Abstract
Early childhood is a period where children acquire different skills. Development delays are a result of a failure to meet these milestones due to various factors. Research on development delays and their causes has mainly focused on the causes before and during birth. One of the risk factors identified is the maternal gestation age, with studies indicating that children born by women aged 35 and above are at risk of developmental delay. The mother’s mental health was another risk factor that was shown to cause developmental delays in children. Specifically, the work focused on depression, which is common in women after birth. The education level of the parents was viewed as a strong factor in determining development delays. The review shows that type or mode of delivery is an important risk factor, but there is less clarity on its impacts. The articles also differed in their views on socioeconomic factors causing development delays in children. The studies show that development delays affect children significantly when they become adults. The literature review proposes that future studies focus on investigating the effects of type or mode of delivery on a child’s development to provide clarity.
Introduction
The review of the literature is focused on the causes of developmental delays in early childhood. Developmental delay (DD) can be defined as interruptions in areas of speech and language development, motor development, social development, and cognitive development (Sharma et al., 2019). Early childhood is the period between birth and age eight (Demirci & Kartal, 2018). The chosen research articles focus on risk factors and determinants that cause developmental delay in children. The papers adopt quantitative methods for analysis and data collection, which is an advantage. Aspects such as socioeconomic status, maternal gestation age, mental health, and education level are identified as risk factors by the chosen research papers. The researchers illustrate how different social and economic factors influence the status of parents, which in turn affects the development of children. The chosen studies focus on populations from different regions and backgrounds, which is essential in providing a broader picture of the topic. This review will analyze each article and show how they relate to each other.
Sharma et al. (2019) study investigated the risk factors for developmental delays among children in a rural community. The findings of the study indicate that gestation age is a factor that can be used to predict the delay in achieving developmental milestones for children. Sharma et al. (2019) note that gestation age can predict motor and speech development delay risk. Demirci and Kartal (2018) assessed the sociocultural risk factors for developmental delay in children aged 3-60 months. The study was different from other studies because it focused on the maternal, paternal, and sociocultural factors that can be associated with DD in early childhood. The findings show that maternal gestation age of 35 years and above and delivery by cesarean section increased the risk of developmental delay in early childhood (Demirci & Kartal, 2018). Therefore, age and the mode of delivery are viewed as contributing factors to developmental delay.
The findings of Demirci and Kartal (2018) are similar to the findings of Sharma et al. (2019) in that maternal gestational age is considered a significant risk factor for DD in early childhood. Maternal age and pregnancy complications are correlated because pregnant women aged 35 years and above are at higher risk of miscarriage, hypertension, and placenta previa (Demirci & Kartal, 2018). Sharma et al. (2019) results were different in that the mode of delivery was not associated with a risk for developmental delays. This is in contrast to Demirci and Kartal’s (2018) study, which confirms that delivery by cesarean section was linked to a higher risk for DD. However, the study by Sharma et al. (2019) indicated that prolonged labor, perinatal complications, and birth injury were risk factors for developmental delays. Therefore, the two studies indicate that maternal gestational age was a significant factor but differed in mode of delivery.
Von Sneidern et al. (2017) study investigated the link between adverse childhood experiences and developmental delay. The results of the study show that developmental delays were present mainly in children with adverse childhood experiences. Vameghi et al. (2018) investigated the relationship between social determinants of maternal health and child development. The factors which were analyzed were socioeconomic status, anxiety, depression, social support, and stress. The findings of the research show that maternal socioeconomic status and maternal depression are the two factors that have significant effects on child development. The results by Vameghi et al. (2018) correlate with the findings from von Sneidern et al. (2017), which also showed that socioeconomic status is a risk factor for developmental delay. This is because adverse childhood experiences include poor living conditions, which are grouped under socioeconomic status.
The findings in the study by Demirci and Kartal (2018) on the cesarean section being a risk factor correlated to results by Sharma et al. (2019). This shows that the factor mode or type of delivery elicits different interpretations from different scholars. Neves et al. (2020) investigated whether maternal nutritional status before and during pregnancy was associated with developmental delays in early childhood. The results of the paper show that maternal underweight and gestational weight gain were associated with developmental risks in both girls and boys. The study also found that the gender of the child does not determine the risk of DD in children. This is similar to the findings by Demirci and Kartal (2018), and Sharma et al. (2019). Based on the above, the factor of the gender of infants or children may not be a significant predictor of development delays.
The research by Demirci and Kartal (2018) indicated that family socioeconomic actors and maternal and paternal education levels are substantial risk factors for DD. This is similar to the findings by Vameghi et al. (2018), which show that socioeconomic status correlates with developmental delay. This indicates that income level has a significant impact on the development of children. Maternal and paternal education were viewed as important risk factors for developmental delays (Demirci & Kartal, 2018). The education levels of parents are crucial because children spend the majority of their time at home. This can be related to the poor nutritional status of pregnant women during and before birth. Awareness of what diet is needed during pregnancy can result in better development for the child (Neves et al., 2020). Sharma et al. (2019) note that mothers’ education level was not associated with DD. This is in contrast to the findings by Demirci and Kartal (2018), which show that maternal and paternal education can be used to predict development delays in children. Therefore, the education level of the parent is a factor that is viewed in different ways by scholars.
Early identification of developmental delays is provided as an effective way to prevent the effects of DD on children. Sharma et al. (2019) indicate that healthcare providers should be focused on the documentation of developmental delays during hospital visits. Demirci and Kartal (2017) also indicate that early screening for possible risk factors of DD can be essential in preventing the effects. Vameghi et al. (2018) proposed that risk factors such as anxiety and depression in mothers should be identified and a solution provided. This shows that early identification is viewed as the main solution that can help mothers. Therefore, the review of the literature indicates that mothers’ health, socioeconomic status, maternal and paternal education, maternal gestational age, and labor complication are significant risk factors for developmental delays in children.
Method
The review of the literature was focused on the topic of the causes of developmental delays in early childhood. The initial search generated a total of 260 articles that were related to the subject. The method used to generate articles for the review involved retrieval from an online database. The keywords used to scout for articles were developmental delays in early childhood and causes of developmental delays in early childhood. Initially, the search word developmental delay was used, but the results were general and did not suit the review needs. The requirements were studies that researched the risk factors associated with developmental delays in a variety of settings. After a review of the 260 articles, 30 papers were pre-selected. The 30 studies were then reviewed using a criterion that focused on the recency of the paper, the topic, the method applied, and the findings of the study.
The final number of articles selected for the literature review was 5. The studies met the criterion because they were published after 2017 and were focused on the topic. The reviewed articles were easily accessible, which made it easy for the review. The need to select recently published studies was to ensure the review focused on current findings. This would ensure that the interpretation relies on up-to-date information. The analysis of the articles was conducted by first reading through the abstract. The summary contained all the relevant information that is needed to determine the characteristics of the research. An important part of the selection of papers was to check the methods used to analyze the data. Preference was on articles that used quantitative methods or mixed methods approach. This is because quantitative procedures provide reliable data which can be counter-checked.
Discussion
The chosen articles selected sample sizes using different rules because of the nature of the study populations. Even though the sample sizes of most of the studies appear small, the papers meet the principle of a representative sample size. For example, the sample size in von Sneidern et al. (2017) was 94 preschool children from rural areas. The study by Demirci and Kartal (2018) adopted a sample size of 1514 children in a cohort of over 150,000 children. The chosen number of participants can be considered representative because of the sampling method applied. The sample size in each of the research papers enabled the scholars to generate relevant findings. Using large sample sizes can result in better results and can take more time. Sample sizes offer a way for scholars to generate findings that are representative of the whole study population.
On the aspect of validity, which analyzes the accuracy of the model used, all the research articles met these requirements. This is evident in the use of questionnaire models that have been developed to measure development delays in children. For example, in the study by von Sneidern et al. (2017), an ACEs (Adverse Childhood Experiences) questionnaire was used, while in Neves et al. (2020) paper, an INTER-NDA assessment tool was used for developmental delays. These are tools that have been standardized and checked for validity and approved for use in research. This indicates that the majority of the papers used procedures that guaranteed accurate findings. However, the research by Demirci and Kartal (2018) did not provide information on the method used to collect data in the abstract. The results of the research articles related to existing information on the topics can also ascertain validity. Therefore, the research articles met the principle of validity based on the methods used to collect and analyze the data.
The chosen research studies were focused on different environments and situations. The research findings could be applied to other settings because the findings were concerned with developmental delays for children in a specific age bracket. However, two studies were focused on rural areas, which means that the results may only be applicable in similar settings, for example. The study by Sharma et al. investigated the risk factors for developmental delays among children in rural communities of Northern India (2019). On the other hand, von Sneidern et al. (2017). assessed the link between ACEs and developmental delay of children in a rural area in Colombia. Therefore, the results of the two studies can be applied to settings similar to the ones used by the authors.
In terms of reliability, the selected articles provide reliable results, which can be reproduced in a similar setting. This is because the methods section of each paper provides information on how the analysis was conducted. Other scholars can adopt similar methods in different situations and achieve similar results. Statistical analysis ensures that findings can be replicated with similar data sets. All the selected articles use quantitative methods of data analysis, which means that the results are reliable. The application of standardized tools for collecting data also enhances both the validity and reliability of the findings. This is because pre-made testing tools adhere to the principles of validity and reliability. Therefore, the papers used for the review of literature enhance the body of knowledge on developmental delays in early childhood.
Conclusion
In summary, research on developmental delays in children has focused a lot on the causes before, during, and after birth. The major findings from the analysis are that maternal gestational age, maternal and paternal education, and the health of the mother are significant risk factors for developmental delays. Upcoming research can address the issue of type or mode of delivery and whether it is a significant factor. This would help provide more clarity on the topic. Future studies can also focus on the mental health of the mother as a risk factor before and during pregnancy.
References
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.
Neves, P. A., Gatica-DomĂnguez, G., Santos, I. S., Bertoldi, A. D., Domingues, M., Murray, J., & Silveira, M. F. (2020). Poor maternal nutritional status before and during pregnancy is associated with suspected child developmental delay in 2-year-old Brazilian children. Scientific Reports, 10(1), 1-11.
Sharma, N., Masood, J., Singh, S. N., Ahmad, N., Mishra, P., Singh, S., & Bhattacharya, S. (2019). Assessment of risk factors for developmental delays among children in a rural community of North India: A cross-sectional study. Journal of Education and Health Promotion, 8(1), 112.
Vameghi, R., Amir Ali Akbari, S., Sajedi, F., Sajjadi, H., & Alavi Majd, H. (2018). Relation between Social Determinants of Maternal Health and Child Development: A Path Analysis. International Journal of Pediatrics, 6(12), 8643-8654.
von Sneidern, E., Cabrera, K. P., Galeano, N., Plaza, M., & Barrios, M. (2017). Association between adverse childhood experiences (ACEs) and developmental delay of preschool children in a rural area of Colombia. Journal of Child & Adolescent Trauma, 10(3), 225-232.