Maltreated infants and toddlers: predictors of developmental delay

The aim of this study was to examine the relationship of child, caregiver, and maltreatment characteristics at the time of the investigation with low scores on developmental measures obtained 18 and 36 months after substantiation in a nationally representative sample of maltreated infants and toddlers.

A proxy for developmental delay was constructed based on a criterion of 2 or more scores > or = 1 SD below the mean in the domains of adaptive behavior, cognition or communication at each assessment time point. Twenty-three percent of children were classified as having developmental delay, 26% with inconsistent low scores, and 51% with no low scores. An ordered logistic regression was conducted to determine factors associated with low scores.

Case worker report of special needs at the time of the investigation, living in continuous poverty, and with caregiver characteristics of cognitive impairment and not having a high school education were associated with low scores. Failure to provide and "other" types of maltreatment, which included sexual abuse and abandonment, were more highly associated with low scores 18- and 36-month postinvestigation. A notable finding was that 15% of children were <6% height/weight. Parameter estimates from an ordered logistic regression are presented to explain the increased likelihood of low scores.

Characteristics associated with low scores and the developmental delay proxy are identifiable at the time of investigation of maltreatment of infants and toddlers, emphasizing the urgency of providing early intervention developmental services to avoid developmental delay and to maximize outcomes in this highly vulnerable population.