Ill health and developmental delays in Adelaide four-year-old children.

Abstract

Standardized medical, visual, audiometric screening and two developmental tests were carried out on 982 four-year-old children. The aims of the study were to determine the prevalence of functionally important health problems, to compare a comprehensive developmental screening test with a simpler one, to assess observer bias in visual screening, and to measure effects of socio-economic status on health and development. Eighteen per cent had minor problems commonly related to development, nutrition, vision and hearing, requiring counselling and / or observation, 16% had new problems requiring assessment and/or treatment, and 0.9% had a severe handicap. Twenty-five per cent had multiple problems of varying severity. The commonest problems of moderate severity were visual 5.4%, secretory otitis media 6.6%, hearing toss 6.1%, wheezing bronchitis 3%, obesity 5.3%, male urogenital delects 4%, minor heart disease 1.1%, and 4.9% had generalized developmental delay confirmd by psychological assessment (I.Q. 50–90). The shorter test failed to detect delay in many of these. Developmental language disorders were confirmed in 4.6% of the total. Many of the 4.2% with behavioural problems, which were significantly more common in one parent families, also showed developmental delays Orthoptists were more accurate at vision screening than nurses. The increased prevalence of developmental delays and benaviour problems in lower socio-economic groups is significant but, with the exception of obesity, the variations in physical problems are not.