Parental Concerns About Child Development and Risk of Developmental Delay

Parental concerns and observations about their child’s development and behavior are an important indication of a child’s potential risk for developmental, behavioral, and/or social delays. Parents of young children (aged 4 months to 5 years) were asked about eight specific concerns they may have about their child’s learning, development, or behavior that can predict risk of developmental issues. These eight items were based on the Parent’s Evaluation of Developmental Status (PEDS)©.1 The parents of 40.1 percent of children in this age group reported at least one concern from this list, and this percentage did not vary significantly across locations.

In urban and large rural areas, parents of boys were more likely to report concerns about their learning, development, or behavior than the parents of girls; however, there was no difference for children in small rural areas. Parents of boys in small rural areas were also significantly less likely to report concerns than those in large rural and urban areas (39.0 versus 46.9 and 44.2 percent, respectively). Concerns did not vary for girls across locations.

With regard to race and ethnicity, Hispanic children in all locations were more likely than non-Hispanic White children to have their parents report one or more concerns. In urban and large rural areas, parents of non-Hispanic White children were also less likely to report concerns than those of non-Hispanic Black and non-Hispanic children of multiple or other races. This racial and ethnic difference was not apparent in small rural areas. Parental concerns did not vary significantly by location for any racial or ethnic group.

Parents’ responses to concerns about their children’s development were also used to assess the child’s risk for behavioral, developmental, or social delays. Depending on the child’s age, parents’ concerns in specific areas most likely to predict delays are used to determine a child’s level of risk for future delays. Children whose parents have concerns in one area that is predictive of a delay are considered to be at moderate risk, and children whose parents have concerns in two or more areas are considered to be at high risk. Children whose parents have concerns not predictive of delays or no concerns are classified as low risk. The concerns of the parents of 26.2 percent of children were significant enough to indicate that their child is at moderate or high risk of delay; this percentage does not vary significantly by location.

With regard to race and ethnicity, rates did not vary by location for any specific group. The percentage of children at moderate or high risk of developmental delay was lowest among non-Hispanic White children in every location, compared to all other racial and ethnic groups. About one-fifth of non-Hispanic White children in each location were at moderate or high risk for developmental delay, compared to about a third of Hispanic children and approximately 30 percent or more of non-Hispanic Black and non-Hispanic children of multiple or other races.

Parents were asked if they had concerns about…

  • How child talks and makes speech sounds;
  • How child understands what you say;
  • How child uses his/her hands and fingers to do things;
  • How child uses his/her arms and legs;
  • How child behaves;
  • How child gets along with others;
  • How child is learning to do things for himself/herself; and
  • How child is learning preschool or school skills.

1 Glascoe FP. Parents´ Evaluation of Developmental Status. Nashville, TN: Ellsworth & Vandermeer Press LLC, 2006.

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