Abstract
Background: This study was undertaken to determine the association between poor developmental attainment (PDA) and biological, home environment and socio-demographic factors in a population-based sample of Canadian children.
Methods: Cross-sectional data from two cycles (1994/95 and 1996/97) of the National Longitudinal Survey of Children and Youth were used. Children aged 1–5 years were included. PDA was defined as ≤15th percentile for motor and social developmental skills (1–3 year olds) or Peabody Picture Vocabulary Test (4–5 year olds). Multiple logistic regression was used.
Results: The proportion of children with PDA varies across Canada, between males and females, and by age. Among 1 year olds in Cycle I, having a low birthweight (OR=3.3; 95% CI: 2.1–5.2), being male (OR=1.6; 95% CI: 1.2–2.2) and having a mother who is an immigrant (OR=1.6; 95% CI: 1.1–2.2) increased the odds of PDA. Similar results were observed in Cycle II. Among children aged 4–5 years in Cycle II, having a mother who is an immigrant (OR=5.3; 95% CI: 4.1–6.9) and a mother with low educational attainment (OR=2.8; 95% CI: 2.1–3.9) increased the odds of PDA. Low income was a significant predictor of PDA across all age groups.
Interpretation: The strong and consistent associations with living in a low-income household, having a mother with low educational attainment or a mother who is an immigrant highlight the need for targeting developmental assessments and services to this population.
Résumé
Contexte: Cette étude a été effectuée pour évaluer les liens entre le niveau de développement (ND) et les facteurs biologiques, domestiques et socio-démographiques dans un échantillon représentatif d’enfants canadiens.
Méthode: Les données transversales de deux cycles (1994–1995 et 1996–1997) de l’Enquête longitudinale nationale sur les enfants et les jeunes ont été utilisées. Les enfants âgés de 1–5 ans ont été inclus. Un faible ND a été défini comme inférieur au 15e percentile pour les aptitudes de développement moteur et social (1–3 ans) ou selon le Test d’échelle vocabulaire en image Peabody (4–5 ans). La régression logistique multiple a été utilisée.
Résultats: La proportion d’enfants souffrant d’un faible ND varie d’une région à l’autre du Canada selon le sexe et l’âge. Chez les enfants de 1 an du Cycle I, le fait d’avoir un faible poids à la naissance (RC=3,3; IC de 95 % = 2,1–5,2), d’être un garçon (RC=1,6; IC de 95 % = 1,2–2,2) et d’avoir une mère immigrée (RC=1,6; IC de 95 % = 1,1–2,2) augmentaient le risque de présenter un faible ND. Les mêmes résultats ont été obtenus dans le Cycle II. Chez les enfants de 4–5 ans du Cycle II, le fait d’avoir une mère immigrée (RC=5,3; IC de 95 % = 4,1–6,9) et une mère avec un faible niveau d’études (RC=2,8; IC de 95 % = 2,1–3,9) augmentaient le risque de présenter un faible ND. Un foyer à faible revenu était un facteur de risque significatif de faible ND dans toutes les catégories d’âge.
Interprétation: Les liens forts et cohérents entre le fait de vivre dans un foyer à faible revenu, d’avoir une mère faiblement scolarisée et d’avoir une mère immigrée soulignent le besoin de cibler des contrôles et des services de développement pour ces enfants.
Footnotes
Disclaimer: This analysis was based on the Statistics Canada master file National Longitudinal Survey of Children and Youth which contains anonymized data collected in the 1994/95 and 1996/97 Special Survey. All computations were prepared by the Population Health Sciences Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. The responsibility for the use and interpretation of these data is entirely that of the authors. The opinions expressed do not represent the views of Statistics Canada.
Acknowledgements: Funding for this project was made available through the National Health Research and Development Program (NHRDP grant no. 6606-06-1999/2590112). The Paediatric Outcomes Research Team is funded by The Hospital for Sick Children Foundation. Dr. Teresa To is supported by the Canadian Institutes of Health Research and the Ontario Ministry of Health and Long-Term Care through an Investigator Award. Dr. Paul Dick is supported by the Ontario Ministry of Health and Long-Term Care through a Career Scientist Award (#05239). Dr. Astrid Guttmann is supported by a Senior Research Fellowship from the Canadian Institutes of Health Research. The results and conclusions are those of the authors; no official endorsement by the Ministry of Health is intended or should be inferred.
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