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

Abstract

Introduction: Children from low-income families are at increased risk of behavioural problems. However, factors contributing to such problems were not well-understood. This study aims to explore the association between parent, child and family factors and behavioural problems of children from low-income families in Hong Kong. Methodology: A cross-sectional study was conducted on 217 parent-child pairs recruited from two less affluent districts in Hong Kong between March 2016-October 2017. The primary parents were invited to complete a face-to-face questionnaire, which collected: 1) Their child’s behavioural problems using Strength-and-Difficulties-Questionnaire(SDQ), special education needs and physical health ; 2) Their own physical and mental health, stress level using DepressionAnxiety-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 ConflictTactics-Scale-for-Parent-and-Child(CTSPC)-physical assault subscale and neglect potential using CTSPC-neglect subscale; 3) Socio-demographic factors including household income, marital, education and employment status of parents. Multivariable linear regression with backward selection method was adopted to identify the parental and child factors associated child behavioural problems. Results: 114(53%) of the 217 recruited families lived in poverty. 49(23%) were single-parent and 126(58.1%) primary parent were unemployed. Mean age of the children was 10.7 years (standard deviation(SD)=2.0); 114(53%) children were boy. 25(11.5%) and 16(7.4%) children had known Attention-Deficit-Hyperactivity-Disorder(ADHD) and dyslexia, respectively. The mean total-difficulty-score(TDS) measured by SDQ was 10.4(SD=6.0). After adjusting for covariates, younger age of the child(p<0.001), diagnosis of ADHD(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. Conclusions: Parental stress and family disharmony were significant modifiable factors associated with behavioural problems of children from low-income Chinese families, regardless of household income, single-parent, parenting style and physical health of both parent and child. Further longitudinal study to confirm whether the relationship is bidirectional will allow design of an optimal intervention strategy for reducing children’s problematic behaviour.