Detecting developmental delays in infants from a low-income South African community: comparing the BSID-III and PEDS tools

ABSTRACT

Detecting developmental delays is essential for early intervention in low to middle-income countries. A cross-sectional, within-subject, comparative design was employed to determine the performance of the Parents Evaluation of Developmental status (PEDS) tools smartphone application and the Bayley Scales of Infant and Toddler Development III (BSID III) to detect developmental delays in 174 young children aged 3–18 months. Data were collected at a primary healthcare (PHC) clinic in an underserved high-risk community in South Africa. The PEDS tools identified 56% (n = 97), and the BSID-III 35% (n = 61) of the 158 children with possible developmental delays, with an overall agreement of 65% between tests. The PEDS tools referral rate was significantly higher (p = 0.004) than that of the BSID-III. The high-risk nature and age group may have contributed to poor agreement across tools. A combination of tools for screening and assessment in infants in a South African PHC context may be necessary.

KEYWORDS:

• Communication delays
• developmental delay
• primary health care
• early intervention
• mhealth

Acknowledgements

The authors thank all the children and caregivers who participated in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Thuthuka Funding Grant (TTK170512230728) from the National Research Foundation (NRF).

Notes on contributors

Shabnam Abdoola

Shabnam Abdoola is a dually qualified SLT & A, with a Master’s Degree in Early Childhood Intervention. She is employed as a lecturer in the Department of Speech-Language Pathology and Audiology, University of Pretoria, where she currently lectures modules on disorders of fluency, early communication intervention and ethics. Miss Abdoola was previously employed in academia at the University of the Witwatersrand and in clinical private and public practice. Her research interests are early childhood intervention, developmental delay, public health, and service delivery in underserved communities. Miss Abdoola is currently busy with her PhD, entitled ‘Developmental screening using mobile health technology: A South African primary health care perspective’. She was awarded the Vice Chancellor’s Academic Development Grant, as well as a NRF Thuthuka Grant for her PhD.

De Wet Swanepoel

Prof. De Wet Swanepoel is professor in the Department of Speech-Language Pathology and Audiology, University of Pre-toria with adjunct positions at the University of Western Australia, and is a senior research fellow at the Ear Science Institute Australia. Prof. Swanepoel’s research capitalizes on the growth in information and communication technologies to explore, develop and evaluate innovative service delivery models and applied solutions to improve access to early development and health services, particularly in ear and hearing care. He has published more than 140 peer-reviewed articles, books and book chapters and has received numerous national and international awards in recognition of his work. Prof. Swanepoel serves as president of the International Society of Audiology and as deputy editor-in-chief of the International Journal of Audiology.

Jeannie Van Der Linde

Dr Jeannie van der Linde is senior lecturer in the Department of Speech-Language Pathology and Audiology, University of Pretoria. Her research explores early childhood development and service delivery in underserved communities. Innovative solutions are explored to improve service delivery in these communities. Her research focus originated from her masters and PhD studies. Her recent publications include: ‘Evaluation of a Zulu translation of the Parents’Evaluation of Developmental Status’ (van der Merwe, Cilliers, Mare, van der Linde, & le Roux, 2017) and ‘Early detection of communication delays with the PEDS tools in at-risk South African infants’ (van der Linde, Swanepoel, Hanekom, Lemmer, Schoeman, Glascoe, & Vinck, 2016).

Frances P. Glascoe

Dr Frances Page Glascoe is the author of PEDS, co-author of the PEDS: DM, and has conducted abundant research on these measures as well as other screening tools. For 12 years, she directed the rotation in developmental and behavioural paediatrics at Vanderbilt University and is the recipient of the American Academy of Paediatrics Dale Richmond Award for contributions in child development. Dr Glascoe is a Professor of Paediatrics at Vanderbilt University and serves on the editorial board of the Journal of Developmental and Behavioural Paediatrics. She has one child (well, a young adult actually) who is a costumer at the Metropolitan Opera in New York City.