Prenatal Risk Factors for Developmental Delay in Newcomer Children

Causes of developmental disabilities Developmental disabilities can involve a cognitive or sensory difficulty, social or communications/language-related problem, a motor impairment, adaptive delay or some combination of these. The Global Disease Control Priorities Project estimates that 10% to 20% of individuals worldwide have a developmental disability of some kind.1 In the U.S. alone, it is estimated that 9% of children younger than 36 months of age have a possible developmental problem,2 while 13.87% of children 3 to 17 years of age have a developmental disability.3 Health care providers who see newcomer families have a pivotal role to play in identifying and initiating early treatment for developmental disabilities. As child or family advocates, we communicate not only with family members but with related health services, including community programs and supports Developmental disabilities may last a lifetime but early recognition of their existence, a timely diagnosis and an appropriate treatment plan can make a difference for the children and families involved. When seeing newcomer families, recognize that risk factors are cumulative. In many parts of the world, suboptimal conditions and care during pregnancy and childbirth can have a range of impacts on developmental health. Consider the spectrum: risks common in developing countries, specific to this family’s country of origin, and factors that are family- or ethnicity-specific. Be ready for diverse attitudes about developmental disabilities. Respond quickly and sensitively to early signs of a developmental disability. A timely intervention will improve developmental outcomes and the family’s adjustment. Developmental disabilities in immigrant and refugee children do not always have a known cause. Common prenatal and perinatal risk factors to consider when taking a patient or family history are reviewed here. Prenatal risk factors include: Preconceptional factors Infections Exposure to toxins Maternal chronic illness Maternal nutritional deficiencies Perinatal causes may include: Pregnancy-related complications Infections Rh isoimmunization Prematurity and low birth weight Prenatal risk factors Preconceptional factors Preconceptional causes of developmental disability relate predominantly to genetic disorders or malformation syndromes. Genetic disorders are the most commonly identified causal factor for intellectual and other disabilities, and include single gene disorders, multifa