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Purpose: To explore the accuracy and cost‐effectiveness of three vision screening models among preschool children in rural China. Methods: Vision screening was carried out among children aged 4–5 years in 65 preschools in two counties in Northwest China, using Crowded Single Lea Symbols to test visual acuity. Children were assigned randomly by school to one of three screening models: screening by teachers (15 schools, 1835 children), local optometrists (30 schools, 1718 children) or volunteers (20 schools, 2183 children). Children identifying ≥2 symbols incorrectly in either eye failed screening. Accuracy of screening was compared with screenings executed by experienced optometrists among 141 children selected randomly from the three screening models. Direct and indirect costs for each model were assessed. Costs to detect a true case failed screening were estimated. Results: The sensitivity for three models ranged from 76.9% to 87.5%, specificity from 84.9% to 86.7% and standardized positive predictive value from 83.7% to 85.7%. None differed significantly between models. The costs per case detected were $37.53, $59.14 and $52.19 for the teachers, local optometrists and volunteers. In producing the cost estimates for teacher screening and local optometrist screening models, we used a salary payment that was identical for both models (with the salary being equal to that of the optometrist). The teacher screening model was the most cost‐effective. Conclusion: Accuracy of screening by teachers, local optometrists and volunteers was the same in this setting, but the use of teachers was most cost‐effective, reducing the cost per case detected by almost 40%. [ABSTRACT FROM AUTHOR]

• Home-visiting interventions have positive effects on child cognitive development, parenting beliefs and parenting practices of caregivers in rural China. • Home-visiting interventions have null effects on child social-emotional development in rural China. • Three mechanisms are identified through which interventions are able to raise child cognitive development. • Shifting parenting beliefs; increasing parenting practices; and shifting parenting beliefs thus fostering better parenting practices of primary caregivers are the three mechanisms that are driving our overall results of the impact of home-visiting interventions on early child development. To better understand the impacts of parenting interventions (e.g., parental training of psychosocial stimulating activities) on child developmental outcomes and design effective policies to benefit young children, it is essential to identify the mechanisms through which the interventions work. To this end, this paper presents the results of two randomized controlled trials that offered home visitation, parenting trainings to 435 households (with 527 households as the control group) in 174 villages across three provinces in China. The findings from the randomized controlled trials showed that the interventions significantly improved child cognitive development and had a positive effect on the primary caregivers' parenting practices and their parenting beliefs. The analysis suggests three possible mechanisms through which the parenting interventions affected child cognitive development: changing the parenting beliefs of the primary caregivers, shifting the parenting practices of the primary caregivers, and improving the primary caregivers' parenting beliefs, thus fostering better parenting practices. [ABSTRACT FROM AUTHOR]

Background: Social-emotional development during the first three years of life is associated with later social-emotional development and cognitive development. In rural China, research has found large shares of children under age three are developmentally delayed, yet little is known about the paths of social-emotional development before age 3 or how developmental paths predict later social-emotional skills and cognitive skills.Aims: To investigate the paths of child social-emotional development during ages 0-3 and examine how different paths predict social-emotional development and cognitive development at preschool age.Methods: Three waves of longitudinal panel data from 1245 children in rural Western China was collected. Child social-emotional development was measured by the Ages and Stages Questionnaire: Social-Emotional. Child cognitive development was measured by the Bayley Scales of Infant Development and by the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition. Four paths of child social-emotional development were classified: "never" social-emotionally delayed; "persistently" social-emotionally delayed; "improving," or "deteriorating."Results: 331 (27%) were never social-emotionally delayed; 373 children (30%) were persistently social-emotionally delayed; 149 children (12%) experienced improving social-emotional development; and 392 children (31%) experienced deteriorating social-emotional development. Children who were never social-emotionally delayed or who were on an "improving" path had higher social-emotional development at preschool age (p < .01). Children who were persistently social-emotionally delayed (p < .5) and on a deteriorating path (p < .01) had lower social-emotional development at preschool age. Children on the persistently delay path also were shown to have lower levels of cognitive development at preschool age (p < .01).Conclusions: Different paths of child social-emotional development before age 3 are associated with different social-emotional and cognitive development at preschool age. [ABSTRACT FROM AUTHOR]

• Teacher qualifications are significantly correlated to preschool child development. • Teacher education level is highly associated with preschool child development. • Teacher professional ranking is highly associated with preschool child development. • Teacher experience has no relation to preschool child development. • Teacher training has no relation to preschool child development. In the preschool period, interactions between teachers and children are an essential input for healthy development. However, it is not well understood how the qualifications of preschool teachers contribute to child development during the preschool period, and previous international studies have returned mixed results. We drew on data from a longitudinal study of 1031 preschool children age 49–65 months in rural China to examine the associations between teacher qualifications and the development of preschool children. The findings showed that 36% of preschool children in the sample are developmentally delayed. Overall, teacher qualifications (education level, specialization in early childhood education, professional ranking, experience and training) were significantly associated with preschool-age child developmental outcomes. Teacher professional ranking and educational attainment were positively and significantly correlated with two measures of child language development, but a degree specialized in early childhood education was negatively related to vocabulary acquisition. No significant correlations were found between teacher experience or teacher training and child developmental outcomes. The study concludes that policymakers should encourage highly educated and professionally ranked teachers to serve in rural preschools in order to improve the development of preschool children. [ABSTRACT FROM AUTHOR]