Exploring prevalence and key determinants of developmental difficulties among young children: a cross-sectional study in urban Bangladesh

BACKGROUND AND AIMS: Developmental difficulties (DD) refer to delays, disorders, or disabilities in a child's development across domains such as cognition, language, motor, and social-emotional functioning. Evidence on DD among very young children in urban Bangladesh remains limited. This study aimed to assess the prevalence of suspected DD and identify associated factors among young children in urban Bangladesh. METHODS: This cross-sectional study, conducted in Bangladesh, recruited 405 children aged 0-3 years and their parents using multistage sampling with random ward selection followed by household recruitment. Participants were enrolled from eight different wards in Dhaka City between July 2023 and October 2024. Data were collected through interviews and observations using a semi-structured questionnaire, including the Trivandrum Developmental Screening Chart (TDSC) for 0-3 years. The chi-square test was used to examine the association between the dependent variables and covariates, while logistic regression assessed the strength of the associations. RESULTS: Overall, 27.9% screened positive for suspected DD. Higher prevalence was observed among younger children (≤ 12 months, p = 0.007), children with low birth weight (LBW) (p < 0.001), and those from lower- and middle-income families (p = 0.025). In adjusted analysis, age ≤ 12 months (AOR: 2.79, 95% CI: 1.65-4.70), LBW (AOR: 6.20, 95% CI: 2.84-13.52), and poor hygiene practices (AOR: 2.83, 95% CI: 1.39-5.75) were independently associated with suspected DD. CONCLUSION: One in four young children aged 0-3 years in urban Bangladesh screens positive for suspected DD. The findings underscore the need for early screening and for strengthening clinical, social, and environmental interventions to mitigate developmental challenges and enhance early childhood development.