Abstract:

Objective: To compare the mean scores of norm groups in China and US for children aged 1 to 66 months using Ages and Stages Questionnaires, Third Edition (ASQ-3), and examine the differences in development of young children in these two countries, including a discussion of plausible reasons for these differences. Methods: Parents of children in China norm group completed the pencilpaper version of ASQ-3; and parents of US norm group either completed the pencil-paper version or the web version of ASQ-3. The mean scores of the children aged 1 to 66 months in the two norm groups on five developmental domains (i.e., communication, gross Motor, fine Motor, problem solving, and personal social) were compared. Data were analyzed using SAS 9.3 and MS Excel. Results: China norm group included 4,452 young children, and within each age interval,218 to 227 young children. A sample of 18,572 young children was recruited for US norm group, 352 to 2,088 young children in each age interval. The results showed that the mean scores of the two norm groups were significantly different on11 age intervals (55%) in communication domain. US norm group scored higher than China norm group at 2, 4, 6, 8, and 10 months; there were no major differences between the two groups between12-20 months;and China norm group scored higher between 22-54 months. In gross motor domain, significant differences were found in 15 age intervals (75%). US norm group scored higher than China norm group in age intervals before 20 months; the two groups performed at similar level between 22 and 30 months;and China norm group outperformed US norm group in all age intervals after 33 months. In fine motor domain, the scores of the two norm groups were significantly different in 14 age intervals (70%), and within the 14 age intervals, China norm group scored significantly higher than US norm group only at 54-month age interval. The scores of US norm group were higher than those of China norm group in all age intervals before 24 months. Though the two groups scored at a similar level in age intervals after 24 months, the scores of US norm group were slightly higher. In problem solving domain, significant differences were found in 15 age intervals between the two norm groups (75%), and US norm group scored higher than China norm group in all age intervals except 54 months. In personal-social domain, significant differences were found in 17 age intervals (85%). US norm group performed better than China norm group in the age intervals before 14 months. From 16 to 36 months age intervals, US norm group outperformed China norm group in five age intervals, but China norm group scored higher in the age intervals after 42 months. Conclusion: Young children in China norm group scored significantly lower than their peers in US norm group on ASQ-3 in the age intervals younger than 24 months though their scores increased and eventually were similar or higher than the US norm group at older intervals. It is of great importance to pay close attention to early development of young children, since developmental delays at an early age may have a far more significant impact on the child, family, and our society than we could imagine.