.001), diagnosis of ADHD in the child (p=0.012), higher parental stress (p<0.001), working primary parent (p=0.039) and family disharmony (p=0.042) were significantly associated with increasing behavioural problems of the studied children. Conclusion: Parental stress, parent working status and family disharmony were significant modifiable factors associated with behavioral problems of children from low-income Chinese families, while household income, single-parent, parenting style, physical punishment, neglect and physical health of both parent and child were not. Further longitudinal study to confirm whether the relationship is bi-directional will allow design of an optimal intervention strategy for reducing children’s problematic behaviour.