Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

Abstract

Objective: To assess the feasibility of a shared approach combining the clinical expertise of family pediatricians and parents perspectives in identifying potential disorders in children using standard clinical practice tools. Study design: Within the NASCITA birth cohort, in addition to the family pediatricians clinical evaluation, the M-CHAT-R was completed by parents to assess the childs language, social skills, behavior, and sensory areas. Parents were also asked to complete the PSI-SF to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. Results: The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatricians assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR=2.42, 95%CI: 1.20-4.86) and having sleep disorders (OR=2.48, 95% CI 1.19-5.71) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR=3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). Conclusions: Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.