Sociodemographic and Biomedical Correlates of Developmental Delay in 2- and 4-Year-Olds with Sickle Cell Disease.
Jeffrey Schatz, Laura Reinman, Sarah E Bills and 1 others
PMID 34570066WHAT IT FOUND
In children with sickle cell disease, risk factors for developmental delay shift with age.
Private insurance and professional daycare were protective in two-year-olds, while severe disease and abnormal stroke screening were linked to delay in four-year-olds.
Key findings
01For two-year-olds, having private health insurance and attending professional daycare were each independently associated with a lower likelihood of a positive developmental screening.
02For four-year-olds, having a severe sickle cell genotype and having an abnormal transcranial Doppler exam each independently increased the likelihood of a positive developmental screening.
03The overall rate of positive developmental screenings did not differ significantly between two-year-olds and four-year-olds, but the factors associated with those screenings did.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on sociodemographic data available in medical records, which provides only a limited view of the social environment and may not capture other important factors like parent mental health or home cognitive stimulation. The associations with abnormal transcranial Doppler exams are based on a small number of children, reducing the certainty of these specific findings. Sleep apnea and hydroxyurea treatment data were incomplete for many participants, so null findings for these factors may reflect data gaps rather than a true lack of association. The cross-sectional design cannot establish causality; it only identifies associations at a single point in time.
Declared interests
The study was supported by the National Institutes of Health (Extramural). No other conflicts of interest are reported in the provided text.
The easy way to misread this
Do not conclude that sociodemographic factors become irrelevant in four-year-olds simply because they were not statistically significant in this study. The authors note that the medical record data provided only a limited window into the social environment, so the absence of a finding here does not mean social factors stop mattering.