Early detection of neurodevelopmental disorders in children with delayed milestones: Navigating between overlapping trajectories and the limits of a single-diagnosis categorical approach (A Preliminary Study for the CONDOR Cohort)

Abstract

Context

Neurodevelopmental disorders are characterized by motor, language, cognitive, or socio-emotional delays and/or deficits in affected children. However, a categorical view of these disorders leads to a limited understanding of the challenges they pose.

Methods

Among 184 children aged 1–7 years, referred due to concerns about their development and who subsequently received a primary diagnosis of ADHD, ASD, IDD, LD, or DCD following a care pathway in a child psychiatry service, we assessed delays in gross and fine motor skills, language, and socio-emotional development. Delays were assessed based on the child’s age using developmental milestones from the American Academy of Pediatrics. Adjustments were made for age, sex, and medical history.

Results

Our findings indicate that children with NDDs exhibit functional overlaps. The number of fine motor delays was comparable among children with ASD, DCD, and IDD. Similarly, language delays did not differ significantly among those with ASD, LD, and IDD. Children with ADHD did not exhibit more fine motor difficulties than those with other diagnoses. Children with IDD were among the most significantly affected across all four evaluated domains.

Discussion

These results highlight the intertwined nature of these domains in early neurodevelopment, even though the lack of data on comorbidities significantly limits our conclusions. Nevertheless, it emphasizes the importance of adopting a functional approach to enhance early detection. This also calls into question the relevance of the categorical DSM approach in both clinical practice and research, emphasizing the need to establish a functional classification of delays and deficits.