Physical Discipline, Deprivation, and Differential Risk of Developmental Delay Across 17 Countries.

OBJECTIVE Parenting behaviors have largely been studied in isolation with regard to child development in cross-national contexts. We examine and compare the relative strength of association between physical discipline and deprivation with risk for children's socio-emotional and cognitive developmental delay in a cross-national sample. METHOD The sample was drawn from the UNICEF Multiple Indicator Cluster Survey. Analyses used observations with data on parental physical discipline, parenting behaviors associated with deprivation, and child developmental outcomes. The present analysis included 29,792 children aged 36-59 months across 17 countries. Using the Early Child Development Index, risk for cognitive or socio-emotional developmental delay was indicated if a child could not accomplish 2 or more items within that specific sub-domain. Overall risk for delay was indicated if a child was at risk in either sub-domain. Associations between discipline, deprivation and delay were assessed using multivariable logistic regression. RESULTS Five of the seven exposures were associated with risk for overall developmental delay. Physical discipline (OR=1·49 [95% CI 1·39-1·59]; p<0·001) had the largest association with risk for socio-emotional delay. Not having books (OR=1·62 [95% CI 1·42-1·84]; p<0·001) and not counting with the child (OR=1·47 [95% CI 1·32-1·64]; p<0·001) had the largest associations with risk for cognitive delay. CONCLUSION The exposures of physical discipline and deprivation measured here have distinct associations with risk for socio-emotional and cognitive delay cross-nationally. Programmatic and clinical interventions should seek to act on adversities that are relevant to the targeted delay.