title: Indian children with developmental disabilities: early versus late referral for intervention.
abstract: OBJECTIVE
  To study the age at referral, of children with neurodevelopmental disabilities to Child Development and Early Intervention Clinic and compare the neuromorbidity and socio-economic profile of the early and late presenters.
  
  
  METHODS
  This retrospective observational study was conducted at Child Development and Early Intervention Clinic (CDEIC) located in Northern India. Case records of children enroled at CDEIC in last 5 y; with neurodevelopmental disabilities namely Mental Retardation/Global Developmental Delay, Cerebral Palsy, hearing and vision impairment were separated and studied.
  
  
  RESULTS
  Two thousand and twenty cases were included in this study. 62.8 % presented before 3 y of age (early presenters) and 37.1 % presented at 3 y or more (late presenters). There was no difference in the overall rates and severity of mental retardation in early and late presenters. The proportion of children with quadriparetic cerebral palsy, hearing impairment, vision impairment and multiple disabilities was significantly more in early presenters. The early presenters had better parental education status, less number of siblings, better immunization status and more were delivered at a hospital and residing in urban areas.
  
  
  CONCLUSIONS
  Large numbers of children with neurodevelopmental disabilities are referred late for intervention services, leading to loss of opportunity for early intervention. Children with purely mental disability are the ones, most likely to be referred late. Socio-economic differences are significantly contributing to these delayed referrals.
authors.affiliation: Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, 110002, India, drmonicajuneja@rediffmail.com.
authors.forename: Monica
authors.initials: M
authors.lastname: Juneja
authors.forename: Rahul
authors.initials: R
authors.lastname: Jain
authors.forename: Biswaroop
authors.initials: B
authors.lastname: Chakrabarty
authors.forename: Devendra
authors.initials: D
authors.lastname: Mishra
authors.forename: Philomina
authors.initials: P
authors.lastname: Saboo
mesh_terms: D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors