Association of Possible Developmental Delays with Emotional and Behavioral Disorders, and Risk Factors in Children Under Six in Karachi, Pakistan: A Cross-sectional Study

Developmental delays refer to a child not reaching expected milestones. They are linked to various factors and, if unaddressed in early childhood, can lead to long-term consequences in adulthood. Objectives: To determine the association of developmental delays with emotional and behavioural disorders and other risk factors in children less than six years of age. Methods: This cross-sectional study was conducted at a primary healthcare center in a Karachi slum from October 2020 to July 2021. Using non-probability consecutive sampling, 425 participants (parents of children aged 1-5½ years) were selected. Data were collected using the validated Survey of Well-being of Young Children tool and analyzed in SPSS version 23.0. Logistic regression assessed associations between outcomes and risk factors. Results: Of 425 participants, 161 (37.9%) had possible developmental delays. No association was found with emotional/behavioural disorders (p=0.30). Binary logistic regression linked delays to male gender, uneducated parents, unemployed mothers, low income, domestic violence, and tobacco/drug exposure at home (p<0.05). After adjustment, significant associations remained with the mother’s education (aOR=1.785, CI: 1.040-3.065, p=0.036), income (aOR=3.361, CI: 1.197-9.434, p=0.021), and domestic violence (aOR=2.603, CI: 1.055-6.423, p=0.027). Conclusions: It was concluded that the prevalence of developmental delays in slum-dwelling children is high. No association was found with emotional/behavioural disorders. Socioeconomic factors, such as the mother’s education.