Socioeconomic Status and Child Developmental Delay: A Prospective Cohort Study

Abstract

Background: Children with developmental delays are at higher risk of poor health, and lower educational attainment and wellbeing than the normal ones. Objectives: As previous studies had contradictory results regarding the association between socioeconomic status (SES) and child development, the current study aimed at determining this association at the age of 60 months. Methods: The current prospective cohort study was conducted in Shiraz, Iran, from summer 2011 to the end of 2016. The study was conducted on 640 mothers registered in the Fars Birth Cohort study. A checklist comprised of social and economic parts was employed. The children’s communication development was also assessed using the ages and stages questionnaire for 60-month-old children. In addition, SES was determined using 25 variables. Data analysis was performed using SPSS version 19.0 and partitioning around medoid (PAM) clustering in R 3.5.0 software; P value < 0.05 was considered as the level of significance. Results: The majority of the subjects (79.1%) were categorized as the moderate level of SES; 106 (16.56%) children had a delay in at least one developmental domain. The current study results showed that the education level of parents and the occupational status of mothers were significantly associated with delayed communication skills in children (P < 0.05). Delay in communication skills was significantly more prevalent among children whose parents had a low education level (P < 0.05). After controlling other confounders, the relative risk of delay in communication skills was 3.7 times higher among children in the moderate level of SES and almost 10 times higher among the ones in the low level of SES. Conclusions: Children brought up in families with low SES had the highest level of delay in communication skills, followed by the ones in families with moderate SES. Considering the importance of communication skills in children socialization, more attention should be paid to SES of the families with preschool kids. It seems quite reasonable if health policymakers put more emphasis on the communication skills of preschool children.