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Social disadvantage and developmental diagnosis in pre-schoolers
Norma Kayrouz1, Susan L Milne1, Jenny L McDonald1
1The Child Assessment Team, Department of Community Paediatrics, Campbelltown Hospital, Sydney, New South Wales, Australia.
Insights
Children with global developmental delay (GDD) face greater social disadvantage and child protection involvement than those with autism spectrum disorder (ASD). These findings highlight needs for targeted support services for disadvantaged children with developmental diagnoses.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Social Epidemiology
Background:
- Social disadvantage is a significant factor influencing child development.
- Understanding the differential impact of social risk on various developmental diagnoses is crucial for effective intervention.
Purpose of the Study:
- To investigate the association between social disadvantage and developmental diagnoses in preschool children.
- To compare social risk factors in children with Autism Spectrum Disorder (ASD) versus those with Global Developmental Delay (GDD) without ASD.
Main Methods:
- A cohort of 845 preschool children assessed between 2012-2015.
- 469 families were interviewed, with 290 diagnosed with ASD and 107 with GDD (comparison group).
- Social risk factors were compared using chi-squared tests and logistic regression analysis.
Main Results:
- Children with ASD were more likely to be male and have parents with high stress scores.
- Children with GDD were significantly more likely to reside in disadvantaged suburbs, have a sole parent, and have child protection services involvement.
- Parental stress was a significant factor for ASD, while socioeconomic and systemic factors were more prominent for GDD.
Conclusions:
- Children with GDD (without autism) exhibit higher rates of social disadvantage and child protection contact compared to children with ASD.
- These disparities underscore the need for tailored assessment, early intervention, and support systems for vulnerable children with developmental disabilities and their families.
- Findings have implications for resource allocation and service provision in early childhood developmental support.
Aim:
To explore the association between social disadvantage and developmental diagnoses in pre-school children.
Methods:
Between 2012 and 2015, 845 pre-school children were assessed by the Child Assessment Team at Campbelltown Hospital. A social worker interviewed 469 families and these children were eligible for inclusion in the study. Autism spectrum disorder (ASD) was confirmed in 290 children. Of those without ASD, 72 did not have global developmental delay (GDD) and were excluded from the study. The remaining 107 children with GDD were used as the comparison group. Social risk factors in the two groups were compared using χ 2 tests. Variables with statistical significance were then entered into a logistic regression.
Results:
After logistic regression, children with ASD were more likely to be male (odds ratio (OR) 3.1, 95% CI 0.195-0.529; P < 0.001) and their parents were more likely to have a clinically significant stress score (OR 1.3, 95% CI 0.334-0.992; P = 0.047). Children with GDD were more likely to live in a disadvantaged suburb (OR 1.7, 95% CI 1.042-2.940; P = 0.034), more likely to have a sole parent (OR 1.8, 95% CI 1.062-3.082; P = 0.029) and much more likely to have had involvement with child protection services (OR 3.9, 95% CI 2.044-7.416; P < 0.001).
Conclusions:
Children with GDD without autism were more likely to be disadvantaged and to have had contact with child protection services than children with ASD. This has implications for the assessment, early intervention and support services for children with disabilities and their families.