FAMILY CHARACTERISTICS AND PSYCHOSOCIAL CORRELATES OF DEVELOPMENTAL DELAY AMONG UNDER FIVE CHILDREN IN TWO COMMUNITIES IN LAGOS

Abstract

Background: Developmental delay is a term used for children who lacked developmental features and skills in developmental task expected for the children of their age. Research findings indicate that 200 Million children in sub Saharan African are developmentally delayed in one area or the other. This delay often leads to poor school readiness, poor educational attainment, lack of job opportunities and intergenerational poverty and backwardness. Factors associated with this condition are of concern, some are genetically determined while some are as a result of psychosocial and family living conditions which can be modified. In as much as health and social facilities for identification and management of this condition are not readily available in low and middle-income country like Nigeria, the best approach will be to identify these modifiable factors that are associated with the developmental delay with the aim of preventing them. Though research has shown that some family characteristics and psycho social factors are associated with developmental delay, very few studies have assessed these factors in Nigeria OBJECTIVE This study aimed to determine the family characteristics and psychosocial factors associated with developmental delay in children under the age of five years in Lagos, Nigeria. METHODOLOGY In a cross sectional study design, 501 apparently normal children aged five years and below, with their primary care givers were recruited from Afariogun and Oluyeye communities in Oshodi LCDA, Lagos. Four hundred and eighty-six (486) were valid for analysis yielding 97% response rate. Instruments used for data collection were: Socio Demographic Questionnaire for demographic data information for the children and their primary caregivers.. Ages and Stages Questionnaire (ASQ) – for determining developmental delay in the children. Patient Health Questionnaire (PHQ-9), Oslo Social Support Scales (Oslo-3), and Short form Questionnaire (SF-8) for psycho social characteristics of the caregivers. Data was analyzed using Statistical Package for Social Sciences (SPSS), version 20. Percentages and figures were used for socio demographic characteristics of the children and their caregivers. Chi Square was used for associations between family characteristics, psychosocial factors and developmental delay. Level of significance was 0.05. RESULTS Ages of the children ranged from 1.5 months to 60 months with a mean of 27.8 + 13.3months, their gestational ages at birth ranged from 7 to 10 months with a mean of 8.9±0.32months. The ages of the care givers ranged from 20 to 45 years with a mean of 30.6 + 7.01 years. The prevalence of developmental delay in the studied children was found to be 23%. Child’s socio-demographic characteristics found to be significantly associated with developmental delay were: Male gender (p= 0.001), pre-term birth (p= 0.045), middle birth order (p= 0.001)and having a child being cared for by non-parent (p=0.010). The family characteristics and psychosocial factors found to have a significant association with developmental delay were increasing age of caregiver (p<0.001), being married (p=0.001), living in an overcrowding environment (p=0.003), maternal depression (p=0.001) and poor social support (p<0.001). CONCLUSION The findings of this study showed that developmental delay is prevalent in children under the age of five years in the study communities in Lagos State. Secondly, it showed that family characteristics have a significant association with developmental delay in children. Thirdly, this study concludes that of the psycho-social factors studied, maternal depression and poor social support tend to be significantly associated with developmental delay. Child development could be influenced by the synergistic effects of the family, environment, social structures, interactive bonding and emotional nurturance from caregivers which work to nurture proper child development. Addressing family characteristics and psychosocial factors associated with developmental delay should be an integral component of promotional and preventive measures aimed at improving child development in Nigeria.