Social Communicative and Motor Competence in an Epidemiological Sample of Rural Ugandan Children.

Background: Social communicative skills in early childhood have been shown to be influenced by multiple genetic and socio-cultural factors. Cultural factors such as childrearing practices have been cited in the literature as plausible explanations for the differences in developmental trajectories (e.g. motor, language, social and emotional skills etc.) observed among infants from diverse cultural backgrounds. Thus, environmental variations and differences in children’s abilities may affect social emotional, language abilities, learning and health outcomes. It has been observed that school-aged children with movement coordination difficulties experience social interaction challenges and vice versa. However, less is understood regarding the co-occurrence of social communication and motor delays among epidemiological samples of preschool-age children , particularly in low-and middle-income countries. Few studies have examined social communicative skills and motor ability among preschool age children in resource-limited settings. Determining whether deficits in social communication and motor development co-occur during early childhood may help to classify behavioural phenotypes and to identify appropriate interventions to address specific problems.

Objectives: The purpose of this study was to determine the proportion of children with delayed motor abilities who demonstrate co-occurring social communication delays among an epidemiological sample of rural preschool age Ugandan children.

Methods: We conducted a population-representative survey of adults aged 18 years and older who lived in the Iganga-Mayuge Health and Demographic Surveillance Site. Respondents who identified as being a caregiver of a child aged 36-59 months were eligible for the study. Participants children were assessed using UNICEF’s Early Childhood Development (ECD) questionnaire. Descriptive statistics were used to determine the base rate of children with potential motor and social communication delays.

Results: From November 6, 2017 to June 20, 2018, we enrolled 720 (360 boys, 360 girls) Ugandan children with an average age of [46.9±6.7 months], Out of the 720 children who were screened, 4.2% [n=30, mean age 45.4 months SD (7.7)] had social interaction challenges, 6.4% [n=46, mean age 46.7 months SD (6.9)] demonstrated receptive language difficulties and 7.4% [n=53, mean age 46.6 months SD (6.7)] were identified as having motor delays. Of those judged to have impaired social skills, 16.7% demonstrated receptive language difficulties and 6.7% also exhibited motor problems.

Conclusions: Findings indicate socio-emotional, receptive language and motor problems tend to co-occur among children during the early stages of development. Integrated screening and surveillance infrastructure need to be developed within the Ugandan low-income context to facilitate early identification, subtyping and intervention.