Abstract
There is a need for developmental screening that is easily administered in resource-poor settings. We hypothesized that known risk factors would predict failed developmental screening on an adapted screening tool in East African children living in poverty. The sample included 100 healthy Ugandan children aged 6–59 months. We adapted a parent-reported developmental screener based on the Child Development Review chart. The primary outcome was failure to meet age-appropriate milestones for any developmental domain. Venous blood was analyzed for lead, and caregivers completed a demographics questionnaire. We used multivariate logistic regression models to determine if elevated blood lead and stunting predicted failure on the screener, controlling for maternal education level, age in months past the lower bound of the child’s developmental age group, and absence of home electricity. In the sample, 14% (n = 14) of children failed one or more milestones on the screener. Lead levels or stunting did not predict failing the screener after controlling for covariates. Though this tool was feasibly administered, it did not demonstrate preliminary construct validity and is not yet recommended for screening in high-risk populations. Future research should include a larger sample size and cognitive interviews to ensure it is contextually relevant.
Highlights
Worldwide it is estimated that 200 million children under 5 years of age do not reach their developmental potential annually [1]
Failure on the screening tool was negatively correlated with lead levels and positively correlated with stunting; these correlations failed to reach significance and all of the bivariate correlations were close to zero
We applied an adapted and administered screening tool designed to identify developmental milestones of children living in the Katanga urban settlement in Kampala, Uganda
Summary
Worldwide it is estimated that 200 million children under 5 years of age do not reach their developmental potential annually [1]. 80% of children with disabilities live in low- and middle-income countries [2,3]. Known risk factors that are associated with poor developmental outcomes include nutritional stunting, inadequate cognitive stimulation, and lead exposure [4]. Previous studies in Africa reveal that delayed achievement of developmental milestones can be predicted by identifying stunting in high risk populations [5,6,7]. Children who experience poor nutrition early in life are more likely to have growth stunting [8,9]. Stunting in children is known to cause persistent cognitive deficits [10]. The burden of nutritional deficiencies falls heavily on low and middle-income regions; as approximately 90% of Children 2018, 5, 101; doi:10.3390/children5080101 www.mdpi.com/journal/children
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