Achievable Window Research Articles

The study on achievement of motor milestones and associated factors among children in rural North India.

Background:Nearly 14% of children worldwide do not reach their developmental potential in early childhood. The early identification of delays in achieving milestones is critical. The World Health Organization (WHO) has developed normal age ranges for the achievement of motor milestones by healthy children. This study aimed to assess the gross motor developmental achievements and associated factors among children in rural India.Materials and Methods:A cross-sectional study was conducted with rural children in North India. A pretested questionnaire was used to collect the data. The median age at the time of the highest observed milestone was calculated and compared with the WHO windows of achievement.Results:Overall, 221 children aged 4–18 months were included in the study. The median age of motor development exhibited a 0.1–2.1-month delay compared to the WHO median age of motor milestone achievement. The prevalence of the gross motor milestone achievements for each of the six milestones ranged from 91.6% to 98.4%. Developmental delay was observed in 6.3% of the children. After adjusting for different variables, children with birth order of second or more were found to be significantly associated with the timely achievement of gross motor milestones.Conclusion:The apparently healthy children of the rural area of Haryana achieved gross motor milestones with some delay with respect to the WHO windows of achievement. Although the median value of this delay was low, awareness campaigns should be implemented to promote timely identification of children with development delays.

Windows of achievement for development milestones of Sri Lankan infants and toddlers: estimation through statistical modelling.

The normative age ranges during which cohorts of children achieve milestones are called windows of achievement. The patterns of these windows of achievement are known to be both genetically and environmentally dependent. This study aimed to determine the windows of achievement for motor, social emotional, language and cognitive development milestones for infants and toddlers in Sri Lanka. A set of 293 milestones identified through a literature review were subjected to content validation using parent and expert reviews, which resulted in the selection of a revised set of 277 milestones. Thereafter, a sample of 1036 children from 2 months to 30 months was examined to see whether or not they had attained the selected milestones. Percentile ages of attaining milestone were determined using a rearranged closed form equation related to the logistic regression. The parameters required for calculations were derived through the logistic regression of milestone achievement statuses against ages of children. These percentile ages were used to define the respective windows of achievement. A set of 178 robust indicators that represent motor, socio emotional, language and cognitive development skills and their windows of achievement relevant to 2 to 24 months of age were determined. Windows of achievement for six gross motor milestones determined in the study were shown to closely overlap a similar set of windows of achievement published by the World Health Organization indicating the validity of some findings. A methodology combining the content validation based on qualitative techniques and age validation based on regression modelling found to be effective for determining age percentiles for realizing milestones and determining respective windows of achievement.

Greater length-for-age increases the odds of attaining motor milestones in Vietnamese children aged 5-18 months.

Early childhood malnutrition has been associated with delayed development. Limited data exist however about the timing of developmental delay early in life. We assessed motor milestone (MM) achievement using the World Health Organization's windows of achievement for gross motor milestones. We performed secondary analysis of baseline data of 158 Vietnamese children aged 5-18 months from a randomized community intervention trial. Median age of motor milestone achievement was compared to WHO reported medians. Multivariate logistic regression was used to identify socioeconomic, anthropometric and dietary factors associated with motor milestone achievement during the windows of achievement. Thirty four per cent of the children were stunted. Median age of MM achievement of Vietnamese children lagged by 2.4-3.7 months, compared to the WHO median for all MMs. Greater length-for-age increased the odds for walking with assistance, standing alone and walking alone by more than 3 times. Greater weight-for-age increased the odds by 3.6 for hand-and-knees crawling. Likewise, frequency of daily complementary feeding raised the odds by 3.6 for standing with assistance. In this first application of WHO windows of achievement in Viet Nam, pre-schoolers achieved motor milestones later than WHO reported median age. High prevalence of stunting and association of length-for-age with motor milestone achievement underscore the importance of addressing chronic malnutrition to optimize children's growth and development.