Shared reading is associated with fewer emotional/behavioral problems and better prosocial behavior in preschool children: a cross-sectional study in western China

BackgroundThe home literacy environment, particularly shared reading, plays a critical role in preschool children’s cognitive and socioemotional development. However, its associations with emotional and behavioral problems remain underexplored in large-scale studies. This study examined the relationship between shared reading and emotional/behavioral problems as well as prosocial behavior in preschool children.MethodsA cross-sectional study was conducted using stratified cluster sampling across 189 kindergartens in a major city in western China. A total of 21,366 parent-child pairs were included. Shared reading was assessed with the reading subscale of the StimQ-P (score range 0–22), which evaluates quantity, diversity of concepts and content, and interactivity quality. Emotional and behavioral problems were measured using the parent-reported Strengths and Difficulties Questionnaire (SDQ). Multivariate logistic regression and generalized additive models were employed to examine associations, adjusting for child age, gender, parental socioeconomic factors, lifestyle variables, and parental mental health (CES-D).ResultsHigher shared reading scores were significantly associated with lower odds of emotional/behavioral problems (adjusted OR = 0.96 per point increase, 95% CI: 0.95–0.97, P < 0.0001) and higher odds of adequate prosocial behavior (adjusted OR = 1.09, 95% CI: 1.08–1.10, P < 0.0001) in fully adjusted models. All four dimensions of shared reading showed independent associations. Nonlinear analyses revealed threshold effects, with associations becoming stronger above approximately 18 points for total difficulties and 15 points for prosocial behavior. These associations were largely consistent across subgroups after correction for multiple testing.ConclusionIn this large cross-sectional study conducted in western China, higher levels of shared reading were associated with lower odds of emotional/behavioral problems and higher odds of prosocial behaviors among preschool children. The results suggest possible threshold patterns in these associations. However, given the cross-sectional nature of the study, causality cannot be established.