6287 Comparison of parental concerns of child’s development versus clinician concerns in a tertiary early intervention clinic from South India

Objectives The rapid development of neonatal care has improved the survival of premature babies. Most of these premature babies have a tumultuous neonatal course, raising concerns regarding their long-term neurodevelopmental outcomes. Parents express concerns when they suspect their child's milestone achievement trajectory differs from their older siblings or peers.¹ Our study aims to explore the convergence between parental concerns and clinicians' concerns regarding their child's development. Methods This retrospective cross-sectional study, was conducted in a tertiary hospital in South India and included data of children presenting to the early intervention clinic, between January 2019- March 2023. During the visits, children were assessed by the clinician and the parental concerns regarding the growth and development of their offspring were categorized into domains. We categorized parental concerns into any of the five standard domains and additional five common development concerns reported by parents. We looked for any convergence between parental concerns and clinicians' concerns. Cohen's kappa was used to measure the strength of agreement in each domain and tested using McNamar's test. The influence of maternal parity and education status on this convergence was explored using Student's Chi-square tests. Results Out of a total of 1800 appointments during our study period, excluding the revisits, our sample size was 826. Results showed low convergence between the caregivers and the professionals in most of the domains. Hearing (98%) followed by Vision (90%), Cognition (84.9%) and Hypertonia (84.4%) were the domains of concern that had the highest degree of convergence. The strength of the agreement was found to be fair (0.2- 0.4) in the domains of mobility, personal delay and hearing while it was poor (<0.2) in the rest of the domains. There was an increased tendency towards convergence in mothers with graduate degrees in the domains of hearing and vision. The higher the parity, the stronger the agreement for speech (p=0.053) which surprisingly had an inverse relationship for hypertonia (p= 0.001), both of which achieved statistical significance. Conclusion To our knowledge, this is the first study from India exploring this relationship. Our study raises the concern of sub-optimal knowledge of normal developmental trajectories and milestones among mothers of our study group in spite of being one of the states with the highest literacy rates. This highlights the importance of structured prenatal, antenatal and postnatal education for would-be mothers, universally keeping in line with the WHO sustainable developmental goals. Reference Chen IC, Lee HC, Yeh GC, Lai CH, Chen SC. The relationship between parental concerns and professional assessment in developmental delay in infants and children: a hospital-based study. J Chin Med Assoc 2004;67:239–44.