Child: care, health and development · 2026
Rate and Associates of Early Childhood Care and Education Attendance Among Children With Developmental Difficulties From a Middle-Income Country, Turkey.
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Iskenderli Hale Sandikci, Akin Ezgi Ozalp
Аннотация
BACKGROUND: Although the World Health Organisation (WHO) Nurturing Care Framework included early learning opportunities as a main component for optimal child development, important inequalities exist between high-income and low- and middle-income countries (LMICs) regarding early childhood care and education (ECCE) attendance for children with developmental difficulties (DDs). We aimed to determine the rate and associates of ECCE attendance for young children with DDs from a middle-income country, Turkey.
METHODS: Using a cross-sectional design, we recruited children aged 12-60 months who were admitted to Ankara University Developmental Paediatrics Division, a tertiary referral clinic, for their first visit due to DDs during the period between 1 January 2022 and 1 January 2023. We used the Expanded Guide for Monitoring Child Development and comprehensive developmental assessment for the rate and associates of ECCE attendance among children with DDs.
RESULTS: Of 978 children with DDs admitted to Ankara University Developmental-Behavioural Paediatrics Division in the study period, 482 (49.3%) comprised the sample. Most were boys (64.9%); median age was 32 (min-max: 13-60) months. Of these, 110 (22.8%) children had chronic health conditions, 85 (17.6%) had isolated language delay, 72 (14.9%) had autism spectrum disorder, 60 (12.4%) had global developmental delay, 68 (14.1%) were followed for preterm birth, and 49 (10.2%) were followed for behavioural problems. Of all, 72 (14.9%) children attended ECCE. In the logistic regression model, being ≥ 36 months (OR: 5.84, 95% CI: 3.15-10.81) and having a working mother (OR: 3.63, 95% CI: 1.73-7.59) were independent factors associated with ECCE attendance.
CONCLUSIONS: Among children with DDs attending a tertiary developmental-behavioural paediatrics referral clinic in Turkey, a middle-income country, the rate of ECCE attendance was low, particularly for children under 3 years of age and children of homemaker mothers. Urgent interventions are needed for equity in opportunities for learning for young children with DDs in LMICs, especially those with complex developmental and health care needs, for whom early developmental support is essential.
METHODS: Using a cross-sectional design, we recruited children aged 12-60 months who were admitted to Ankara University Developmental Paediatrics Division, a tertiary referral clinic, for their first visit due to DDs during the period between 1 January 2022 and 1 January 2023. We used the Expanded Guide for Monitoring Child Development and comprehensive developmental assessment for the rate and associates of ECCE attendance among children with DDs.
RESULTS: Of 978 children with DDs admitted to Ankara University Developmental-Behavioural Paediatrics Division in the study period, 482 (49.3%) comprised the sample. Most were boys (64.9%); median age was 32 (min-max: 13-60) months. Of these, 110 (22.8%) children had chronic health conditions, 85 (17.6%) had isolated language delay, 72 (14.9%) had autism spectrum disorder, 60 (12.4%) had global developmental delay, 68 (14.1%) were followed for preterm birth, and 49 (10.2%) were followed for behavioural problems. Of all, 72 (14.9%) children attended ECCE. In the logistic regression model, being ≥ 36 months (OR: 5.84, 95% CI: 3.15-10.81) and having a working mother (OR: 3.63, 95% CI: 1.73-7.59) were independent factors associated with ECCE attendance.
CONCLUSIONS: Among children with DDs attending a tertiary developmental-behavioural paediatrics referral clinic in Turkey, a middle-income country, the rate of ECCE attendance was low, particularly for children under 3 years of age and children of homemaker mothers. Urgent interventions are needed for equity in opportunities for learning for young children with DDs in LMICs, especially those with complex developmental and health care needs, for whom early developmental support is essential.