Developing a population-based proxy score of social developmental delay for pre-school children in a lower-middle income country.

Researchers created a screening tool to identify early signs of social delays (which can be linked to autism) in 4-year-old children in Honduras. They found that about 1 in 20 children showed signs of social developmental delays, with learning and behavior challenges being most common. The good news is that delays weren't more common in any particular group based on gender, age, or family income. However, this tool needs more testing before it can be widely used.

This study developed a population-based screening tool to identify social developmental delays potentially associated with autism spectrum disorder in preschool children from Honduras. Using data from 1,723 four-year-olds in the 2019 UNICEF Multiple Indicator Cluster Survey, researchers created a 10-point Social Developmental Delay Proxy Score (SDDPS). The study found 4.6% of children had scores indicating possible social developmental delays, while 65% showed concerns in one or two developmental domains. Learning behavior difficulties were most commonly reported.

No significant associations were found between delays and demographic factors including sex, age, location, or socioeconomic status. The authors emphasize this tool requires validation before broader implementation.

This preliminary screening tool could help identify children needing developmental assessment in resource-limited settings where specialized tools aren't available. However, validation studies are essential before implementation. The findings support universal screening approaches regardless of demographic factors.

The tool requires validation in this and other populations before clinical use. The study relied on caregiver reports which may introduce bias. Sample was limited to one country and age group (48-59 months), limiting generalizability to other settings and ages.

The distribution of early social developmental delays, which are often associated with autism spectrum disorder (ASD), is not well documented in low and middle-income countries. The UNICEF Multiple Indicator Cluster Survey (MICS) collects population-representative data on child health in many countries. The objective of the study was to create a social developmental delay scale to estimate population-based early social delay relevant for ASD among pre-school children and identify characteristics associated with delay in a lower-middle-income country. Data were from the Honduran 2019 MICS6.

We created a 10-point social developmental delay proxy score (SDDPS) with scores ≥3 indicating possible delay. Using data from children 48-59-month-old (n = 1723), reported by primary caregivers, we estimated prevalence of social developmental delays; we used linear and Poisson regressions to characterize associations between SDDPS and socio-demographic characteristics. Applying the SDDPS, 4.6 % (95 % CI: 0.61 %:8.66 %) of 4-year-olds in Honduras had scores consistent with social developmental delays, indicated by 3 or more domains of concern relating to learning behavior and social interaction. Sixty-five percent had one or two domains of possible concern, with scores in domains relating to learning behavior being the most common.

Differences across sex, age, urbanicity, and socioeconomic status were not significantly associated with delays in multivariate models. Existing surveys may be used to yield population-relevant data on social developmental delay in settings where more sensitive measures are not available at the population level. The SDDPS provided a preliminary estimate of the prevalence of social developmental delays in a lower-middle income Latin American country. The scale must be validated for use in this and other populations.