Violent disciplinary behaviors towards left-behind children in 20 counties of rural China

Background: Left-behind children (LBC) are a vulnerable group in rural China, and violent discipline is a noteworthy problem all over the world. However, violent disciplinary behaviors towards LBC had been less studied. This study aimed to explore the associations between left-behind status and violent discipline. Methods: A cross-sectional study with a multistage sampling method was conducted among 3409 children aged 1-4 years in 20 counties of rural China. A structured questionnaire was used to investigate the left-behind status and other characteristics by a face-to-face interview with caregivers. The Child Discipline Module of the 5th Multiple Indicator Cluster Survey was used to assess violent disciplinary behaviors, including only non-violent discipline, psychological aggression, any physical punishment, severe physical punishment, and any violent discipline method. Multivariable logistic regression model was applied to examine the associations between left-behind status and violent discipline. Results: The proportions of LBC with a single parent working outside the home (LBCS) and LBC with both parents working outside the home (LBCB) were 32.4% and 15.2%, respectively. Compared with non-left-behind children (NLBC), LBCS had a higher probability of psychological aggression (adjusted odds ratio [aOR], 1.26; 95% confidence interval [CI]: 1.07-1.48), any physical punishment (aOR, 1.30; 95% CI: 1.10-1.54), and any violent discipline method (aOR, 1.26; 95% CI: 1.05-1.52); LBCB had a higher probability of psychological aggression (aOR, 1.34; 95% CI: 1.06-1.79). No significant difference in violent disciplinary behaviors was observed between LBCS and LBCB. Conclusions: Violent discipline towards LBC was a serious problem in rural China. Future intervention programs for LBC are recommended to focus on these issues.