A Cross Sectional Study of Factors Influencing Severity of Developmental Delay and Its Co Morbidities

Background-Developmental delay (DD) is one of the commonest conditions seen by paediatrician with many preventable factors contributing to it and affecting its long term prognosis.

Aim-To study the factors associated with severity of developmental delay and its co-morbidities.

Methods-162 patients attending the child guidance clinic who fulfilled the inclusion criteria were selected for study by purposive sampling from a tertiary referral centre. Detailed physical and psychological evaluation was done for the patients. Developmental quotient (DQ) was assessed by the clinical psychologist using Denver’s developmental screening test. Comorbidities were assessed. Data, thus obtained was statistically evaluated.

Results and discussion- Of the 162 patients studied, the diagnosis was mild DD in 50.61%; moderate DD in 27.8%; severe DD in 17.9% and profound DD in 4.3%. Majority was less than 20 months age; 1^st or 2^nd  birth order; males; coming from a low socioeconomic status; rural, joint family background with low  parental literacy; product  of consanguineous, full term spontaneous vaginal delivery. Age of child and Mothers literacy was significantly associated with DQ of the child. Perinatal factors of statistical significance included neonatal seizures(NNS), neonatal jaundice(NNJ), septicaemia. NNS and HIE were significantly correlated with seizures later in life. Co morbidities significantly associated with DD included seizures, Down’s syndrome, cerebral palsy, autism and behavioural problems. Other co-morbidities included microcephaly, hydrocephalus, congenital talipes equno varus, cleft palate, congenital heart disease, visual and hearing impairment.

Limitations-It was a cross sectional hospital based study on a small number of patients. Long term effects of intervention were not studied.

Conclusions and Future directions- Increasing awareness for prevention and early identification with a multi disciplinary approach for the management of the developmentally delayed child will improve the long term prognosis.