NEURODEVELOPMENTAL AND BEHAVIORAL ATTRIBUTES OF PRESCHOOL CHILDREN WITH GLOBAL DELAY AND ABNORMAL MRI

Objectives: To explore the relation of abnormal MRIs, developmental and behavioural difficulties in preschoolers with global developmental delay (GDD).

Methods: All parents/guardians completed (a) a semi-structured interview about their child and family (b) the Child Development Inventory (CDI) (c) Possible Problems Checklist (PPC) (d) Child Behavior Checklist 1 ½ to 5 (CBCL). For analysis, items were grouped by relevance. The Mann-Whitney test compared groups. A two-tailed p value of <0.05 indicated statistical significance. Thirty-nine MRIs (26%) were abnormal: CNS malformation 13 (33.3%), white matter abnormality 6 (15.4%), postischemic lesion 13 (33.3%), widening of the Virchow-Robin spaces 4 (10.3%), phakomatosis 2 (5.1%), and one neoplasm (2.6%). Children with abnormal MRIs were more likely to have more delayed self-help, fine motor, and groß motor, and general development skills. Their parents were more likely to report fewer possible problems especially emotional problems and lower internalizing problems and attention deficit/hyperactivity problems scores.

Results: One hundred and fifty-two consecutive parents/guardians of children, ranging from 19 to 70 months. All children had GDD with significant delays (developmental ratios <.70) in two or more domains.

Conclusion: Neuroimaging is currently recommended as part of the diagnostic evaluation of a child with GDD especially if there are physical findings. Children with motor delays and fewer behavioural concerns are more likely to have abnormal MRIs. This study suggests that developmental and behavioral assessments are discerning between groups and have the potential to guide investigations.