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Risk Markers for Poor Developmental Attainment in Young Children
Results From a Longitudinal National Survey
Teresa To, PhD;
Astrid Guttmann, MDCM, MSc, FRCPC;
Paul T. Dick, MDCM, MSc, FRCPC;
Jay D. Rosenfield, MD, MEd, FRCPC;
Patricia C. Parkin, MD, FRCPC;
Marjan Tassoudji, MSc;
Tatiana N. Vydykhan, MSc;
Hongmei Cao, MSc;
Jennifer K. Harris, MSc
Arch Pediatr Adolesc Med. 2004;158:643-649.
Objective To evaluate social and environmental determinants of poor developmental attainment among preschool children by means of longitudinal data from a population-based sample of Canadian children.
Design Secondary analysis of data from cycles 1 (1994-1995) and 2 (1996-1997) of the National Longitudinal Survey of Children and Youth using a cohort design with 2-year follow-up.
Participants A total of 4987 children aged 1 to 5 years at baseline, whose biological mother completed risk factor information and who were included in both cycles.
Main Outcome Measures Poor developmental attainment (developing unusually slowly) was defined as scores more than 1 SD below the age-standardized mean for the Motor and Social Development Scale, revised Peabody Picture Vocabulary Test, or Canadian Achievement Tests in mathematics and reading/comprehension, depending on the child's age.
Results The prevalence of sustained poor developmental attainment after 2 years of follow-up was 4.6%. Factors found to be associated with poor developmental attainment included male sex (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.10-1.70), maternal depression (OR, 1.64; 95% CI, 1.25-2.15), low maternal education (OR, 1.57; 95% CI, 1.19-2.08), maternal immigrant status (OR, 1.93; 95% CI, 1.38-2.71), and household low income adequacy (OR, 1.43; 95% CI, 1.11-1.83).
Conclusions Having a mother who has symptoms of depression, has low education, or is an immigrant, and living in a household with low income adequacy increase the risk of poor developmental attainment in children aged 1 to 5 years. The notable risks associated with these factors indicate them as possible targets for screening and interventions to prevent poor developmental attainment.
From the Population Health Sciences Program, Research Institute (Drs To, Guttmann, Dick, and Parkin and Mss Tassoudji, Vydykhan, Cao, and Harris), Division of Paediatric Medicine and the Paediatric Outcomes Research Team (Drs To, Dick, Rosenfield, and Parkin), Brain and Behavioral Program, Research Institute (Dr Rosenfield), and Division of Neurology (Dr Rosenfield), The Hospital for Sick Children, Toronto, Ontario; Departments of Pediatrics (Faculty of Medicine) (Drs To, Guttmann, Dick, Rosenfield, and Parkin), Public Health Sciences (Dr To and Ms Cao), and Health Policy, Management, and Evaluation (Drs To, Dick, and Parkin), University of Toronto, Toronto; and Institute for Clinical Evaluative Sciences, Toronto (Drs To, Guttmann, and Dick).
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