Stages Questionnaire Research Articles

Diagnostic accuracy of Ages and Stages Questionnaire, Third Edition to identify abnormal or delayed gross motor development in high-risk infants.

To investigate the diagnostic accuracy of parent-completed Ages and Stages Questionnaire, Third Edition (ASQ-3) to identify abnormal or delayed gross motor development in infants born less than 1000 g or less than 28 weeks gestation. Prospective cohort study of high-risk infants comparing ASQ-3 as the index test with concurrent score on Alberta Infant Motor Scale (AIMS) as the reference standard, at 4-, 8- and 12-month corrected (post-term) age. Reference standard positivity cut-offs were 'Abnormal motor development' (AIMS Clinical Range) and 'Motor delay' (AIMS score >1 SD below mean, not captured in Clinical Range). Participating infants (n = 191) had mean gestational age (95% confidence interval (CI)) 26.8 weeks (26.6-27.1) and mean birthweight (95% CI) 870 g (844-896). AIMS rated 51%, 31% and 23% of infants as having 'Abnormal motor development' and 12%, 28% and 13% with 'Motor delay', at 4, 8 and 12 months, respectively. Diagnostic accuracy of ASQ-3 to identify abnormal motor development was acceptable for older infants only if 'Monitor' cut-off was used: sensitivity (95% CI) 33% (23-44), 86% (73-95) and 80% (63-92) and specificity (95% CI) 84% (74-92), 76% (66-84), and 76% (67-83) at 4, 8 and 12 months, respectively. ASQ-3 sensitivity to identify motor delay was low. ASQ-3 has poor sensitivity to identify abnormal or delayed motor development at 4 months. Using the 'Monitor' cut-off improves the diagnostic accuracy of ASQ-3 for identification of older infants with abnormal motor development who are at high risk of motor disability. However, ASQ-3 has poor sensitivity to identify motor delay. Clinical motor assessment of high-risk infants is recommended, particularly in early infancy.

Looking beyond the neonatal: what does administrative data tell us about the preschool health and developmental outcomes of children exposed to opioids in utero?

BackgroundThe world is facing an opioid epidemic. Children of women who use opioids in pregnancy are difficult to follow-up over long periods using traditional research methods due to the complexity of their lives. Resultingly, we have little robust evidence on their longer-term outcomes. ObjectiveThis study aimed to explore the impact of illicit and prescription opioid exposure in pregnancy on preschool health and developmental outcomes. ApproachData identified 6,408 children (born 2009-2019 in Scotland) exposed to opioids through illicit use and/or medication assisted treatment (MAT), alongside a matched control group (n.19,089). Regression models will examine associations between opioid exposure and key outcomes up to age 5, including the Ages and Stages Questionnaire, accidents and injuries, and chronic health conditions such as asthma, controlling for other risk factors (e.g. alcohol use in pregnancy, gestation). ResultsEarly results indicated differences in neonatal outcomes, with poorer outcomes for the illicit opioid/MAT cohort in terms of being born early, having lower birthweight, length and head circumference, and being more likely to be removed from their mother prior hospital discharge. Modelling of preschool outcomes is underway and will be finished in June 2024. ConclusionsHaving proven that we can identify these children in administrative data, this paper will present cutting-edge data on the impact of exposure to illicit and prescription opioids on preschool outcomes. This will provide robust evidence on these impacts, and highlight where additional support might be required for these children from birth to starting school.

Child protection and developmental trajectories of children who entered care as infants

AbstractInfants have the highest rate of admission into out‐of‐home care in Australia, with rising rates of entry to care occurring around the world. Our previous research identified children who entered care as infants as having high levels of developmental vulnerability. The objective of this study was to determine the child protection and developmental trajectories of children who entered care as infants and whether meeting developmental needs through service provision improves trajectories and outcomes for these children. This is a prospective cohort study using three waves (2011–2016) of survey data from the New South Wales Pathways of Care Longitudinal Study which includes standardised assessments (Age and Stages Questionnaire, Brief Infant Toddler Social Emotional Assessment and the Child Behaviour Checklist), as well as linked administrative child protection and health data. Our findings suggest that children who entered care as infants predominantly remained in the care system and had a high level of developmental vulnerability as infants. A large group had positive physical and cognitive developmental trajectories with service provision increasing over time; however, early service provision is needed. Another group was identified as having early social–emotional concerns and displaying worsening social–emotional trajectories. Intervention for this group is an important priority to reduce risk of ongoing poor mental health outcomes.

Neurodevelopment at age 5.5 years according to Ages & Stages Questionnaire at 2 years’ corrected age in children born preterm: the EPIPAGE-2 cohort study

ObjectiveTo report neurodevelopment at age 5.5 years according to developmental delay screening with the Ages & Stages Questionnaire (ASQ) in late infancy in preterm-born children.DesignPopulation-based cohort study, EPIPAGE-2.SettingFrance, 2011–2017.Participants2504 children...

Comparison of parent or caregiver-completed development screening tools with Bayley Scales of Infant Development: a systematic review and meta-analysis

BackgroundParent/caregiver-completed developmental testing (PCDT) is integral to developmental care in children; however, there is limited information on its accuracy. In this systematic review, we compared the diagnostic accuracy of PCDT...

Perceived autonomy support in individuals with Parkinson’s disease requiring emergency care: a cross-sectional pilot study

BackgroundIndividuals with Parkinson’s disease (PD) report a diminished perceived functional autonomy as their condition progresses. For those seeking emergency care, it is unknown whether the patient-physician relationship is instrumental in respecting patient autonomy. This study evaluated patient autonomy ideals in individuals with PD requiring emergency care and the perceived support for autonomy from emergency department physicians.MethodIndividuals with PD (n = 36, average age 78.1 years) were surveyed using the Ideal Patient Autonomy questionnaire (IPA) and the Health Care Climate Questionnaire (HCCQ). A multivariable regression analysis assessed whether patients’ Hoehn and Yahr stage and IPA questionnaire results predicted HCCQ items.ResultsThe IPA questionnaire revealed that individuals with PD in need of emergency care emphasize the significance of medical expertise (IPA ‘doctor should decide’ theme 0.71) in decision-making and their desire to be fully informed about all potential risks (IPA ‘obligatory risk information’ theme 0.71). The average HCCQ values showed a decreasing trend across Hoehn and Yahr stages 1 to 5: 6.19, 6.03, 5.83, 5.80, and 5.23, respectively. HY scale values also influenced HCCQ items related to the physician’s role.ConclusionIn our cohort, individuals with Parkinson’s disease tend to rely on medical expertise for decision-making and prioritize complete risk information during emergency care. However, this autonomy support diminishes as functional disability levels increase.

The Importance of Follow-Up Visits for Children at Risk of Developmental Delay-A Review.

The group of patients for whom the structured follow-up systems are intended were children born very preterm (<32 weeks gestation) or full-term born children with severe neonatal complications. The methods for monitoring neurodevelopment include the following: The General Movements Assessment (GMA), the Ages and Stages Questionnaire (ASQ-3), the Bayley Scales of Infant and Toddler Development (BSID-4), and the Parent Report of Children's Abilities-Revised (PARCA-R). The results of follow-up visits should be registered. The benefits of follow-up neuromotor development assessments can be observed at school age and even in adulthood.

Association between the third trimester maternal serum metabolome and child growth and development through the first year of life

Evidence suggests that maternal metabolome may be associated with child health outcomes. We analyzed the association between the maternal metabolome between 28–35 gestational weeks and child growth and development during the first year. A prospective cohort of 98 mother–child dyads was followed at birth, 1, 6, and 12 months. Maternal serum samples were collected for targeted LC–MS/MS analysis, which measured 132 metabolites. The child's growth and development were assessed at each time-point. Z-scores were calculated based on WHO growth standards, and the domains of development were assessed using the Ages and Stages Questionnaires (ASQ-3). Multiple linear mixed-effects models were performed and confounders were identified using a Diagram Acyclic Graph. The Benjamini–Hochberg correction was used for multiple comparison adjustments. We found a positive association between lysophosphatidylcholines (14:0; 16:0; 16:1; 17:0; 18:0; 18:1; 18:2; 20:4) with the z-score of weight-for-age, and lysophosphatidylcholines (14:0; 16:0; 16:1; 18:0) and taurine with the z-score of weight-for-length, and lysophosphatidylcholines (14:0; 16:0; 16:1; 17:0; 18:0; 18:1; 18:2; 20:4) and glycine with the z-score of BMI-for-age. The leucine, methionine, tryptophan, and valine were negatively associated with the fine motor skills domain. We observed an association between maternal metabolome and the growth and child's development throughout the first year.

Association between maternal multimorbidity and neurodevelopment of offspring: a prospective birth cohort study from the Japan Environment and Children’s Study

ObjectivesTo investigate the association between multimorbidity during pregnancy and neurodevelopmental delay in offspring using data from a Japanese nationwide birth cohort study.DesignThis study was a prospective birth cohort study.SettingThis study...

Predictive validity of the Standardized Infant NeuroDevelopmental Assessment (SINDA) to identify 4–5 year-old children at risk of developmental delay in a low-risk sample

BackgroundEarly detection of developmental problems is important as it allows for early intervention. Previous studies, in high-risk infants, found high predictive values of atypical scores on the Standardized Infant NeuroDevelopmental Assessment (SINDA) for later neurodevelopmental disorders (i.e., cerebral palsy, intellectual disability). AimsThe present study explored SINDA's predictive values to identify risk of developmental delay at 4–5 years. Study designCohort study. Subjects786 low-risk Dutch children (367 boys; median gestational age: 40 (27–42) weeks; mean birth weight: 3455 (SD 577) grams). Outcome measuresThe SINDA was assessed at 2–12 months and risk of developmental delay was assessed using the Ages and Stages Questionnaire (ASQ) at 4–5 years. SINDA's predictive values were determined for five ASQ domains and the total ASQ score for children at risk of marked (all ASQ domains deviant) and any (one or more ASQ domains deviant) developmental delay. ResultsPresence of one atypical SINDA scale score showed low to moderate sensitivities (12–88 %, depending on the SINDA scale and ASQ domain involved), moderate to high specificities (66–94 %), low positive predictive values (PPVs; 3–16 %), and high negative predictive values (NPVs; 95–100 %) for children at risk of marked and any developmental. Presence of multiple atypical SINDA scale scores predicted deviant ASQ domains slightly better (sensitivities = 11–62 %, specificities = 90–98 %, PPVs = 6–30 %, and NPVs = 95–100 %). ConclusionsIn low-risk infants, SINDA's predictive value is low for detecting children at risk of marked and any developmental delay at 4–5 years, as reflected by the low sensitivities. One of the explanations is the relatively low prevalence of developmental delay in low-risk populations. This might have consequences for the application of the SINDA in general healthcare settings (e.g. child health clinics), but further studies are needed to draw this conclusion.

Infants’ early recovery from sleep disturbance is associated with a lower risk of developmental delay in the Japan Environment and Children’s Study

To examine whether patterns, such as the timings of onset or recovery from sleep disturbance, are associated with later developmental problems, including autism spectrum disorder (ASD). Mothers participating in the Japan Environment and Children’s Study with a child aged 3 years were included in the analyses. Children were assessed for short sleep and frequent awakenings at 1 month, 6 months, and 1 year of age. Developmental problems were evaluated at 3 years of age based on ASD diagnosis and developmental delay, using the Japanese translation of the Ages and Stages Questionnaire (ASQ) 3rd edition. Sleep disturbance patterns were classified by onset age, and developmental problem risks were examined based on onset/recovery ages. Among 63,418 mother-infant dyads, 0.4% of infants were later diagnosed with ASD, and 14.4% had abnormal scores on any ASQ domains. The later the onset of short sleep, the lower the risk of abnormal ASQ scores (RR of short sleep onset at 1 year: 1.41; 6 months: 1.52; 1 month: 1.57). The earlier the infants recovered from short sleep persistence, the lower the risk of developmental delay (RR of remittance of sleep problems identified at 1 month by 6 months: 1.07; 1 year: 1.31; not before 1 year: 1.57). Although not all patterns were significant, later short sleep onset and earlier recovery were associated with lower ASD risk. These findings may have significant implications for future interventions in infant development.

Relationship of nutritional behaviors and parent–child interactions with developmental domains of Iranian toddlers: a cross-sectional study

BackgroundHealth service providers closely monitor the developmental state of toddlers to identify the factors affecting this process because any defect during this period will cause irreversible damage. Therefore, this study investigated the relationship of nutritional behaviors and parent–child interactions with the developmental domains of Iranian toddlers.MethodsThis cross-sectional, descriptive-analytical study was conducted on 341 toddlers aged 12–36 months covered by comprehensive health centers in the south of Tehran in 2021–2022. The participants were selected through single-stage cluster sampling. To this end, 16 comprehensive health centers were randomly selected, and then some of the clients from each center were randomly selected as the sample. The required data were collected through the Ages and Stages Questionnaire (ASQ), the Children’s Eating Behavior Questionnaire (CEBQ), the Child-Parent Relationship Scale (CPRS), and a demographics form. They were then analyzed statistically using descriptive and inferential statistics in SPSS-21, considering a significance level of p < 0.05.ResultsThe results showed that most participants were normal in all developmental domains (communication, gross motor, fine motor, personal-social, and problem-solving), with a mean developmental delay ranging from 1.8 to 7%. The most serious problem of participants requiring medical referral was related to gross motor (7%) with a mean of 54.35 ± 7.28 followed by communication (6.5%) with a mean of 49.41 ± 9.67. The mean nutritional behavior of participants was 77.9 ± 21.7. A significant relationship was found between the nutritional behaviors of participants and the problem-solving domain of development (p = 0.018). The results also indicated a mean parent-child interaction score of 94.26 ± 12.63. There was a significant relationship between parent-child interactions and the communication area of development (p = 0.04).ConclusionSince some areas of toddler development are influenced by children’s nutritional behavior and parent-child interactions, it is necessary to train families to identify, monitor, and correct the factors affecting the development of their children. Health system officials and planners are also recommended to develop interventions to improve the nutritional behaviors of children and parent-child interactions.

The association between overprotective parenting, parental perceptions of child vulnerability and growth and development of children with congenital heart disease

Abstract Background Congenital Heart Disease (CHD) is the most prevalent childhood birth defect, leading to health concerns in growth and development post-surgery. Parents mostly shoulder the responsibility for post-hospitalization care. The chronic nature of caring for a child with CHD induces significant stress, fostering perceptions of the child as highly vulnerable and resulting in overprotective behaviors. These behaviors could restrict the child's developmental opportunities, affecting overall growth and development. Purpose The purpose was to investigate the association between parental perceptions of child vulnerability, overprotective parenting, and growth and development of children with CHD. Methods The study employed a cross-sectional, comparative design. The total sample included 186 [93 CHD and 93 healthy controls] parents and their child aged 1-5 years. Data on parenting practices were gathered using the Child Vulnerability Scale and Parental Protection Scale. Child development was examined using the Ages and Stages Questionnaire-3. Growth and other clinical variables were gathered from the medical records. Data were analyzed using descriptive statistics, correlational and mediation analyses. Results CHD parents exhibited higher overprotective parenting (p=0.008) and perceived their child as more vulnerable (p&amp;lt;0.001) than healthy controls. In CHD, parental perception of child vulnerability was associated with worse gross motor (p=0.010) and problem-solving development (p=0.011), while among the controls, overprotective parenting was negatively associated with height (p=0.027) and weight (p=0.003). The path analyses revealed direct effects but no mediating or moderating effects of perceived child vulnerability and overprotectiveness on growth and development of the child with CHD. Higher parental perceptions of child vulnerability were associated with lower height (b1= -0.253, 95% CI: -0.397 to -0.087) and weight (a2= -0.098, 95% CI: -0.195 to 0.003). The higher the parental stress, the greater the perceptions of child vulnerability were (d1= 0.108, 95% CI: 0.058 to 0.160) and the worse communication skills of the child (cʹ2= -0.250, 95% CI: -0.422 to 0.091). Higher education level of the parents was associated with less perceptions of child vulnerability (d1= -1.562, 95% CI: -2.753 to -0.623), better fine motor development (c2=6.948, 95% CI: 4.137 to 9.552) and less overprotective parenting (f1=-1.874, 95% CI: -3.186 to -0.499). Higher perceptions of child vulnerability were associated with lower personal-social development (b1= -0.378, 95% CI: -0.803 to 0.046). Top of Form. Conclusion Healthcare providers should consider the diverse parental and child factors identified to initiate interventions aimed at parenting practices, realistic perceptions of their child’s condition, and reducing parental stress to optimize growth and development in children with CHD.

Social-emotional problems in 3-to 5-year-old children: a cross-sectional study of highly educated migrants in a Chinese urban area.

Previous research has primarily examined the mental well-being of children from labor migrant families, yet there is a lack of understanding regarding the mental well-being of children from highly educated migrant backgrounds. This study investigated the social-emotional problems of 3-5-year-olds from highly educated migrant families residing in an urban area of China, as well as explored potential differences in demographic variables. A cross-sectional study was conducted in Qiantang District, Hangzhou, China, with 1,494 (53.3% boys) children selected via a convenient sampling method. The Ages & Stages Questionnaires: social-Emotional, Second Edition (ASQ:SE-2) was used to measure social-emotional problems. The results showed that 23.6% of the children were at risk for social-emotional problems. More boys (26.7%) than girls (20.1%) had scores above the cut-off. Additionally, more children in the low socioeconomic status (29.9%) had scores above the cut-off than those in the high socioeconomic status (18.9%). There were three common issues among all age groups: "being more active than others," "excessive attachment to parents," and "being overly friendly with strangers. The social-emotional development of children from highly educated migrant families is a significant aspect that deserves recognition, contributing valuable insights to the existing literature on this topic.

Developmental Outcomes of Traumatic Brain Injury in Infants and Children: A Prospective Study

Abstract Background Traumatic brain injury (TBI) in children is a significant health burden worldwide. Children aged 0 to 4 years have the highest incidence of TBI among the non-elderly. These children suffer from long term neurological deficits that compromise their quality of life and daily living activities. Objective To determine the developmental outcomes of infants and children with TBI. Subjects and Methods A prospective descriptive study on infants and children with TBI was conducted. Developmental outcomes by Age and Stage Questionnaire 3rd edition (ASQ-3) was assessed twice; once at hospital discharge and another time 3 months later. Further, Bayley scales of infants and toddlers’ development III was assessed only once in the second visit. Results at discharge and follow up were compared and correlated. Results Eighty -five patients were included in the study with 63.5% were males and the median age was 24(12-34) months, range (1- 42 months). There were statistically significant difference between ASQ-3 at discharge and follow up which was higher at follow up than at discharge indicating better developmental outcomes(P &amp;lt; 0.001 for all aspects). Comparison between ASQ-3 (problem solving) and Bayley Scale (cognitive) at follow up shows that there was no statistically significant difference between them with kappa agreement and 95% CI of 0.527 (0.218–0.837). Also, comparison between ASQ-3 (motor) at follow-up and Bayley Scale (motor)at follow up shows that there was no statistically significant difference between them with kappa agreement and 95% CI of 0.285 (0.001 - 0.569). Also, comparison between ASQ-3 (communication) and Bayley Scale (language) at follow up shows that there was no statistically significant difference between them with kappa agreement and 95% CI 0.501 (0.235 - 0.766). this means that both tests were comparable Conclusions ASQ-3 can be used as a screening tool for infants and children after TBI before referral to Bayley scale. Developmental milestones improved at follow up in most infants and children after TBI.

Mortality and neurodevelopmental outcomes at 2years' corrected age of very preterm infants with necrotising enterocolitis or spontaneous intestinal perforation: The EPIPAGE-2 cohort study.

The primary objective was to evaluate the impact of necrotising enterocolitis (NEC) and spontaneous intestinal perforation (SIP) on mortality and neurodevelopmental outcomes at 2years' corrected age (CA) in infants born before 32weeks' gestation (WG). We studied neurodevelopment at 2years' CA of infants with NEC or SIP who were born before 32 WG from the EPIPAGE-2 cohort study. The primary outcome was death or the presence of moderate-to-severe motor or sensory disability defined by moderate-to-severe cerebral palsy or hearing or visual disability. The secondary outcome was developmental delay defined by a score < 2 SDs below the mean for any of the five domains of the Ages and Stages Questionnaire. At 2years' CA, 46% of infants with SIP, 34% of infants with NEC, and 14% of control infants died or had a moderate-to-severe sensorimotor disability (p < 0.01). This difference was mainly due to an increase in in-hospital mortality in the infants with SIP or NEC. Developmental delay at 2years' CA was more frequent for infants with SIP than controls (70.8% vs 44.0%, p = 0.02) but was similar for infants with NEC and controls (49.3% vs 44.0%, p = 0.5). On multivariate analysis, the likelihood of developmental delay was associated with SIP (adjusted odds ratio = 3.0, 95% CI 1.0-9.1) but not NEC as compared with controls. NEC and SIP significantly increased the risk of death or sensorimotor disability at 2years' CA. SIP was also associated with risk of developmental delay at 2years' CA.

Two-Year Outcomes of Umbilical Cord Milking in Nonvigorous Infants

Compared with early cord clamping (ECC), umbilical cord milking (UCM) reduces delivery room cardiorespiratory support, hypoxic-ischemic encephalopathy, and therapeutic hypothermia in nonvigorous near-term and full-term infants. However, UCM postdischarge outcomes are not known. To determine the 2-year outcomes of children randomized to UCM or ECC at birth in the Milking in Nonvigorous Infants (MINVI) trial. A secondary analysis to evaluate longer-term outcomes of a cluster-randomized crossover trial was conducted from January 9, 2021, to September 25, 2023. The primary trial took place in 10 medical centers in the US, Canada, and Poland from January 5, 2019, to June 1, 2021, and hypothesized that UCM would reduce admission to the neonatal intensive care unit compared with ECC; follow-up concluded September 26, 2023. The population included near-term and full-term infants aged 35 to 42 weeks' gestation at birth who were nonvigorous; families provided consent to complete developmental screening questionnaires through age 2 years. UCM and ECC. Ages and Stages Questionnaire, 3rd Edition (ASQ-3) and Modified Checklist for Autism in Toddlers, Revised/Follow-Up (M-CHAT-R/F) questionnaires at ages 22 to 26 months. Intention-to-treat analysis and per-protocol analyses were used. Among 1730 newborns from the primary trial, long-term outcomes were evaluated in 971 children (81%) who had ASQ-3 scores available at 2 years or died before age 2 years and 927 children (77%) who had M-CHAT-R/F scores or died before age 2 years. Maternal and neonatal characteristics by treatment group were similar, with median birth gestational age of 39 (IQR, 38-40) weeks in both groups; 224 infants (45%) in the UCM group and 201 (43%) in the ECC group were female. The median ASQ-3 total scores were similar (UCM: 255 [IQR, 225-280] vs ECC: 255 [IQR, 230-280]; P = .87), with no significant differences in the ASQ-3 subdomains. Medium- to high-risk M-CHAT-R/F scores were also similar (UCM, 9% [45 of 486] vs ECC, 8% [37 of 441]; P = .86). In this secondary analysis of a randomized clinical trial among late near-term and full-term infants who were nonvigorous at birth, ASQ-3 scores at age 2 years were not significantly different between the UCM and ECC groups. Combined with previously reported important short-term benefits, this follow-up study suggests UCM is a feasible, no-cost intervention without longer-term neurodevelopmental risks of cord milking in nonvigorous near-term and term newborns. ClinicalTrials.gov Identifier: NCT03631940.

Effects of Age, Burn, and Amount of Physiotherapy Services on the Developmental Status of Children under 5 Years of Age with Burn Injuries using the Ages and Stages Questionnaire

Effects of Age, Burn, and Amount of Physiotherapy Services on the Developmental Status of Children under 5 Years of Age with Burn Injuries using the Ages and Stages Questionnaire

Impact of family and caregiver factors on development and behaviours in maltreated young children

Introduction: This study aimed to evaluate the prevalence of developmental and emotional/behavioural concerns in maltreated children and to examine the impact of adverse family/caregiver risk factors on these outcomes. Method: We analysed family demographic and baseline data of 132 maltreated children and their caregivers from a family support programme in Singapore. We examined the associations of 3 main risk factors (i.e. caregiver mental health, educational attainment and family socio-economic status [SES]) with developmental/behavioural outcomes using multivariable logistic regression, controlling for caregiver relationship to the child. Caregiver mental health was assessed using the Patient Health Questionnaire 9 (PHQ-9) and General Anxiety Disorder 7 (GAD-7) tools. Developmental/behavioural outcomes were assessed using the Ages and Stages Questionnaires (ASQ-3), ASQ-Social-Emotional (ASQ-SE), and the Child Behaviour Checklist (CBCL). Results: The children ranged in age, from 2 months to 3 years 11 months (median age 1.7 years, interquartile range [IQR] 0.9–2.6). Among caregivers, 86 (65.2%) were biological mothers, 11 (8.3%) were biological fathers, and 35 (26.5%) were foster parents or extended family members. Low family SES was associated with communication concerns on the ASQ-3 (adjusted odds ratio [AOR] 3.04, 95% CI 1.08-8.57, P=0.04). Caregiver mental health concerns were associated with increased behavioural concerns on the CBCL (AOR 6.54, 95% CI 1.83–23.33, P=0.004) and higher scores on the ASQ-SE (AOR 7.78, 95% CI 2.38–25.38, P=0.001). Conclusion: Maltreated children with caregivers experiencing mental health issues are more likely to have heightened emotional and behavioural concerns. Those from low SES families are also at increased risk of language delay, affecting their communication.

Prevalence and socio-economic determinants of growth and developmental delays among Iranian children aged under five years: A cross sectional study

BackgroundThe main cause of growth and development delays remains unknown, but it can occur as an interaction between genetic, environmental, and socio-economic factors.ObjectiveThe aim of the study was to investigate the prevalence and social determinants of growth and developmental delays among children aged under five years in Qazvin, Iran.MethodsA cross-sectional study was conducted between January 2019 to December 2020 with participation of 1800 mothers with children aged 4–60 months who were referred to comprehensive health centers in Qazvin city, Iran. Structural and intermediate social determinants of health were assessed including: parents and children socio-demographic characteristics, families’ living and economic status, parents’ behavioral factors, household food security, mother’s general health, and perceived social support. Children’s growth was assessed based on their anthropometric assessment and their development was assessed using their age-specific Ages and Stages Questionnaire. Data were analyzed using univariable and multivariable logistic regression models using SPSS software version 24 and Stata version 14.ResultsThe prevalence of developmental problems in each domain were 4.28% for personal and social delay, 5.72% for gross motor delay, 6.5% for communication delay, 6.72% for fine motor delay, and 8% for problem-solving delay. The prevalence of weight growth delays was 13.56% and height growth delays was 4.66%. Communication, gross motor, and problem-solving delays were higher among children whose fathers’ smoked cigarettes. Fine motor delays were lower among mothers with education status of high school diploma and university degree vs. the under diploma group. Personal and social delay was significantly higher among families with fair economic status and lower among children when their fathers were employed (vs. unemployed). Weight and height growth delays were higher among mothers who had experienced pregnancy complications and household food insecure families, respectively.ConclusionThere are different predictors of growth and developmental delay problems among Iranian children aged under five years including fathers’ smoking, families’ economic status, and household food insecurity as well as history of mothers’ pregnancy complications. The present study’s findings can be used to screen for at-risk of growth and developmental delays among children and could help in designing and implementation of timely interventions.