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CDC Kerala 16: Early Detection of developmental delay/disability among children below 6 y--a district model
M K C Nair1, G S Harikumaran Nair, M Beena
1Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695011, Kerala, India, cdcmkc@gmail.com.
Insights
Early detection of childhood disability in children under 6 years is crucial. A district-wide screening identified developmental delays and disabilities, enabling timely intervention for affected children.
Area of Science:
- Pediatrics
- Public Health
- Developmental Pediatrics
Background:
- Early detection and intervention are critical for managing childhood disabilities.
- A systematic approach is needed to identify developmental delays in young children.
- Existing healthcare infrastructure can be leveraged for community-based screening programs.
Purpose of the Study:
- To establish a district-level model for early childhood disability detection in children under 6 years.
- To create referral pathways for diagnosis confirmation and home-based early intervention.
- To assess the prevalence of developmental delays and disabilities in the target population.
Main Methods:
- Trained Accredited Social Health Activist (ASHA) workers conducted preliminary surveys using the Trivandrum Developmental Screening Chart (TDSC).
- Expert teams evaluated screen-positive children in developmental evaluation camps at primary health centers (PHCs).
- A total of 101,438 children were screened, with 2,477 identified as positive cases.
Main Results:
- Of 1,329 children evaluated, 43.1% were normal; 49.89% had developmental delay.
- Speech and language delay affected 24.98%, and multiple disabilities were present in 22.95%.
- Confirmed diagnoses included cerebral palsy (8.43%), intellectual disability (16.85%), visual impairment (3.31%), and neuromuscular disorders (1.35%).
Conclusions:
- The district-wide screening demonstrated a community prevalence of 3.08% for developmental delay/disability using TDSC criteria.
- A significant proportion of screened children required further evaluation and intervention.
- The model effectively identified children needing support, highlighting the importance of community health workers in early detection efforts.
Objective:
To develop a district model for establishing early detection of childhood disability below 6 y of age and to develop appropriate referral linkages for confirmation of the diagnosis and establish home based early intervention therapy to all needy children.
Methods:
Trained Accredited Social Health Activist (ASHA) workers conducted the preliminary survey for identifying developmental delay/disability among children below 6 y of age using Trivandrum Developmental Screening Chart (TDSC) (0-6 y) and a team of experts assessed the screen positives in developmental evaluation camps conducted at primary health centres (PHCs).
Results:
Community survey was carried out and 1,01,438 children below 6 y of age in Thiruvananthapuram district were screened by ASHA workers and 2,477 (2.45%) positive cases (TDSC two or more item delay) were identified and these children were called for the developmental evaluation camps conducted at 80 PHCs in the district. Among the 1,329 children who reached the evaluation camps 43.1% were normal. 24.98% children had speech and language delay and 22.95% children had multiple disabilities. Developmental delay was observed among 49.89% children and cerebral palsy in 8.43% and intellectual disability 16.85% were confirmed. Visual impairment in 3.31% and neuromuscular disorders in 1.35 were found among children evaluated in the camp.
Conclusions:
The results of this district wide early detection of disability survey by trained ASHA workers among children below 6 y of age showed a community prevalence of 3.08% observed, based on two or more item delay in TDSC and among these children, 43.1% were normal, 49.89% had developmental delay, 24.98% had speech and language delay and 22.95% had multiple disabilities.