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

Abstract

AbstractObjectiveTo 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 designWithin the NASCITA birth cohort, in addition to the family pediatrician’s clinical evaluation, the M-CHAT-R was completed by parents to assess the child’s 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.ResultsThe follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatrician’s 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).ConclusionsIntegrating 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.