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      Evaluating the Knowledge, Attitudes, and Practices of Saudi Arabian Parents Regarding Red Flags in Developmental Milestones

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          Abstract

          Background

          Parents serve a fundamental role in monitoring developmental milestones and identifying potential delays during early childhood, enabling timely interventions. However, previous studies in Saudi Arabia have shown limited awareness among parents regarding age-specific norms and red flags across developmental domains. This knowledge gap can severely impact the detection and management of abnormalities. Hence, a comprehensive understanding of Saudi parental knowledge, attitudes, and practices concerning childhood developmental trajectories is imperative. 

          Methodology

          This cross-sectional study assessed developmental milestone awareness, beliefs, and behaviors among Saudi parents. A sample of 1,052 parents completed a validated 38-item questionnaire covering knowledge, attitudes, practices, and demographics. Knowledge was assessed across developmental domains using 22 multiple-choice questions, with scores categorized as excellent (≥75%), good (50%-75%), fair (40%-50%), or poor (≤39%). Attitudes and practices were captured on five-point Likert scales. Descriptive and chi-square analyses were conducted using IBM SPSS Statistics for Windows, Version 28.0 (IBM Corp., Armonk, NY). 

          Results

          The majority of participants were females (844, 80.2%), with a mean age of 38.8 years. Serious knowledge inadequacies existed regarding developmental timelines across domains, especially motor milestones like crawling (93, 29.4% correct), sitting unsupported (45, 27.6%), pointing at objects (278, 26.4%), and responding to names (440, 41.8%). Overall, 2 (0.2%) participants showed excellent and 281 (26.7%) showed good understanding, while 490 (46.6%) had poor knowledge. Significant sociodemographic variations were observed, with women and experienced parents demonstrating greater awareness ( < 0.001). Despite knowledge gaps, 542 (51.5%) actively sought developmental information themselves, and over 50% trusted pediatric guidance. Most participants expressed a willingness to undergo screenings if risk factors existed and reported spending a considerable amount of daily interaction time with their children, focusing on developmental needs.

          Conclusions

          Critical developmental milestone knowledge shortfalls and selective attitudes persist among Saudi parents, warranting public education and physician-parent communication that enhance interventions to enable impactful developmental monitoring and prompt responses to abnormalities in a timely manner. 

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          Most cited references16

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          Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening.

          , , (2006)
          Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home and an appropriate responsibility of all pediatric health care professionals. This statement provides an algorithm as a strategy to support health care professionals in developing a pattern and practice for addressing developmental concerns in children from birth through 3 years of age. The authors recommend that developmental surveillance be incorporated at every well-child preventive care visit. Any concerns raised during surveillance should be promptly addressed with standardized developmental screening tests. In addition, screening tests should be administered regularly at the 9-, 18-, and 30-month visits. (Because the 30-month visit is not yet a part of the preventive care system and is often not reimbursable by third-party payers at this time, developmental screening can be performed at 24 months of age. In addition, because the frequency of regular pediatric visits decreases after 24 months of age, a pediatrician who expects that his or her patients will have difficulty attending a 30-month visit should conduct screening during the 24-month visit.) The early identification of developmental problems should lead to further developmental and medical evaluation, diagnosis, and treatment, including early developmental intervention. Children diagnosed with developmental disorders should be identified as children with special health care needs, and chronic-condition management should be initiated. Identification of a developmental disorder and its underlying etiology may also drive a range of treatment planning, from medical treatment of the child to family planning for his or her parents.
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            How do primary care physicians identify young children with developmental delays? A national survey.

            Little is known about the current practices of primary care physicians regarding developmental surveillance and screening during pediatric preventive care visits. We conducted a mailed survey of a random national sample of pediatricians and family physicians to describe their practices and identify factors that predict use of developmental screening tools, an efficacious way of identifying children with developmental delays. Most physicians reviewed developmental milestones and prompted parents for developmental concerns at preventive care visits. Approximately half of the physicians used a formal developmental screening instrument. Female physician gender predicted higher rates of use of screening tools for family physicians, but not for pediatricians. Most physicians seemed committed to the early diagnosis of developmental delays. Substantial variability in surveillance and screening practices, barriers of time and reimbursement, and under-reliance on parent-completed questionnaires underscore areas for improvement.
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              Developmental delay: identification and management at primary care level

              Developmental delays are common in childhood, occurring in 10%–15% of preschool children. Global developmental delays are less common, occurring in 1%–3% of preschool children. Developmental delays are identified during routine checks by the primary care physician or when the parent or preschool raises concerns. Assessment for developmental delay in primary care settings should include a general and systemic examination, including plotting growth centiles, hearing and vision assessment, baseline blood tests if deemed necessary, referral to a developmental paediatrician, and counselling the parents. It is important to follow up with the parents at the earliest opportunity to ensure that the referral has been activated. For children with mild developmental delays, in the absence of any red flags for development and no abnormal findings on clinical examination, advice on appropriate stimulation activities can be provided and a review conducted in three months’ time.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                23 January 2024
                January 2024
                : 16
                : 1
                : e52769
                Affiliations
                [1 ] Pediatrics, Al-Baha University, Al-Baha, SAU
                [2 ] Clinical Pharmacy, Al-Noor Specialist Hospital, Mecca, SAU
                [3 ] College of Medicine, King Saud University, Riyadh, SAU
                [4 ] College of Medicine, Alfaisal University, Riyadh, SAU
                [5 ] Pediatrics, Al Aziziya Hospital, Jeddah, SAU
                [6 ] General Practice, Al-Baha Health Affairs, Al-Baha, SAU
                [7 ] Respiratory Therapy, King Saud bin Abdulaziz University for Health Sciences, Alahsa, SAU
                [8 ] College of Medicine, Imam Abdulrahman Bin Faisal University, Dhahran, SAU
                [9 ] Medicine, University of Tabuk, Tabuk, SAU
                [10 ] Medicine, Al-Rayan College of Medicine, Al-Madinah al-Munawwarah, SAU
                [11 ] Medicine, Al-Baha Faculty of Medicine, Al-Baha University, Al-Baha, SAU
                Author notes
                Article
                10.7759/cureus.52769
                10882250
                38389630
                aa7beeaa-d8ae-4d38-863a-508ed065d204
                Copyright © 2024, Alzahrani et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 22 January 2024
                Categories
                Family/General Practice
                Neurology
                Pediatrics

                practices,red flags,attitudes,knowledge,developmental milestones,saudi arabian parents

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