A Cross-sectional Survey Comparing Parental and Clinician Concerns in an Early Intervention Clinic in South India

Abstract

Introduction

Neonatal survival has improved in low- and middle-income countries, but post-discharge community support for neonatal intensive care unit graduates lags behind high-income countries, leaving parents with limited healthcare support. Effective advice depends on clear communication, which can be hindered by differing perspectives. This study examines parental and clinician concerns about child development in 826 infants at a South Indian Early Intervention Clinic.

Methods

To standardise and compare the parents’ and clinicians’ concerns, we defined and categorised them into eight domains: mobility, hand use, speech, hearing, increased tone, vision, cognition and ‘other’. Cohen’s kappa was used to measure agreement, while log-linear models were used to assess the effect of mothers’ education and parity on the agreement.

Results

We observed significant differences in alignment between parental and clinician concerns in most domains (P < .001), but stronger agreement on mobility and personal delay issues (κ = 0.235 and 0.395). Parity significantly influenced tone (P = .001) and speech (P = .012), while maternal education had no impact.

Conclusion

Our findings show good alignment in observable development concerns but differences in sensory, language and cognition areas. This underscores the need for patient education on developmental milestones, expectations and timely support access to resources.