Association of parental verbal responsivity with reduced mental health problems in preschool-aged children: a cross-sectional study of 21,366 dyads in western China

Background Mental health problems affect 7%−18% of preschool-aged children globally, with early interventions crucial for mitigating long-term impacts. Parental verbal responsivity (PVR) is a modifiable factor linked to cognitive and emotional development, yet large-scale studies on its association with mental health in young children remain scarce. Methods This cross-sectional study was conducted between February 28 and March 5, 2025, in a western Chinese city, involving 21,366 parent-child dyads from 189 kindergartens. Parental Verbal Responsivity (PVR) was assessed using the parent-reported StimQ, which measures verbal interactions during daily routines, play, and regulation activities. Child mental health was evaluated via the parent-reported Strengths and Difficulties Questionnaire (SDQ). Multivariable logistic regression models were employed, adjusting for relevant sociodemographic and lifestyle covariates. Results After full adjustment, each unit increase in PVR corresponded to 4% reduced odds of total difficulties (95%CI 0.95–0.96) and 7% increased odds of prosocial behaviors (95%CI 1.06–1.08), both with P < 0.0001 significance. Subgroup analyses revealed effect modifications by parental gender, education, employment status, annual family income, and smoking status and alcohol intake status. Conclusion In this large-scale study, a weak association was found between verbal interaction frequency and child mental health, explaining less than 1% of outcome variance. This highlights the limitation of measuring only interaction frequency and underscores the need for future research to incorporate multi-informant and observational methods to better understand pathways to child mental health.