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National Health And Morbidity Survey 2016 : Maternal And Child Health (MCH) Volume II : Findings

6.1. Developmental Delay

Contributors : Noraida Mohamad Kasim, Maisarah Omar, Kawselyah Juval, Norazizah Ibrahim Wong,
Mohamad Aznuddin Abdul Razak, Mohd Azza Azlan, Aminah Bee Mohd Kassim Sangita Dharshini Terumalay,
Norazizah Ibrahim Wong, Tahir Aris

6.1.1. Introduction

Developmental delay (DD) is defined as the failure of an individual under the age 5 years to meet
1
expected developmental milestones across multiple areas of intellectual functioning. The prevalence
of developmental delay among infants, toddlers and preschool children has been estimated at 5-16%
2
globally. Delayed development is commonly associated with mental or physical disabilities or both,
resulting in substantial functional limitation on major life activities. 3,4

Most developmental disabilities are thought to be caused by multiple risk factors. These includes
genetic and environmental factors as well as complications during antenatal, perinatal and postnatal
period. Early detection and intervention can improve neurodevelopmental outcomes and maximise
5
the child’s abilities.

The Ministry of Health Malaysia has taken initiatives to improve the early detection of developmental
delay among children aged 0 to 6 years through regular clinic visit and developmental screening
tests. The revised child health programme (2008) includes specific developmental screening at
specified intervals. Red Flags for the various developmental domains namely gross motor, vision and
fine motor, speech and language as well as social skills have been included. In addition, the Modified
Checklist for Autism in Toddlers (MCHAT) was incorporated in the New Child Health Record Book and
has been fully implemented from year 2013.

6.1.2. Findings

In NHMS 2016, the developmental milestones were assessed according to the respondent’s age. The
questions were derived from four components i.e gross motor, fine motor, social skills and speech.
Failure in any one of the above components was categorized as developmental delay.

The total prevalence of developmental delay among children aged 6-59 months was 3.3% (95% CI:
2.58-4.19). According to the four components, the highest prevalence was found in speech at 1.7%
(95% CI: 1.22-2.44) followed by social skills at 1.2% (95% CI: 0.85-1.57), fine motor at 0.7% (95%
CI: 0.52-1.01) and gross motor at 0.6% (95% CI: 0.41-0.87).

The prevalence of developmental delay among Malaysian citizens was 3.1% (95% CI: 2.43-3.93).
However the non-Malaysian citizens showed higher prevalence of 14.3% (95% CI: 8.69-22.52),
probably due to smaller numbers of respondents.

The percentages of children aged 6-59 months who were developmentally delayed according to
sociodemographic status is shown in Table 6.1.2. The percentages of developmental delay according
to various age groups was 4.8% (95% CI: 2.04-10.75) for those aged 6-11 months , 4.0% (95% C1:
2.80-5.81) for those aged 12-23 months and 2.9% (95% CI: 2.25-3.66) for those aged 24-59 months.

1. Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
2. Bremberg, S. 2000. Quality of Evidence for the Present Swedish Child Health Surveillance Programme. Acta Paediatricals Supplement, 434, 8-11.
3. Earl M. and Hay, S. (2006). Setting the Stage for Success: Implementation of Developmental and Behaviour Screening and Surveillance in Primary Care
Practice-the North Carolina Assessing Better Child Health and Development (ABCD) Project. Paediatrics, 118, 183-185
4. Karoly L., Greenwood S., Everingham J., Hoube M., Kilburn C., Rydell M., 2005. Investing in our children: what we know and don't know about the cost
and benefits of early interventions. RAND report.
5. Center For Disease Control and Prevention (CDC) http://www.cdc.gov/ncbddd/childdevelopment/index.html
6. Amar Singh H. 2005. Pre-schoolers-Who's Baby an Evaluation of the Need for Health Service (Child Health Surveillance) Pre -School Children. Eight
National Paediatric Conference, (pp. 1-8). Malaysia.