Psychomotor developmental delay in urban children from 0 to 5 years: Case study of the urban area of ​​Cuenca, Ecuador

A cross-sectional survey was conducted in the period January-June 2009 on children in the age group 0 to 5 years to determine the prevalence of delays in psychomoter development. The surveyed infancy population belonged to public, private, regular and special Child Development Centers of the City of Cuenca. Delays in psychomoter development with and without disabilities were recorded, together with the number of children that benefited from early care taking. Observations were related to the level of malnutrition, failure of brain growth, the family composition, the migration of parents and the replacement caregiver by mother-absence. The stratified random probability sample was calculated with EpiInfoTM with 5% frequency delay, 3% error of inference, 95% confidence and 10% loss (N = 8537, n = 462). Seven teams of specialists diagnosed first the delay in psychomoter development using the Brunet-Lezine test, followed by measuring the disability of the 0 to 3 year old children using the Situation Dependency Valorization Scale, and the Situation Dependency Rating Scale for the 3 to 5 year olds. The malnutrition status was assessed measuring the anthropometry expressed in number of standard deviations with reference to the WHO growth charts. All other variables were recorded on the basis of surveys. The study revealed that 11% (IC95%, 8 to 14%) demonstrated a delay in psychomotor development, 6% without disability and 5% with disability, and 31% benefited from early intervention. A relationship between delayed psychomotor development with malnutrition (p < 0,001), microcephaly (p < 0,002) and non-nuclear family (p < 0,005) was found. Neither the replacement caregiver by mother-absence, nor the migration of the parents, seems to be causal factors. Results justify the establishment of early intervention programs.