Assessing Developmental Delays in Early Childhood: Insights from Iranian Children Using the Bayley Scales of Infant and Toddler Development (BSID-III)

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The Bayley Scales of Infant and Toddler Development (BSID-III) is widely used for developmental assessment but remains understudied in Iranian children. Methods This cross-sectional study assessed 707 Iranian children aged 1 to 42 months in Yazd, Iran, using the BSID-III. We hypothesized differences in BSID-III scores compared to normative samples, considering age, gender, and parental education. Data were collected from two health centers in Yazd, with trained examiners following standardized procedures. Parental education was analyzed for its impact on developmental outcomes. Comparisons between BSID-III scores and Ages and Stages Questionnaire (ASQ) outcomes provided additional insights. Results Iranian children exhibited varying rates of developmental disorders across cognitive, language, and motor domains, influenced by parental education (higher parental education correlated with a reduced occurrence of developmental disorders). For instance, in the cognitive domain, 15.8% of children demonstrated developmental disorders. The language scale exhibited varying rates: 20.1% for perceptual communication and 18.4% for expressive communication. Furthermore, the BSID-III and ASQ results demonstrated discordances, highlighting the complexities of assessment. Conclusions This study contributes to the knowledge of developmental assessment in Iranian early childhood. It emphasizes the importance of culturally sensitive adaptations of assessment tools and the role of parental education in shaping developmental outcomes. Future research should incorporate diverse, longitudinal samples for enhanced understanding. Ultimately, this study aims to inform clinical practices, policy development, and early intervention programs, committed to fostering optimal development for all children, irrespective of their backgrounds. Developmental Delay Bayley Scales of Infant and Toddler Development Children Parental Education Cultural Adaptation Background Developmental delay is a term that describes the condition of children who do not meet the expected milestones for their age in one or more domains of development, such as cognitive, motor, language, social-emotional, or adaptive skills [ 1 ]. Developmental delay can have various causes, such as genetic disorders, prenatal exposure to drugs or alcohol, prematurity, low birth weight, infections, malnutrition, or environmental deprivation [ 2 ]. Developmental delay can have significant implications for the child's health, education, and well-being, as well as for the family and society [ 3 ]. One of the tools that is widely used to assess developmental delay in early childhood is the Bayley Scales of Infant and Toddler Development (BSID) [ 4 ]. The BSID is a standardized test that measures the developmental functioning of children from 1 to 42 months of age across five domains: cognitive, language, motor, social-emotional, and adaptive behavior [ 5 ]. The BSID has been revised several times since its first edition in 1969, and the latest version is the BSID-III, which was published in 2006 [ 6 ]. The BSID-III has been validated and standardized for different populations and cultures around the world [ 7 – 15 ]. However, there is limited research on the use and performance of the BSID-III in Iranian children. Previous studies have reported that Iranian children scored lower than the normative sample on some domains of the BSID-II [ 16 ] and the BSID-III [ 17 ], suggesting that cultural and environmental factors may influence the test results. Therefore, the aim of this study was to evaluate the developmental outcomes of children aged 1 to 42 months in Yazd, Iran, using the BSID-III. We hypothesized that Iranian children would score lower than the normative sample on some domains of the BSID-III, and that there would be significant differences in the test scores according to age, gender and maternal education. Methods Study Design This research employed a descriptive cross-sectional design to assess the developmental status of children aged 1 to 42 months using the BSID-III. Data were collected from two health centers in Yazd, Bagher Salari and Haji Maqsoudi, recognized for conducting the BSID-III assessments. Study Population The study population consisted of children who underwent Bayley tests at the aforementioned health centers in Yazd, Iran. A total of 707 children aged between 1 and 42 months, referred with suspected developmental delay, were included. The study was conducted from January to December 2020, with participants selected through the census sampling method. Exclusion criteria encompassed children born prematurely to ensure result integrity and analysis consistency. Data Collection and Quality Control Data collection involved reviewing and extracting information from children's files. Two trained examiners, who had completed a BSID-III certification course, performed data collection. The examiners adhered to standardized administration and scoring procedures as described in the BSID-III manual [6]. Examiners were blinded to participants' demographic and clinical information. A third examiner conducted data entry and quality control, ensuring accuracy and completeness. Demographic characteristics and Bayley test results were collected, spanning cognitive, linguistic, and motor development domains. BSID-III Test The BSID-III is a standardized test assessing developmental functioning in children aged 1 to 42 months across five domains: cognitive, language, motor, social-emotional, and adaptive behavior [6]. It comprises items administered by trained examiners. Test results include raw scores, scaled scores, composite scores, percentile ranks, age equivalents, and growth scores [6]. The BSID-III has been validated and standardized for diverse populations [7-15]. Statistical Data Analysis Data analysis involved using SPSS software version 25 to compute descriptive statistics, including frequency and percentage distributions. Chi-square tests were employed to explore associations between different variables, with significance set at 0.05. Developmental Status Criteria: Children's developmental status was determined by aligned scores, which ranged from 1 to 19. Aligned scores were categorized as follows: Aligned score > 7: Normal (more than -1SD) 4 < Aligned score ≤ 7: Mild developmental problems (-1SD to -2SD) Aligned score ≤ 4: Severe developmental problems (less than -2SD) Comparison with ASQ Questionnaire To compare BSID-III results with the Ages and Stages Questionnaire (ASQ) outcomes, information from both tests was recorded and managed using Excel software. The Kappa coefficient of agreement assessed concordance between the two tests in identifying developmental disorders. Ethical Considerations The Ethics Committee of Shahid Sadoughi University of Medical Sciences approved the study (IR.SSU.REC.1400.150), ensuring adherence to ethical guidelines and regulations for human research. Written informed consent was obtained from parents or guardians, and participants' data confidentiality was maintained throughout the study. Results The investigation aimed to assess the prevalence and patterns of developmental disorders among children aged 1 to 42 months in Yazd using the BSID-III. A total of 707 children were included in the study, encompassing both genders and various age groups. The BSID-III was employed to measure cognitive, language, and motor development domains. The results revealed several significant findings regarding the prevalence of developmental disorders, the influence of parental education, and the comparison between the BSID-III scores and the ASQ outcomes. The prevalence of developmental disorders across the cognitive, language, and motor scales was investigated (Table 1 ). In the cognitive domain, 15.8% of the studied children demonstrated developmental disorder. The language scale exhibited varying rates: 20.1% for perceptual communication and 18.4% for expressive communication. Similarly, the movement scale displayed developmental disorders of 13.6% for fine movements and 15.7% for gross movements. Notably, the highest frequency of developmental disorders within the language domain pertained to perceptual communication (20.1%) and expressive communication (18.4%). Within these domains, 6% and 5.8% respectively presented with severe forms of the disorder. Table 1 Disorder Status within Developmental Areas (Based on BSID-III Results) Developmental Area Normal (N) Mild Developmental Problems (MDP) Severe DP (SDP) Total Cognitive 586 (84.2) 77 (11.1) 33 (4.7) 696 (100) Perception 548 (79.9) 97 (14.1) 41 (6.0) 686 (100) Expression 563 (81.6) 87 (12.6) 40 (5.8) 690 (100) Fine Motor 591 (86.4) 76 (11.1) 17 (2.5) 684 (100) Gross Motor 581 (84.3) 71 (10.3) 37 (5.4) 689 (100) Regarding the distribution of ages within the study population, out of the 707 children examined, 78.4% were aged 2 years and under, while 21.6% were over 2 years old. The highest percentage of normal scores, based on the Bayley criteria (Table 2 ), was observed in the Fine Motor area, followed by the Perception area. The presented results (Table 2 ) indicated significant variations in the distribution of Bayley's leveled scores in the areas of perception, expression, and fine motor based on age categories. Table 2 Disorder Status within Age Groups (Based on BSID-III Results) Age Groups Disorder Status Cognitive Perception Expression Fine Motor Gross Motor <= 24 Months N 468 (85.7) 452 (83.2) 472 (86.4) 477 (88.2) 459 (84.5) MDP 56 (10.3) 69 (12.7) 59 (10.8) 52 (9.6) 52 (9.6) SDP 22 (4.0) 22 (4.1) 15 (2.7) 12 (2.2) 32 (5.9) Total 546 (100) 543 (100) 546 (100) 541 (100) 543 (100) > 24 Months N 118 (78.7) 96 (67.1) 91 (63.2) 114 (79.7) 122 (83.6) MDP 21 (14.0) 28 (19.6) 28 (19.4) 24 (16.8) 19 (13.0) SDP 11 (7.3) 19 (13.3) 25 (17.4) 5 (3.5) 5 (3.4) Total 150 (100) 143 (100) 144 (100) 143 (100) 146 (100) P value 0.087 0.000 0.000 0.032 0.267 Further analysis explored the relationship between developmental disorder prevalence and parental education. An inverse correlation was observed between the father's education level and the occurrence of developmental disorders across all developmental areas (Table 3 ). As the father's education level increased, the frequency of developmental disorders decreased significantly. Table 3 Disorder Status within Father’s Education Level Groups (Based on BSID-III Results) Father’s Education Level Disorder Status Cognitive Perception Expression Fine Motor Gross Motor Middle & Primary School N 69 (71.9) 58 (61.1) 69 (71.9) 68 (71.6) 66 (70.2) MDP 14 (14.6) 28 (29.5) 15 (15.6) 21 (22.1) 17 (18.1) SDP 13 (13.5) 9 (9.5) 12 (12.5) 6 (6.3) 11 (11.7) Total 96 (100) 95 (100) 96 (100) 95 (100) 94 (100) High School & Associate Degree N 195 (82.3) 181 (77.4) 180 (77.6) 203 (86.8) 198 (83.9) MDP 28 (11.8) 34 (14.5) 31 (13.4) 24 (10.3) 24 (10.2) SDP 14 (5.9) 19 (8.1) 21 (9.1) 7 (3.0) 14 (5.9) Total 237 (100) 234 (100) 232 (100) 234 (100) 236 (100) Bachelor’s Degree N 193 (89.8) 180 (85.7) 186 (86.9) 188 (90.0) 187 (88.2) MDP 18 (8.4) 24 (11.4) 24 (11.2) 18 (8.6) 18 (8.5) SDP 4 (1.9) 6 (2.9) 4 (1.9) 3 (1.4) 7 (3.3) Total 215 (100) 210 (100) 214 (100) 209 (100) 212 (100) Master’s Degree or Higher N 125 (88.0) 126 (89.4) 124 (87.3) 127 (90.7) 126 (89.4) MDP 16 (11.3) 8 (5.7) 15 (10.6) 12 (8.6) 11 (7.8) SDP 1 (0.7) 7 (5.0) 3 (2.1) 1 (0.7) 4 (2.8) Total 142 (100) 141 (100) 142 (100) 140 (100) 141 (100) P Value 0.000 0.000 0.000 0.001 0.002 In contrast, the mother's education level correlated with the frequency of developmental disorders in specific areas (Table 4 ). While it led to a significant decrease in all developmental areas except gross movements, it showed no substantial impact on gross motor skill development. Table 4 Disorder Status within Mother’s Education Level Groups (Based on BSID-III Results) Mother’s Education Level Disorder Status Cognitive Perception Expression Fine Motor Gross Motor Middle & Primary School N 38 (74.5) 31 (62.0) 38 (74.5) 36 (72.0) 39 (78.0) MDP 7 (13.7) 15 (30.0) 5 (9.8) 12 (24.0) 8 (16.0) SDP 6 (11.8) 4 (8.0) 8 (15.7) 2 (4.0) 3 (6.0) Total 51 (100) 50 (100) 51 (100) 50 (100) 50 (100) High School & Associate Degree N 177 (80.1) 160 (73.1) 168 (76.0) 185 (84.5) 178 (80.5) MDP 29 (13.1) 44 (20.1) 40 (18.1) 27 (12.3) 30 (13.6) SDP 15 (6.8) 15 (6.8) 13 (5.9) 7 (3.2) 13 (5.9) Total 221 (100) 219 (100) 221 (100) 219 (100) 221 (100) Bachelor’s Degree N 265 (87.2) 253 (84.9) 256 (85.9) 261 (88.2) 259 (86.3) MDP 30 (9.9) 29 (9.7) 29 (9.7) 29 (9.8) 24 (8.0) SDP 9 (3.0) 16 (5.4) 13 (4.4) 6 (2.0) 17 (5.7) Total 304 (100) 298 (100) 298 (100) 296 (100) 300 (100) Master’s Degree or Higher N 102 (89.5) 101 (89.4) 97 (85.1) 104 (92.0) 101 (90.2) MDP 10 (8.8) 6 (5.3) 11 (9.6) 7 (6.2) 8 (7.1) SDP 2 (1.8) 6 (5.3) 6 (5.3) 2 (1.8) 3 (2.7) Total 114 (100) 113 (100) 114 (100) 113 (100) 112 (100) P Value 0.017 0.000 0.003 0.030 0.149 Moreover, data analysis (Table 5 ) indicated significant variations in the distribution of Bayley's leveled scores in the areas of perception and expression based on gender categories. Table 5 Disorder Status within Gender Groups (Based on BSID-III Results) Gender Disorder Status Cognitive Perception Expression Fine Motor Gross Motor Male N 310 (82.2) 286 (76.5) 291 (77.4) 314 (84.6) 312 (83.4) MDP 45 (11.9) 58 (15.5) 56 (14.9) 45 (12.1) 38 (10.2) SDP 22 (5.8) 30 (8.0) 29 (7.7) 12 (3.2) 24 (6.4) Total 377 (100) 374 (100) 376 (100) 371 (100) 374 (100) Female N 276 (86.5) 262 (84.0) 272 (86.6) 277 (88.5) 269 (85.4) MDP 32 (10.0) 39 (12.5) 31 (9.9) 31 (9.9) 33 (10.5) SDP 11 (3.4) 11 (3.5) 11 (3.5) 5 (1.6) 13 (4.1) Total 319 (100) 312 (100) 314 (100) 313 (100) 315 (100) P value 0.221 0.018 0.005 0.237 0.414 The ASQ was used as a comparator to the BSID-III results (Table 6 ). Among children with normal fine motor development according to the Bayley test, 71.4% were also identified as having normal development in this area in the ASQ test. Conversely, 19% were classified as requiring referral and 9.5% had acute problems in the ASQ test. For children diagnosed with "need for referral" in the Bayley test, 68.8% exhibited normal development in the ASQ assessment. Similarly, discrepancies between the two tests were observed for gross motor (Table 7 ) and cognitive development (Table 8 ) categories. Table 6 Comparing the Outcomes of the BSID-III Fine Motor Area with the ASQ Fine Motor Area in Terms of Disorder Severity Fine Motor (BSID-III) Fine Motor (ASQ) Total P-value Normal (N) Referral Required (RR) Acute Disorder (AD) Normal (N) 15 (71.4) 4 (19.0) 2 (9.5) 21 (100) 0.329 Referral Required (RR) 11 (68.8) 4 (25.0) 1 (6.3) 16 (100) Acute Disorder (AD) 2 (40.0) 1 (20.0) 2 (40.0) 5 (100) Total 28 (66.7) 9 (21.4) 5 (11.9) 42 (100) Table 7 Comparing the Outcomes of the BSID-III Gross Motor Area with the ASQ Gross Motor Area in Terms of Disorder Severity Gross Motor (BSID-III) Gross Motor (ASQ) Total P-value N RR AD N 14 (87.5) 1 (6.3) 1 (6.3) 16 (100) 0.144 RR 11 (64.7) 5 (29.4) 1 (5.9) 17 (100) AD 3 (37.5) 4 (50.0) 1 (12.5) 8 (100) Total 11 (64.7) 5 (29.4) 1 (5.9) 17 (100) Table 8 Comparing the Outcomes of the BSID-III Cognitive Area with the ASQ Connection Area in Terms of Disorder Severity Cognitive (BSID-III) Connection (ASQ) Total P-value N RR AD N 12 (60.0) 1 (5.0) 7 (35.0) 20 (100) 0.055 RR 5 (41.7) 5 (41.7) 2 (16.7) 12 (100) AD 2 (20.0) 4 (40.0) 4 (40.0) 10 (100) Total 19 (45.2) 10 (23.8) 13 (31.0) 42 (100) Comparative analysis of the BSID-III and the ASQ outcomes demonstrated mixed concordance rates across the cognitive (Table 9 ), fine motor (Table 10 ), and gross motor (Table 11 ) domains. The Kappa coefficient of agreement indicated that the frequency distribution of scores in the two tests did not match completely. The developmental status assessments provided by the two tests exhibited differences in their classifications of children as "normal" or "with problems," emphasizing the need for cautious interpretation of the results. Table 9 Comparing the Outcomes of the BSID-III with the ASQ in Terms of Cognitive Area Based on the Existence or Absence of Disorder Cognitive (BSID-III) Connection (ASQ) Kappa Coefficient Normal Disordered Total n % within BSID-III % within ASQ n % within BSID-III % within ASQ n % within BSID-III % within ASQ Normal 12 60.0 63.2 8 40.0 34.8 20 100 50.0 0.095 Disordered 7 31.8 36.8 15 68.2 65.2 22 100 50.0 Total 19 45.2 100 23 54.8 100 42 100 100 Table 10 Comparing the Outcomes of the BSID-III with the ASQ in Terms of Fine Motor Area Based on the Existence or Absence of Disorder Fine Motor (BSID-III) Fine Motor (ASQ) Kappa Coefficient Normal Disordered Total n % within BSID-III % within ASQ n % within BSID-III % within ASQ n % within BSID-III % within ASQ Normal 15 71.4 53.6 6 28.6 42.9 21 100 50.0 0.095 Disordered 13 61.9 46.4 8 38.1 57.1 21 100 50.0 Total 28 66.7 100 14 33.3 100 42 100 100 Table 11 Comparing the Outcomes of the BSID-III with the ASQ in Terms of Gross Motor Area Based on the Existence or Absence of Disorder Gross Motor (BSID-III) Gross Motor (ASQ) Kappa Coefficient Normal Disordered Total n % within BSID-III % within ASQ n % within BSID-III % within ASQ n % within BSID-III % within ASQ Normal 14 87.5 50.0 2 12.5 15.4 16 100 39.0 0.278 Disordered 14 56.0 50.0 11 44.0 84.6 25 100 61.0 Total 28 68.3 100 13 31.7 100 41 100 100 To sum up, the study highlighted the prevalence of developmental disorders in various domains among children aged 1 to 42 months in Yazd using the BSID-III assessment tool. The influence of parental education on developmental disorder prevalence was evident, with higher education levels associated with decreased frequency. Additionally, comparisons between the BSID-III and the ASQ results unveiled variations in developmental status classification, underscoring the importance of utilizing multiple assessment tools to obtain a comprehensive understanding of children's developmental progress. These findings contribute to the existing literature on developmental assessment and underscore the significance of tailored interventions to address children's developmental needs. Discussion The present study aimed to evaluate the developmental outcomes of children aged 1 to 42 months in Yazd, Iran, using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). The findings shed light on the prevalence and patterns of developmental disorders across various domains, highlighted the influence of parental education on developmental disorder prevalence, and compared the BSID-III scores with the Ages and Stages Questionnaire (ASQ) outcomes. In the context of the broader literature, these results contribute to the understanding of developmental assessment in early childhood and underscore the importance of considering cultural and contextual factors in interpreting assessment outcomes. This section will discuss the study's findings in the context of existing literature, highlight implications for clinical practice and policy, address methodological considerations, and suggest areas for future research. The observed prevalence rates of developmental disorders in the cognitive, language, and motor domains among the study population add to the growing body of evidence that emphasizes the significance of early developmental assessment. The findings of this study align with previous research conducted in other settings. For instance, studies such as Valla et al. [ 1 ] and Anderson and Burnett [ 2 ] have reported varying rates of developmental delays, emphasizing the importance of a comprehensive approach to assessment. Valla et al. conducted a regional population-based longitudinal study and found a 19.7% prevalence of suspected developmental delays in infants aged 6 to 12 months [ 1 ]. Our study's cognitive, language, and motor scales showed similar patterns, with prevalence rates ranging from 13.6–20.1%. The diversity in developmental disorder prevalence across different domains may be attributed to the multifaceted nature of development and the intricate interplay of genetic, environmental, and cultural factors. Furthermore, the findings resonate with research by Gould et al. [ 3 ], highlighting the long-term implications of early developmental assessment. Parental education emerged as a significant factor influencing the prevalence of developmental disorders, particularly among fathers. Our study revealed an inverse correlation between parental education levels and the occurrence of developmental disorders. These findings align with previous research by Klein-Radukic and Zmyj [ 4 ], highlighting the role of socioeconomic factors in developmental outcomes. Moreover, our results are consistent with the study by Pitchik et al. [ 18 ], who reported a positive correlation between maternal education and the ASQ and BSID-III scores, indicating better developmental outcomes. Similar observations were made by Ballot et al., who found that higher parental education levels were associated with better developmental outcomes [ 8 ]. The inverse correlation between parental education levels and developmental disorder prevalence underscores the potential benefits of targeted interventions and parental education programs. Similar findings have been documented in other cultural contexts, such as the study by Hoskens et al. [ 5 ], demonstrating the importance of addressing parental education as a key factor in early childhood development. Comparisons between the BSID-III scores and the ASQ outcomes revealed variations in developmental status classification. The observed discordances between the two assessment tools resonate with the broader literature. Madaschi et al. [ 6 ] and Adams-Chapman et al. [ 7 ] similarly noted differences in developmental assessments, highlighting the complexity of capturing the full spectrum of developmental progress through a single assessment tool. In consistent with our results, another study by Gollenberg et al. explored the concurrent validity of parent-completed ASQ and the BSID-II [ 9 ]. Such disparities underscore the need for comprehensive evaluation and the use of multiple assessment tools to obtain a holistic view of children's developmental trajectories. The mixed concordance rates observed in this study mirror findings by Ballot et al. [ 8 ], emphasizing the importance of cautious interpretation of assessment results. The findings from the present study echo those of previous research indicating the need for culturally sensitive adaptations of developmental assessment tools. Soleimani et al. (2022) standardized the BSID-III for Persian children, underscoring the importance of adapting these tools to the local context [ 16 ]. Similar sentiments are shared by Madaschi et al. (2016), who emphasized the necessity of transcultural adaptation and psychometric evaluation of assessment tools for accurate results [ 6 ]. The diverse population samples used in these studies, including those from Ethiopia, Kenya, Nepal, and Cambodia, highlight the cross-cultural applicability of developmental assessment tools [ 10 , 11 , 13 , 14 ]. Several methodological limitations should be acknowledged in interpreting our study's findings. The cross-sectional design, while allowing us to explore associations, does not permit the establishment of causal relationships. To gain a deeper understanding of long-term developmental trajectories and causal links, future research should employ longitudinal designs with larger, more diverse samples. Additionally, our study's focus on children referred with suspected developmental delay may introduce selection bias, potentially affecting prevalence rate estimates. Longitudinal studies would provide a more robust foundation for causal inferences and a broader representation of children, including those without suspected delays. To conclude, the findings of this study provide valuable insights into the developmental outcomes of children aged 1 to 42 months in Yazd, Iran. The observed prevalence rates of developmental disorders, the influence of parental education, and the comparison of assessment tools underscore the importance of early developmental assessment and tailored interventions. These findings contribute to the broader literature on developmental assessment and highlight the need for culturally sensitive approaches to understanding and addressing developmental delays in diverse populations. Conclusions In summary, our study contributes to the growing body of evidence on developmental assessment in early childhood, with a specific focus on the Iranian context. The findings emphasize the need for culturally sensitive adaptations of developmental assessment tools to enhance their precision and relevance. It is crucial for healthcare practitioners and policymakers to consider the prevalence of developmental disorders, the influence of parental education, and the importance of comprehensive assessment strategies in shaping interventions that promote healthy child development. To advance our understanding further, future research should include longitudinal studies with larger and more diverse samples to explore long-term developmental trajectories and causal relationships. These endeavors will enable the effective tailoring of interventions to ensure that every child, regardless of their background or circumstances, has the opportunity to reach their full developmental potential. Our study not only enhances knowledge about child development in Yazd but also offers insights that can inform clinical practices, policy development, and early intervention programs for children with developmental delays. Ultimately, our goal is to foster optimal development for all children, reflecting a commitment to their well-being and future success. Abbreviations BSID Bayley Scales of Infant and Toddler Development ASQ Ages and Stages Questionnaire Declarations Ethics approval and consent to participate The Ethics Committee of Shahid Sadoughi University of Medical Sciences approved the study (IR.SSU.REC.1400.150), ensuring adherence to ethical guidelines and regulations for human research. Written informed consent was obtained from parents or guardians, and participants' data confidentiality was maintained throughout the study. Consent for publication Not applicable Availability of data This study's findings are based on data that are subject to privacy protection by the Shahid Sadoughi University of Medical Sciences and Health Services Ethics Committee. Researchers who qualify for accessing confidential data can request the data from Mehran Karimi at [email protected] . Competing interests The authors declare that they have no competing interests. Funding This study was conducted with the financial support of Shahid Sadoughi University of Medical Sciences in Yazd. Authors' contributions M. K. conceived and designed the study, supervised the research process, and curated the data. A. E. contributed to the design of data collection, and reviewed and edited the manuscript. Z. N. reviewed and edited the manuscript. F. Sh. curated and analyzed the data. N. GM. collected the data. E. A. collected the data, wrote the initial draft of the manuscript, and reviewed and edited the manuscript. All authors have read and agreed to the final version of the manuscript. Acknowledgements We would like to sincerely thank the two health centers in Yazd, Bagher Salari and Haji Maqsoudi, and their staff, notably Mrs. Naeemeh Behjati, for their cooperation and assistance in the data collection process of this research. 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Standardization of the Bayley Scales of Infant and Toddler Development for Persian Children. Archives of Rehabilitation. 2022 May 10; 23(1):8-31. Azari N, Soleimani F, Vameghi R, Sajedi F, Shahshahani S, Karimi H, Kraskian A, Shahrokhi A, Teymouri R, Gharib M. A psychometric study of the Bayley scales of infant and toddler development in Persian language children. Iranian journal of child neurology. 2017; 11(1):50. Pitchik HO, Tofail F, Akter F, Shoab AK, Sultana J, Huda TM, Rahman M, Winch PJ, Luby SP, Fernald LC. Concurrent validity of the Ages and Stages Questionnaire Inventory and the Bayley Scales of Infant and Toddler Development in rural Bangladesh. BMC pediatrics. 2023 Mar 1;23(1):93. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 01 Mar, 2025 Read the published version in BMC Pediatrics → Version 1 posted Editorial decision: Revision requested 22 Apr, 2024 Reviews received at journal 07 Mar, 2024 Reviews received at journal 06 Mar, 2024 Reviews received at journal 06 Mar, 2024 Reviews received at journal 02 Mar, 2024 Reviews received at journal 01 Mar, 2024 Reviewers agreed at journal 26 Feb, 2024 Reviewers agreed at journal 25 Feb, 2024 Reviewers agreed at journal 25 Feb, 2024 Reviews received at journal 22 Feb, 2024 Reviewers agreed at journal 21 Feb, 2024 Reviewers agreed at journal 21 Feb, 2024 Reviewers agreed at journal 21 Feb, 2024 Reviewers agreed at journal 21 Feb, 2024 Reviewers agreed at journal 21 Feb, 2024 Reviewers invited by journal 21 Feb, 2024 Editor assigned by journal 21 Feb, 2024 Editor invited by journal 15 Nov, 2023 Submission checks completed at journal 15 Nov, 2023 First submitted to journal 13 Nov, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3606770","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":249611729,"identity":"404f7dac-73a2-442f-bc97-092a818bf9e3","order_by":0,"name":"Mehran Karimi","email":"","orcid":"","institution":"Shahid Sadoughi University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mehran","middleName":"","lastName":"Karimi","suffix":""},{"id":249611730,"identity":"aedf893a-da2c-4a50-b513-e14e32ae5fc0","order_by":1,"name":"Alireza Emarati","email":"","orcid":"","institution":"Shahid Sadoughi University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Alireza","middleName":"","lastName":"Emarati","suffix":""},{"id":249611731,"identity":"3c9e4af9-58ae-4fbc-81bf-ea61f5f4ecb8","order_by":2,"name":"Zahra Nafei","email":"","orcid":"","institution":"Shahid Sadoughi University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Zahra","middleName":"","lastName":"Nafei","suffix":""},{"id":249611732,"identity":"11cb126f-af17-48bb-9155-78bb8a47054f","order_by":3,"name":"Farimah Shamsi","email":"","orcid":"","institution":"Shahid Sadoughi University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Farimah","middleName":"","lastName":"Shamsi","suffix":""},{"id":249611733,"identity":"a3f10e7d-6e5c-4252-b629-bd13fbb902f2","order_by":4,"name":"Niloofar Gashty Mazar","email":"","orcid":"","institution":"Shahid Sadoughi University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Niloofar","middleName":"Gashty","lastName":"Mazar","suffix":""},{"id":249611734,"identity":"ad27bc5f-94db-4117-a5f8-8b9383389dc2","order_by":5,"name":"Elahe Akbarian","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABA0lEQVRIiWNgGAWjYDACHh4gYQBiMTcwMzDYMDBIEK+FEaQljVgtDHAthwlr4e85e/BzRYFdHgN7Y+Pngorzif2zmw8+YKixicalReJsX7LkGYPkYgaeg83SM87cTpxx51iyAcOxtNwGXHrO8xhINhgwJzZIJDZI87bdTmy4kWMmwdhwGKcW+fM8xj8bDOoTG+QfNv/m/XcucT4hLQZne8yAthwG2sLYJs3bcCBxAyEthmfOpVk2GBxPbONJbLPmOZZsvPFGWrJBAh6/yJ3JPXyz4U91Yj/74cO3eWrsZOfdSD744EONDW7vwwAblHYEq0wgpBwZ2JOieBSMglEwCkYGAABik1zjmdLr+gAAAABJRU5ErkJggg==","orcid":"","institution":"Shahid Sadoughi University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Elahe","middleName":"","lastName":"Akbarian","suffix":""}],"badges":[],"createdAt":"2023-11-13 20:14:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3606770/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3606770/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12887-025-05491-1","type":"published","date":"2025-03-01T15:57:14+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":77622412,"identity":"75b6300e-7e4e-4271-935e-a8d9464b4c75","added_by":"auto","created_at":"2025-03-03 16:05:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1222730,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3606770/v1/5202c29f-1d61-49ff-b1e7-c3281f9e9961.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessing Developmental Delays in Early Childhood: Insights from Iranian Children Using the Bayley Scales of Infant and Toddler Development (BSID-III)","fulltext":[{"header":"Background","content":"\u003cp\u003eDevelopmental delay is a term that describes the condition of children who do not meet the expected milestones for their age in one or more domains of development, such as cognitive, motor, language, social-emotional, or adaptive skills [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Developmental delay can have various causes, such as genetic disorders, prenatal exposure to drugs or alcohol, prematurity, low birth weight, infections, malnutrition, or environmental deprivation [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Developmental delay can have significant implications for the child's health, education, and well-being, as well as for the family and society [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOne of the tools that is widely used to assess developmental delay in early childhood is the Bayley Scales of Infant and Toddler Development (BSID) [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The BSID is a standardized test that measures the developmental functioning of children from 1 to 42 months of age across five domains: cognitive, language, motor, social-emotional, and adaptive behavior [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The BSID has been revised several times since its first edition in 1969, and the latest version is the BSID-III, which was published in 2006 [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe BSID-III has been validated and standardized for different populations and cultures around the world [\u003cspan additionalcitationids=\"CR8 CR9 CR10 CR11 CR12 CR13 CR14\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, there is limited research on the use and performance of the BSID-III in Iranian children. Previous studies have reported that Iranian children scored lower than the normative sample on some domains of the BSID-II [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] and the BSID-III [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], suggesting that cultural and environmental factors may influence the test results.\u003c/p\u003e \u003cp\u003eTherefore, the aim of this study was to evaluate the developmental outcomes of children aged 1 to 42 months in Yazd, Iran, using the BSID-III. We hypothesized that Iranian children would score lower than the normative sample on some domains of the BSID-III, and that there would be significant differences in the test scores according to age, gender and maternal education.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research employed a descriptive cross-sectional design to assess the developmental status of children aged 1 to 42 months using the BSID-III. Data were collected from two health centers in Yazd, Bagher Salari and Haji Maqsoudi, recognized for conducting the BSID-III assessments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population consisted of children who underwent Bayley tests at the aforementioned health centers in Yazd, Iran. A total of 707 children aged between 1 and 42 months, referred with suspected developmental delay, were included. The study was conducted from January to December 2020, with participants selected through the census sampling method. Exclusion criteria encompassed children born prematurely to ensure result integrity and analysis consistency.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection and Quality Control\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData collection involved reviewing and extracting information from children\u0026apos;s files. Two trained examiners, who had completed a BSID-III certification course, performed data collection. The examiners adhered to standardized administration and scoring procedures as described in the BSID-III manual [6]. Examiners were blinded to participants\u0026apos; demographic and clinical information. A third examiner conducted data entry and quality control, ensuring accuracy and completeness. Demographic characteristics and Bayley test results were collected, spanning cognitive, linguistic, and motor development domains.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBSID-III Test\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe BSID-III is a standardized test assessing developmental functioning in children aged 1 to 42 months across five domains: cognitive, language, motor, social-emotional, and adaptive behavior [6]. It comprises items administered by trained examiners. Test results include raw scores, scaled scores, composite scores, percentile ranks, age equivalents, and growth scores [6]. The BSID-III has been validated and standardized for diverse populations [7-15].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Data Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData analysis involved using SPSS software version 25 to compute descriptive statistics, including frequency and percentage distributions. Chi-square tests were employed to explore associations between different variables, with significance set at 0.05.\u003c/p\u003e\n\u003cp\u003eDevelopmental Status Criteria: Children\u0026apos;s developmental status was determined by aligned scores, which ranged from 1 to 19. Aligned scores were categorized as follows:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eAligned score \u0026gt; 7: Normal (more than -1SD)\u003c/li\u003e\n \u003cli\u003e4 \u0026lt; Aligned score \u0026le; 7: Mild developmental problems (-1SD to -2SD)\u003c/li\u003e\n \u003cli\u003eAligned score \u0026le; 4: Severe developmental problems (less than -2SD)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eComparison with ASQ Questionnaire\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo compare BSID-III results with the Ages and Stages Questionnaire (ASQ) outcomes, information from both tests was recorded and managed using Excel software. The Kappa coefficient of agreement assessed concordance between the two tests in identifying developmental disorders.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Ethics Committee of Shahid Sadoughi University of Medical Sciences approved the study (IR.SSU.REC.1400.150), ensuring adherence to ethical guidelines and regulations for human research. Written informed consent was obtained from parents or guardians, and participants\u0026apos; data confidentiality was maintained throughout the study.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe investigation aimed to assess the prevalence and patterns of developmental disorders among children aged 1 to 42 months in Yazd using the BSID-III. A total of 707 children were included in the study, encompassing both genders and various age groups. The BSID-III was employed to measure cognitive, language, and motor development domains. The results revealed several significant findings regarding the prevalence of developmental disorders, the influence of parental education, and the comparison between the BSID-III scores and the ASQ outcomes.\u003c/p\u003e \u003cp\u003eThe prevalence of developmental disorders across the cognitive, language, and motor scales was investigated (Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). In the cognitive domain, 15.8% of the studied children demonstrated developmental disorder. The language scale exhibited varying rates: 20.1% for perceptual communication and 18.4% for expressive communication. Similarly, the movement scale displayed developmental disorders of 13.6% for fine movements and 15.7% for gross movements. Notably, the highest frequency of developmental disorders within the language domain pertained to perceptual communication (20.1%) and expressive communication (18.4%). Within these domains, 6% and 5.8% respectively presented with severe forms of the disorder.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDisorder Status within Developmental Areas (Based on BSID-III Results)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDevelopmental\u003c/p\u003e \u003cp\u003eArea\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal (N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMild Developmental Problems (MDP)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSevere DP (SDP)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCognitive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e586 (84.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33 (4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e696 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerception\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e548 (79.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e97 (14.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41 (6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e686 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExpression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e563 (81.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87 (12.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e690 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFine Motor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e591 (86.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17 (2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e684 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGross Motor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e581 (84.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e689 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding the distribution of ages within the study population, out of the 707 children examined, 78.4% were aged 2 years and under, while 21.6% were over 2 years old. The highest percentage of normal scores, based on the Bayley criteria (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), was observed in the Fine Motor area, followed by the Perception area. The presented results (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) indicated significant variations in the distribution of Bayley's leveled scores in the areas of perception, expression, and fine motor based on age categories.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDisorder Status within Age Groups (Based on BSID-III Results)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge Groups\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisorder Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCognitive\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePerception\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExpression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFine Motor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eGross Motor\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u0026lt;=\u003c/p\u003e \u003cp\u003e24 Months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e468 (85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e452 (83.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e472 (86.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e477 (88.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e459 (84.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69 (12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e52 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e52 (9.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (2.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e32 (5.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e546 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e543 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e546 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e541 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e543 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;\u003c/p\u003e \u003cp\u003e24 Months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118 (78.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96 (67.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e91 (63.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e114 (79.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e122 (83.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28 (19.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24 (16.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19 (13.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (7.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5 (3.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e150 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e143 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e144 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e143 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e146 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.267\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFurther analysis explored the relationship between developmental disorder prevalence and parental education. An inverse correlation was observed between the father's education level and the occurrence of developmental disorders across all developmental areas (Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). As the father's education level increased, the frequency of developmental disorders decreased significantly.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDisorder Status within Father\u0026rsquo;s Education Level Groups (Based on BSID-III Results)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather\u0026rsquo;s Education Level\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisorder Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCognitive\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePerception\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExpression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFine Motor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eGross Motor\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMiddle \u0026amp; Primary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69 (71.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58 (61.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69 (71.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68 (71.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e66 (70.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (14.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (29.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21 (22.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17 (18.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (11.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e96 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e94 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eHigh School \u0026amp; Associate Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e195 (82.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e181 (77.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e180 (77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e203 (86.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e198 (83.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31 (13.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24 (10.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (8.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21 (9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 (5.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e237 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e234 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e232 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e234 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e236 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e193 (89.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e180 (85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e186 (86.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e188 (90.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e187 (88.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (8.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (11.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (8.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18 (8.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 (3.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e215 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e210 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e214 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e209 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e212 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaster\u0026rsquo;s Degree or Higher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125 (88.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e126 (89.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e124 (87.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e127 (90.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e126 (89.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (5.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (8.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (7.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (2.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e142 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e141 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e142 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e140 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e141 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn contrast, the mother's education level correlated with the frequency of developmental disorders in specific areas (Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). While it led to a significant decrease in all developmental areas except gross movements, it showed no substantial impact on gross motor skill development.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDisorder Status within Mother\u0026rsquo;s Education Level Groups (Based on BSID-III Results)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u0026rsquo;s Education Level\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisorder Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCognitive\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePerception\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExpression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFine Motor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eGross Motor\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMiddle \u0026amp; Primary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38 (74.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (62.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38 (74.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e36 (72.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e39 (78.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (13.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (9.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (24.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (16.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (15.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (6.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e50 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eHigh School \u0026amp; Associate Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e177 (80.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e160 (73.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e168 (76.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e185 (84.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e178 (80.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (20.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40 (18.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27 (12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e30 (13.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13 (5.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e221 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e219 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e221 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e219 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e221 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e265 (87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e253 (84.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e256 (85.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e261 (88.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e259 (86.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30 (9.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (9.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29 (9.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29 (9.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24 (8.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17 (5.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e304 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e298 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e298 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e296 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e300 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaster\u0026rsquo;s Degree or Higher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e102 (89.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e101 (89.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e97 (85.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e104 (92.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e101 (90.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (7.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e114 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e113 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e112 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.030\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.149\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMoreover, data analysis (Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e) indicated significant variations in the distribution of Bayley's leveled scores in the areas of perception and expression based on gender categories.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDisorder Status within Gender Groups (Based on BSID-III Results)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisorder Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCognitive\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePerception\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExpression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFine Motor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eGross Motor\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e310 (82.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e286 (76.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e291 (77.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e314 (84.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e312 (83.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58 (15.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56 (14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e45 (12.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e38 (10.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29 (7.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24 (6.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e377 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e374 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e376 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e371 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e374 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e276 (86.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e262 (84.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e272 (86.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e277 (88.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e269 (85.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31 (9.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31 (9.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e33 (10.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13 (4.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e319 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e312 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e314 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e313 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e315 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.414\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe ASQ was used as a comparator to the BSID-III results (Table \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). Among children with normal fine motor development according to the Bayley test, 71.4% were also identified as having normal development in this area in the ASQ test. Conversely, 19% were classified as requiring referral and 9.5% had acute problems in the ASQ test. For children diagnosed with \"need for referral\" in the Bayley test, 68.8% exhibited normal development in the ASQ assessment. Similarly, discrepancies between the two tests were observed for gross motor (Table \u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e) and cognitive development (Table \u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e) categories.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eComparing the Outcomes of the BSID-III Fine Motor Area with the ASQ Fine Motor Area in Terms of Disorder Severity\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFine Motor\u003c/p\u003e \u003cp\u003e(BSID-III)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eFine Motor (ASQ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal (N)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReferral Required (RR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAcute Disorder (AD)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal (N)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.329\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReferral Required (RR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (68.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcute Disorder (AD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparing the Outcomes of the BSID-III Gross Motor Area with the ASQ Gross Motor Area in Terms of Disorder Severity\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGross Motor\u003c/p\u003e \u003cp\u003e(BSID-III)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eGross Motor (ASQ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAD\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.144\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (64.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (64.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparing the Outcomes of the BSID-III Cognitive Area with the ASQ Connection Area in Terms of Disorder Severity\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCognitive\u003c/p\u003e \u003cp\u003e(BSID-III)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eConnection (ASQ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAD\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (35.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (41.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (41.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (45.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (23.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (31.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eComparative analysis of the BSID-III and the ASQ outcomes demonstrated mixed concordance rates across the cognitive (Table \u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e), fine motor (Table \u003cspan refid=\"Tab10\" class=\"InternalRef\"\u003e10\u003c/span\u003e), and gross motor (Table \u003cspan refid=\"Tab11\" class=\"InternalRef\"\u003e11\u003c/span\u003e) domains. The Kappa coefficient of agreement indicated that the frequency distribution of scores in the two tests did not match completely. The developmental status assessments provided by the two tests exhibited differences in their classifications of children as \"normal\" or \"with problems,\" emphasizing the need for cautious interpretation of the results.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eComparing the Outcomes of the BSID-III with the ASQ in Terms of Cognitive Area Based on the Existence or Absence of Disorder\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCognitive (BSID-III)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e \u003cp\u003eConnection (ASQ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKappa Coefficient\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eDisordered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e34.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisordered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e65.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e54.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eComparing the Outcomes of the BSID-III with the ASQ in Terms of Fine Motor Area Based on the Existence or Absence of Disorder\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFine Motor (BSID-III)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e \u003cp\u003eFine Motor (ASQ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKappa Coefficient\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eDisordered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisordered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e57.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab11\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 11\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eComparing the Outcomes of the BSID-III with the ASQ in Terms of Gross Motor Area Based on the Existence or Absence of Disorder\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGross Motor (BSID-III)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e \u003cp\u003eGross Motor (ASQ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKappa Coefficient\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eDisordered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e% within BSID-III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e% within ASQ\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e39.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.278\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisordered\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e44.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e84.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e61.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTo sum up, the study highlighted the prevalence of developmental disorders in various domains among children aged 1 to 42 months in Yazd using the BSID-III assessment tool. The influence of parental education on developmental disorder prevalence was evident, with higher education levels associated with decreased frequency. Additionally, comparisons between the BSID-III and the ASQ results unveiled variations in developmental status classification, underscoring the importance of utilizing multiple assessment tools to obtain a comprehensive understanding of children's developmental progress. These findings contribute to the existing literature on developmental assessment and underscore the significance of tailored interventions to address children's developmental needs.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study aimed to evaluate the developmental outcomes of children aged 1 to 42 months in Yazd, Iran, using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). The findings shed light on the prevalence and patterns of developmental disorders across various domains, highlighted the influence of parental education on developmental disorder prevalence, and compared the BSID-III scores with the Ages and Stages Questionnaire (ASQ) outcomes. In the context of the broader literature, these results contribute to the understanding of developmental assessment in early childhood and underscore the importance of considering cultural and contextual factors in interpreting assessment outcomes. This section will discuss the study's findings in the context of existing literature, highlight implications for clinical practice and policy, address methodological considerations, and suggest areas for future research.\u003c/p\u003e \u003cp\u003eThe observed prevalence rates of developmental disorders in the cognitive, language, and motor domains among the study population add to the growing body of evidence that emphasizes the significance of early developmental assessment. The findings of this study align with previous research conducted in other settings. For instance, studies such as Valla et al. [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] and Anderson and Burnett [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] have reported varying rates of developmental delays, emphasizing the importance of a comprehensive approach to assessment. Valla et al. conducted a regional population-based longitudinal study and found a 19.7% prevalence of suspected developmental delays in infants aged 6 to 12 months [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Our study's cognitive, language, and motor scales showed similar patterns, with prevalence rates ranging from 13.6\u0026ndash;20.1%. The diversity in developmental disorder prevalence across different domains may be attributed to the multifaceted nature of development and the intricate interplay of genetic, environmental, and cultural factors. Furthermore, the findings resonate with research by Gould et al. [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], highlighting the long-term implications of early developmental assessment.\u003c/p\u003e \u003cp\u003eParental education emerged as a significant factor influencing the prevalence of developmental disorders, particularly among fathers. Our study revealed an inverse correlation between parental education levels and the occurrence of developmental disorders. These findings align with previous research by Klein-Radukic and Zmyj [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], highlighting the role of socioeconomic factors in developmental outcomes. Moreover, our results are consistent with the study by Pitchik et al. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], who reported a positive correlation between maternal education and the ASQ and BSID-III scores, indicating better developmental outcomes. Similar observations were made by Ballot et al., who found that higher parental education levels were associated with better developmental outcomes [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The inverse correlation between parental education levels and developmental disorder prevalence underscores the potential benefits of targeted interventions and parental education programs. Similar findings have been documented in other cultural contexts, such as the study by Hoskens et al. [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], demonstrating the importance of addressing parental education as a key factor in early childhood development.\u003c/p\u003e \u003cp\u003eComparisons between the BSID-III scores and the ASQ outcomes revealed variations in developmental status classification. The observed discordances between the two assessment tools resonate with the broader literature. Madaschi et al. [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] and Adams-Chapman et al. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] similarly noted differences in developmental assessments, highlighting the complexity of capturing the full spectrum of developmental progress through a single assessment tool. In consistent with our results, another study by Gollenberg et al. explored the concurrent validity of parent-completed ASQ and the BSID-II [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Such disparities underscore the need for comprehensive evaluation and the use of multiple assessment tools to obtain a holistic view of children's developmental trajectories. The mixed concordance rates observed in this study mirror findings by Ballot et al. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], emphasizing the importance of cautious interpretation of assessment results.\u003c/p\u003e \u003cp\u003eThe findings from the present study echo those of previous research indicating the need for culturally sensitive adaptations of developmental assessment tools. Soleimani et al. (2022) standardized the BSID-III for Persian children, underscoring the importance of adapting these tools to the local context [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Similar sentiments are shared by Madaschi et al. (2016), who emphasized the necessity of transcultural adaptation and psychometric evaluation of assessment tools for accurate results [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The diverse population samples used in these studies, including those from Ethiopia, Kenya, Nepal, and Cambodia, highlight the cross-cultural applicability of developmental assessment tools [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral methodological limitations should be acknowledged in interpreting our study's findings. The cross-sectional design, while allowing us to explore associations, does not permit the establishment of causal relationships. To gain a deeper understanding of long-term developmental trajectories and causal links, future research should employ longitudinal designs with larger, more diverse samples. Additionally, our study's focus on children referred with suspected developmental delay may introduce selection bias, potentially affecting prevalence rate estimates. Longitudinal studies would provide a more robust foundation for causal inferences and a broader representation of children, including those without suspected delays.\u003c/p\u003e \u003cp\u003eTo conclude, the findings of this study provide valuable insights into the developmental outcomes of children aged 1 to 42 months in Yazd, Iran. The observed prevalence rates of developmental disorders, the influence of parental education, and the comparison of assessment tools underscore the importance of early developmental assessment and tailored interventions. These findings contribute to the broader literature on developmental assessment and highlight the need for culturally sensitive approaches to understanding and addressing developmental delays in diverse populations.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn summary, our study contributes to the growing body of evidence on developmental assessment in early childhood, with a specific focus on the Iranian context. The findings emphasize the need for culturally sensitive adaptations of developmental assessment tools to enhance their precision and relevance. It is crucial for healthcare practitioners and policymakers to consider the prevalence of developmental disorders, the influence of parental education, and the importance of comprehensive assessment strategies in shaping interventions that promote healthy child development. To advance our understanding further, future research should include longitudinal studies with larger and more diverse samples to explore long-term developmental trajectories and causal relationships. These endeavors will enable the effective tailoring of interventions to ensure that every child, regardless of their background or circumstances, has the opportunity to reach their full developmental potential. Our study not only enhances knowledge about child development in Yazd but also offers insights that can inform clinical practices, policy development, and early intervention programs for children with developmental delays. Ultimately, our goal is to foster optimal development for all children, reflecting a commitment to their well-being and future success.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBSID Bayley Scales of Infant and Toddler Development\u003c/p\u003e\n\u003cp\u003eASQ Ages and Stages Questionnaire\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Ethics Committee of Shahid Sadoughi University of Medical Sciences approved the study (IR.SSU.REC.1400.150), ensuring adherence to ethical guidelines and regulations for human research. Written informed consent was obtained from parents or guardians, and participants\u0026apos; data confidentiality was maintained throughout the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study\u0026apos;s findings are based on data that are subject to privacy protection by the Shahid Sadoughi University of Medical Sciences and Health Services Ethics Committee. Researchers who qualify for accessing confidential data can request the data from Mehran Karimi at [email protected].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted with the financial support of Shahid Sadoughi University of Medical Sciences in Yazd.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eM. K. conceived and designed the study, supervised the research process, and curated the data. A. E. contributed to the design of data collection, and reviewed and edited the manuscript. Z. N. reviewed and edited the manuscript. F. Sh. curated and analyzed the data. N. GM. collected the data. E. A. collected the data, wrote the initial draft of the manuscript, and reviewed and edited the manuscript. All authors have read and agreed to the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to sincerely thank the two health centers in Yazd, Bagher Salari and Haji Maqsoudi, and their staff, notably Mrs. Naeemeh Behjati, for their cooperation and assistance in the data collection process of this research. We are grateful for their valuable contribution and support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eValla L, Wentzel-Larsen T, Hofoss D, Slinning K. Prevalence of suspected developmental delays in early infancy: results from a regional population-based longitudinal study. BMC pediatrics. 2015 Dec; 15(1):1-8.\u003c/li\u003e\n\u003cli\u003eAnderson PJ, Burnett A. Assessing developmental delay in early childhood\u0026mdash;concerns with the Bayley-III scales. The clinical neuropsychologist. 2017 Feb 17; 31(2):371-81.\u003c/li\u003e\n\u003cli\u003eGould JF, Hunt E, Roberts RM, Louise J, Collins CT, Makrides M. Can the Bayley Scales of Infant Development at 18 months predict child behaviour at 7 years? Journal of Paediatrics and Child Health. 2019 Jan; 55(1):74-81.\u003c/li\u003e\n\u003cli\u003eKlein-Radukic S, Zmyj N. The predictive value of the cognitive scale of the Bayley Scales of Infant and Toddler Development-III. Cognitive Development. 2023 Jan 1; 65:101291.\u003c/li\u003e\n\u003cli\u003eHoskens J, Klingels K, Smits-Engelsman B. Validity and cross-cultural differences of the Bayley Scales of Infant and Toddler Development, in typically developing infants. Early Human Development. 2018 Oct 1; 125:17-25.\u003c/li\u003e\n\u003cli\u003eMadaschi V, Mecca TP, Macedo EC, Paula CS. Bayley-III scales of infant and toddler development: transcultural adaptation and psychometric properties. Paid\u0026eacute;ia (Ribeir\u0026atilde;o Preto). 2016 May; 26:189-97.\u003c/li\u003e\n\u003cli\u003eAdams-Chapman I, Bann CM, Vaucher YE, Stoll BJ, Network HD, Eunice Kennedy Shriver National Institute of Child Health. Association between feeding difficulties and language delay in preterm infants using Bayley Scales of Infant Development. The Journal of pediatrics. 2013 Sep 1; 163(3):680-5.\u003c/li\u003e\n\u003cli\u003eBallot DE, Ramdin T, Rakotsoane D, Agaba F, Davies VA, Chirwa T, Cooper PA. Use of the Bayley scales of infant and toddler development, to assess developmental outcome in infants and young children in an urban setting in South Africa. International scholarly research notices. 2017; 2017.\u003c/li\u003e\n\u003cli\u003eGollenberg AL, Lynch CD, Jackson LW, McGuinness BM, Msall ME. Concurrent validity of the parent‐completed Ages and Stages Questionnaires, with the Bayley Scales of Infant Development II in a low‐risk sample. Child: care, health and development. 2010 Jul; 36(4):485-90.\u003c/li\u003e\n\u003cli\u003eHanlon C, Medhin G, Worku B, Tomlinson M, Alem A, Dewey M, Prince M. Adapting the Bayley Scales of infant and toddler development in Ethiopia: evaluation of reliability and validity. Child: care, health and development. 2016 Sep; 42(5):699-708.\u003c/li\u003e\n\u003cli\u003eMcHenry MS, Oyungu E, Yang Z, Hines AC, Ombitsa AR, Vreeman RC, Abubakar A, Monahan PO. Cultural adaptation of the Bayley scales of infant and toddler development, for use in Kenyan children aged 18\u0026ndash;36 months: a psychometric study. Research in developmental disabilities. 2021 Mar 1; 110:103837.\u003c/li\u003e\n\u003cli\u003eRademeyer V, Jacklin L. A study to evaluate the performance of black South African urban infants on the Bayley Scales of Infant Development III. South African Journal of Child Health. 2013 Jul 3; 7(2):54-9.\u003c/li\u003e\n\u003cli\u003eRanjitkar S, Kvestad I, Strand TA, Ulak M, Shrestha M, Chandyo RK, Shrestha L, Hysing M. Acceptability and reliability of the bayley scales of infant and toddler development-III among children in Bhaktapur, Nepal. Frontiers in Psychology. 2018 Jul 24; 9:1265.\u003c/li\u003e\n\u003cli\u003eVan Beekum M, Berger J, Van Geystelen J, Hondru G, Som SV, Theary C, Laillou A, Poirot E, Bork KA, Wieringa FT, Fortin S. The associations between stunting and wasting at 12 months of age and developmental milestones delays in a cohort of Cambodian children. Scientific Reports. 2022 Oct 25; 12(1):17859.\u003c/li\u003e\n\u003cli\u003eWalker K, Badawi N, Halliday R, Laing S. Brief report: performance of Australian children at one year of age on the Bayley scales of infant and toddler development (version III). The Educational and Developmental Psychologist. 2010 Jun; 27(1):54-8.\u003c/li\u003e\n\u003cli\u003eSoleimani F, Azari N, Vameghi R, Barekati SH, Lornejad H, Kraskian A. Standardization of the Bayley Scales of Infant and Toddler Development for Persian Children. Archives of Rehabilitation. 2022 May 10; 23(1):8-31.\u003c/li\u003e\n\u003cli\u003eAzari N, Soleimani F, Vameghi R, Sajedi F, Shahshahani S, Karimi H, Kraskian A, Shahrokhi A, Teymouri R, Gharib M. A psychometric study of the Bayley scales of infant and toddler development in Persian language children. Iranian journal of child neurology. 2017; 11(1):50.\u003c/li\u003e\n\u003cli\u003ePitchik HO, Tofail F, Akter F, Shoab AK, Sultana J, Huda TM, Rahman M, Winch PJ, Luby SP, Fernald LC. Concurrent validity of the Ages and Stages Questionnaire Inventory and the Bayley Scales of Infant and Toddler Development in rural Bangladesh. BMC pediatrics. 2023 Mar 1;23(1):93.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Developmental Delay, Bayley Scales of Infant and Toddler Development, Children, Parental Education, Cultural Adaptation","lastPublishedDoi":"10.21203/rs.3.rs-3606770/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3606770/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDevelopmental delay in early childhood is a significant concern with multifaceted causes and implications. The Bayley Scales of Infant and Toddler Development (BSID-III) is widely used for developmental assessment but remains understudied in Iranian children.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis cross-sectional study assessed 707 Iranian children aged 1 to 42 months in Yazd, Iran, using the BSID-III. We hypothesized differences in BSID-III scores compared to normative samples, considering age, gender, and parental education. Data were collected from two health centers in Yazd, with trained examiners following standardized procedures. Parental education was analyzed for its impact on developmental outcomes. Comparisons between BSID-III scores and Ages and Stages Questionnaire (ASQ) outcomes provided additional insights.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eIranian children exhibited varying rates of developmental disorders across cognitive, language, and motor domains, influenced by parental education (higher parental education correlated with a reduced occurrence of developmental disorders). For instance, in the cognitive domain, 15.8% of children demonstrated developmental disorders. The language scale exhibited varying rates: 20.1% for perceptual communication and 18.4% for expressive communication. Furthermore, the BSID-III and ASQ results demonstrated discordances, highlighting the complexities of assessment.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis study contributes to the knowledge of developmental assessment in Iranian early childhood. It emphasizes the importance of culturally sensitive adaptations of assessment tools and the role of parental education in shaping developmental outcomes. Future research should incorporate diverse, longitudinal samples for enhanced understanding. Ultimately, this study aims to inform clinical practices, policy development, and early intervention programs, committed to fostering optimal development for all children, irrespective of their backgrounds.\u003c/p\u003e","manuscriptTitle":"Assessing Developmental Delays in Early Childhood: Insights from Iranian Children Using the Bayley Scales of Infant and Toddler Development (BSID-III)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-11-17 04:40:45","doi":"10.21203/rs.3.rs-3606770/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-04-22T18:04:05+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-07T21:25:23+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-06T21:12:13+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-06T07:21:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-02T20:28:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-03-01T21:45:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"076431d3-bba6-4c53-a400-478e12ffbf70","date":"2024-02-26T13:28:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"12ff5256-6a98-4660-b88b-df6072264bee","date":"2024-02-25T16:18:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"da9ba880-a43c-4734-ac66-8099ff378b10","date":"2024-02-25T10:06:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-02-22T13:25:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"21a04ee8-5e33-4f3e-931d-c2373939f17f","date":"2024-02-21T15:34:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9c07b60b-1071-4bef-bdba-4b6a6ff6574e","date":"2024-02-21T12:02:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"cc3cbc1b-1ed3-4b27-bba3-dbd6a0c691fc","date":"2024-02-21T10:16:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"a00f6a71-faf7-4b8b-be42-552e6f4b60a0","date":"2024-02-21T09:59:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"1f28f5e9-d5db-4465-853f-6435e18ee1ff","date":"2024-02-21T09:00:27+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-02-21T08:50:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-02-21T08:45:57+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2023-11-15T11:31:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-11-15T11:22:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2023-11-13T20:02:09+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"08e45812-3ecc-41ae-ad59-f7551e485c2c","owner":[],"postedDate":"November 17th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-03-03T16:00:10+00:00","versionOfRecord":{"articleIdentity":"rs-3606770","link":"https://doi.org/10.1186/s12887-025-05491-1","journal":{"identity":"bmc-pediatrics","isVorOnly":false,"title":"BMC Pediatrics"},"publishedOn":"2025-03-01 15:57:14","publishedOnDateReadable":"March 1st, 2025"},"versionCreatedAt":"2023-11-17 04:40:45","video":"","vorDoi":"10.1186/s12887-025-05491-1","vorDoiUrl":"https://doi.org/10.1186/s12887-025-05491-1","workflowStages":[]},"version":"v1","identity":"rs-3606770","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3606770","identity":"rs-3606770","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}