Detecting Developmental Delays at 3 Months: Insights from a Resource-limited Setting

A bstract Background: Early developmental screening enables identification of infants with developmental concerns during periods of heightened neuroplasticity, allowing timely referral for further evaluation and support. Evidence on standardized developmental screening initiated as early as 3 months of age remains limited, particularly in resource-limited settings. Objectives: This study aimed to assess the yield of developmental screening initiated from 3 months of age at a tertiary Child Guidance and Rehabilitation Center (CGRC), estimate the prevalence of developmental concerns, and examine associations with selected demographic and perinatal factors. Materials and Methods: A retrospective descriptive analysis was conducted after institutional ethics approval (IEC/RC/2023/73). Medical records of 377 infants who underwent developmental screening at CGRC between January 2017 and December 2022 were reviewed. Infants included those attending routine 3-month developmental assessments and those referred from outpatient services at later ages. Developmental screening was performed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Variables recorded included age at screening, sex, gestational age, birth weight, mode of delivery, selected perinatal morbidities, and parental education and occupation. Descriptive statistics summarized screening outcomes, and associations were analyzed using chi-square or Fisher’s exact tests, with statistical significance set at P < 0.05. Results: Of the 377 infants screened, 92 (24.4%) had global developmental delay, 26 (6.9%) were classified as at risk for developmental delay, and 132 (35.0%) demonstrated emerging risk on BSID-III screening. Developmental outcomes were not significantly associated with age at screening, sex, parental education, gestational age, birth weight, body mass index, or recorded perinatal morbidities. Statistically significant associations were observed with mode of delivery and parental occupation. Conclusion: A substantial proportion of infants screened from 3 months of age demonstrated developmental concerns on standardized screening. Early developmental screening at tertiary care centers yields clinically relevant findings and may help identify subgroups requiring closer developmental surveillance. Further prospective studies are needed to evaluate long-term outcomes and the impact of early interventions.