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Title: Patterns of Developmental Delay in Children with Autism Spectrum Disorder: A Perspective from a Developing Country
Authors: Rehamana Waris, Syed Hashim Raza, Ramish Riaz
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2023
Volume: 12
Issue: 3
Language: English
Keywords: Autism Spectrum DisorderSocial SkillsSpeech delayDevelopmental Milestones,Global Developmental DelayCognitive delay
Background: Autism Spectrum Disorder is a developmental disorder characterized by difficulties in social interaction, initiating conversations, delay in language skills, play skills and stereotypic behaviours. Children with severe developmental delay and those with global developmental delays are needed to be identified as they may have long term problems and disabilities.
Materials & Methods: All children below age of 5 years coming first time for assessment of ASD and diagnosed using ADI-R and ADOS-2 were included in the study. Total 334 children met the criterion. All children having performance deficit below 2SD on age appropriate mean were considered as having developmental delay. Those having delay in two or more than two domains were labelled as having global developmental delay. Detailed clinical and developmental assessment was performed.  Data was entered and analysed via SPSS v26.
Results: Mean age of children at time of presentation was 3.6±1.10 years with male to female ratio of 3.5:1. According to developmental assessment using Schedule for growing Scales II, most affected area was speech and language (51.5%) followed by cognitive skills (50.7%), social interactive skills (49.9%), visual skills (46.9%), hearing and language skills, (38.3%), self-care social skills (26.2%), manipulative skills (13.5%) and gross motor skills (0.4%). Global Developmental Delay was found to be present in half of the children for which there was no other possible explanation.
Conclusion: Most of the children with Autism Spectrum Disorder from developmental delay of some sort. Therefore, every child with Autism Spectrum Disorder must be evaluated for Developmental Delay and supported.
To investigate the patterns of developmental delay in children diagnosed with Autism Spectrum Disorder (ASD) in Pakistan.
A descriptive study was conducted at Children's Hospital, Pakistan Institute of Medical Sciences, from May 2017 to April 2020. 334 children under 5 years old, diagnosed with ASD using ADI-R and ADOS-2, were included. Developmental delays were identified if performance was below 2 Standard Deviations (SD) on age-appropriate means across various domains. Global Developmental Delay (GDD) was defined as delays in two or more domains. Data was analyzed using SPSS v26.
graph TD
A["Inclusion Criteria: Children < 5 years, first-time ASD assessment"] --> B["Diagnosis with ADI-R and ADOS-2"];
B --> C["Data Collection: Clinical and developmental assessment, history"];
C --> D["Developmental Delay Assessment using SGS-II"];
D --> E["Identify Global Developmental Delay"GDD" if delays in >= 2 domains"];
E --> F["Data Entry and Analysis in SPSS v26"];
F --> G["Report Findings"];
The study highlights that most children with ASD experience developmental delays, particularly in speech, language, cognitive, and social domains. The high prevalence of GDD in this cohort, potentially linked to factors prevalent in developing countries, underscores the need for comprehensive developmental assessments. The findings suggest that gender and co-morbidities are important considerations in understanding developmental trajectories in children with ASD.
- The mean age of presentation was 3.6 ± 1.10 years, with a male to female ratio of 3.5:1.
- The most affected developmental areas were speech and language (51.5%), cognitive skills (50.7%), and social interactive skills (49.9%).
- Global Developmental Delay (GDD) was present in 50% of the children.
- Females showed more delays across most domains compared to males.
- Co-morbid conditions were found to significantly increase the risk of GDD.
A significant proportion of children with Autism Spectrum Disorder exhibit developmental delays. Early and comprehensive evaluation for developmental delays in all children with ASD is crucial for improving outcomes and prognosis, as early intervention can mitigate the risk of long-term disabilities.
- Mean age of presentation: 3.6 ± 1.10 years. (Confirmed in Results)
- Male to female ratio: 3.5:1. (Confirmed in Results)
- Global Developmental Delay prevalence: 50%. (Confirmed in Results)
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