Abstract
Objective
To describe the developmental risks, and its influence, in young children from a low-income South African community.
Method
An exploratory, cross-sectional research study design was employed. Developmental screening was conducted during home visits with 126 caregivers and children between 0 and 42 months of age from a low-income South African community. Children who failed the rescreen were referred for diagnostic assessment. A binomial logistic regression was used to determine the effect of developmental risks on developmental outcomes.
Results
Seventy-three percent of children screened were identified with a possible developmental delay (n = 59) according to caregiver-report using the PEDS tools. The regression model was statistically significant (χ2 (3) = 34.902, p < 0.001) with exposure to multiple languages (p < 0.05; odds ratio 3.810, CI 1.2–12.4) most indicative of potential developmental delay. Older children (19–42 months) were also more at risk of developmental delay (p < 0.001) than younger children (0–18 months).
Conclusions for Practice
Healthcare professionals serving these vulnerable populations should create awareness amongst caregivers about the effect of developmental risks, in particularly multiple language exposure, on development.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Albers, C. A., & Grieve, A. J. (2007). Test review: Bayley, N. (2006). Bayley scales of infant and toddler development—Third Edition. Journal of Psychoeducational Assessment, 25(2), 180–198. https://doi.org/10.1177/0734282906297199.
Ali, S. S. (2013). A brief review of risk-factors for growth and developmental delay among preschool children in developing countries. Advanced Biomedical Research, 2(4), 1–9. https://doi.org/10.4103/2277-9175.122523.
Barnett, M. A., Gustafsson, H., Deng, M., Mills-Koonce, W. R., & Cox, M. (2012). Bidirectional associations among sensitive parenting, language development, and social competence. Infant Child Development, 21(4), 374–393. https://doi.org/10.1002/icd.1750.
Bayley, N. (2006). Bayley scales of infant and toddler development (3rd ed.). San Antonio, TX: Harcourt Assessment.
Betancourt, T. S., Meyers-Ohki, S. E., Charrow, A., & Hansen, N. (2013). Annual research review: Mental health and resilience in HIV/AIDS-affected children—A review of the literature and recommendations for future research. The Journal of Child Psychology and Psychiatry, 54(4), 423–444. https://doi.org/10.1111/j.1469-7610.2012.02613.x.
Bialystok, E., Luk, G., Peets, K., & Yang, S. (2010). Receptive vocabulary differences in monolingual and bilingual children. Bilingualism: Language and Cognition, 13, 525–531. https://doi.org/10.1017/S1366728909990423.
Black, M. M., Walker, S. P., Fernald, L. C. H., et al. (2017). Early childhood development coming of age: Science through the life course. Lancet, 389, 77–90. https://doi.org/10.1016/S0140-6736(16)31389-7.
Britto, P. R., Lye, S. J., Proulx, K., et al. (2017). Advancing early childhood development: From science to scale 2. The Lancet, 389, 91–102. https://doi.org/10.1016/S0140-6736(16)31390-3.
Budlender, D. (2018). Income support for children in the context of poverty and inequality. In L. Jamieson, L. Berry, & L. Lake (Eds.), South African child gauge 2018 (pp. 93–100). Cape Town: Children’s Institute, University of Cape Town.
Claassen, D., Pieterse, J., Van der Linde, J., Kruger, E., & Vinck, B. (2016). Risks for communication delays and disorders in infants in an urban primary healthcare clinic. South African Journal of Child Health, 10(1), 25–28. https://doi.org/10.7196/SAJCH.2016.v106i1.944.
Cloet, E., Leys, M., & De Meirleir, L. (2017). Access to early diagnostics, intervention, and support for children with a neurobiological developmental delay or disorder. Developmental Medicine & Child Neurology, 59, 1210–1217.
Demirci, A., & Kartal, M. (2018). Sociocultural risk factors for developmental delay in children aged 3–60 months: A nested case-control study. European Journal of Pediatrics, 177(5), 691–697. https://doi.org/10.1007/s00431-018-3109-y.
Dixon, L. Q., Zhao, J., Quiroz, B. G., & Shin, J. (2012). Home and community factors influencing bilingual children’s ethnic language vocabulary development. International Journal of Bilingualism, 16(4), 1–25. https://doi.org/10.1177/1367006911429527.
Fernandes, M., Stein, A., Newton, C., et al. (2014). The INTERGROWTH-21st project neurodevelopment package: A novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children. PLoS ONE, 9(11), 1–34. https://doi.org/10.1371/journal.pone.0113360.
Glascoe, F. P. (2013). Collaborating with parents. Using parents’ evaluation of developmental status to detect and address developmental and behavioral problems (2nd ed.). Nolensville, TN: PEDStest.com, LLC.
Guralnick, M. J. (2013). Developmental science and preventive interventions for children at environmental risk. Infants and Young Children, 26(4), 270–285. https://doi.org/10.1097/IYC.0b013e3182a6832f.
Hall, K., Richter, L., Mokomane, Z., & Lake, L. (2018). South African child gauge 2018. Cape Town: Children’s Institute, University of Cape Town.
Hofer, B., & Jessner, U. (2019). Multilingualism at the primary level in South Tyrol: How does multilingual education affect young learners ’ metalinguistic awareness and proficiency in L1, L2 and L3 ? The Language Learning Journal, 47(1), 76–87. https://doi.org/10.1080/09571736.2016.1195865.
Jamieson, L., Berry, L., & Lake, L. (2017). South African child gauge—survive, thrive, transform. Los Angeles: Children’s Institute.
Karatsoreos, I. N., & McEwen, B. S. (2013). Annual research review: The neurobiology and physiology of resilience and adaptation across the life course. Journal of Child Psychology and Psychiatry, 54(4), 337–347. https://doi.org/10.1111/jcpp.12054.
Maleka, B. K., van der Linde, J., Glascoe, F. P., & Swanepoel, D. (2016). Developmental screening—Evaluation of an m-Health version of the parents evaluation developmental status tools. Telemedicine and e-Health, 22(12), 1–6. https://doi.org/10.1089/tmj.2016.0007.
Matheis, M., Matson, J. L., Hong, E., & Cervantes, P. E. (2019). Gender differences and similarities: Autism symptomatology and developmental functioning in young children. Journal of Autism and Developmental Disorders, 49(3), 1219–1231. https://doi.org/10.1007/s10803-018-3819-z.
Munoz, M., Nelson, A., Johnson, M., et al. (2017). Community-based needs assessment of neurodevelopment, caregiver, and home environment factors in young children affected by HIV in Lima, Peru. Journal of the International Association of Providers of AIDS Care, 16(2), 161–167. https://doi.org/10.1177/2325957416631625.
Panter-Brick, C., & Leckman, J. F. (2013). Resilience in child development—Interconnected pathways to wellbeing. Journal of Child Psychology and Psychiatry, 54(4), 333–336. https://doi.org/10.1111/jcpp.12057.
Pienaar, A. E., & Kemp, C. (2014). Motor proficiency profile of grade 1 learners in the North West province of South Africa: NW-child study. South African Journal for Research in Sport, Physical Education and Recreation, 36(1), 167–182.
Rajan, R., Seth, A., Mukherjee, S. B., & Chandra, J. (2017). Development assessment of HIV exposed children aged 6–18 months: A cohort study from North India. AIDS Care, 29(11), 1404–1409. https://doi.org/10.1080/09540121.2017.1300629.
Rubio-Codina, M., Araujo, M. C., Attanasio, O., Munoz, P., & Grantham-McGregor, S. (2016). Concurrent validity and feasibility of short tests currently used to measure early childhood development in large scale studies. PLoS ONE, 11(8), e0160962. https://doi.org/10.1371/journal.pone.0160962.
Semba, R. D., & Bloem, M. W. (2008). Nutrition and health in developing countries (2nd ed.). NJ, USA: Humana Press, part of Springer Science LLC. https://doi.org/10.1007/978-1-59745-464-3.
Shawar, Y. R., & Shiffman, J. (2017). Generation of global political priority for early childhood development: The challenges of framing and governance. The Lancet, 389(10064), 119–124. https://doi.org/10.1016/S0140-6736(16)31574-4.
Singh, L., & Seet, S. K. (2019). The impact of foreign language caregiving on native language acquisition. Journal of Experimental Child Psychology, 185, 51–70. https://doi.org/10.1016/j.jecp.2019.04.010.
Springer, P. E., Slogrove, A. L., Laughton, B., et al. (2018). Neurodevelopmental outcome of HIV-exposed but uninfected infants in the Mother and Infants Health Study, Cape Town, South Africa. Tropical Medicine and International Health, 23(1), 69–78. https://doi.org/10.1111/tmi.13006.
Statistics South Africa. (2012). Census 2011—Census in brief. Pretoria: Statistics South Africa.
Statistics South Africa. (2017). Poverty trends in South Africa: An examination of absolute poverty between 2006 & 2015. Pretoria: Statistics South Africa.
Stevens, T., Schwartz, S., Mupawose, A., Moonsamy, S., & Black, V. (2017). The effects of in utero exposure to antiretroviral therapy (ART) on the language abilities of HIV exposed uninfected infants. Journal of AIDS and HIV Research, 9(8), 164–170. https://doi.org/10.5897/JAHR2017.0428.
Tager-Flusberg, H. (2016). Risk factors associated with language in autism spectrum disorder: Clues to underlying mechanisms. Journal of Speech, Language, and Hearing Research, 59, 143–154. https://doi.org/10.1044/2015_JSLHR-L-15-0146.
Toumbourou, J. W., Hall, J., Varco, J., & Leung, R. (2014). Review of key risk and protective factors for child development and wellbeing (antenatal to age 25). A. R. A. f. C. a. Y. People.
Uljarevic, M., Katsos, N., Hudry, K., & Gibson, J. L. (2016). Practitioner review: Multilingualism and neurodevelopmental disorders—An overview of recent research and discussion of clinical implications. Journal of Child Psychology and Psychiatry, 57(11), 1205–1217. https://doi.org/10.1111/jcpp.12596.
Valla, L., Wentzel-Larsen, T., Hofoss, D., & Slinning, K. (2015). Prevalence of suspected developmental delays in early infancy: Results from a regional population-based longitudinal study. BMC Pediatrics, 15(215), 1–8. https://doi.org/10.1186/s12887-015-0528-z.
van der Linde, J., Swanepoel, D., Glascoe, F. P., Louw, E., Hugo, J., & Vinck, B. (2015a). Risks associated with communication delays in infants from underserved South African communities. African Journal of Primary Health Care and Family Medicine, 7(1), 7. https://doi.org/10.4102/phcfm.v7i1.841.
van der Linde, J., Swanepoel, D., Glascoe, F. P., Louw, E., & Vinck, B. (2015b). Developmental screening in South Africa: Comparing the national developmental checklist to a standardized tool. African Health Sciences, 15(1), 188–196. https://doi.org/10.4314/ahs.v15i1.25.
van der Linde, J., Swanepoel, D., Hanekom, L., Lemmer, T., & Schoeman, K. (2016). Early detection of communication delays with the PEDS tools in at-risk South African infants. African Journal of Disability, 5(1), a223–a227. https://doi.org/10.4102/ajod.v5i1.223.
van der Merwe, M., Mosca, R., Swanepoel, D., Glascoe, F. P., & Van der Linde, J. (2019). Early detection of developmental delays in vulnerable children by community care workers using an mHealth tool. Early Child Development and Care, 189(5), 855–866. https://doi.org/10.1080/03004430.2018.1480481.
Venetsanou, F., & Kambas, A. (2009). Environmental factors affecting preschoolers’ motor development. Early Childhood Education Journal, 37(4), 319–327. https://doi.org/10.1007/s10643-009-0350-z.
Yousuf Hussein, S., Swanepoel, D., De Jager, L., Myburgh, H., Eikelboom, R., & Hugo, J. (2015). Smartphone hearing screening in mHealth assisted community-based primary care. Journal of Telemedicine and Telecare, 22(7), 405–412. https://doi.org/10.1177/1357633X15610721.
Zysset, A. E., Kakebeeke, T. H., Messerli-Bürgy, N., et al. (2018). The validity of parental reports on motor skills performance level in preschool children: A comparison with a standardized motor test. European Journal of Pediatrics. https://doi.org/10.1007/s00431-017-3078-6.
Acknowledgements
The authors acknowledge Future Families non-governmental organisation (NGO) for allowing us to collaborate with you and contribute to positive change in communities.
Funding
No sources of funding were received for this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
du Toit, M.N., van der Linde, J. & Swanepoel, D. Developmental Risks in Vulnerable Children from a Low-Income South African Community. Matern Child Health J 25, 590–598 (2021). https://doi.org/10.1007/s10995-020-03111-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-020-03111-1