Triagem de desenvolvimento e comportamento de crianças brasileiras: prevalência e influência de fatores sociodemográficos, consumo alimentar e hábitos diários

Abstract

Introduction: Developmental delays during childhood should be rapidly identified through the observation of absence or deviation in expected motor, socioemotional, intellectual, or language skills, which are essential for the acquisition of more complex abilities. Developmental screening instruments represent the most effective approach for early detection of suspected delays. Objective: To investigate the prevalence and associated factors of suspected developmental delay and behavioral problems in Brazilian children using screening tools. Methods: This thesis comprises a systematic review and a cross-sectional study. The review aimed to examine the prevalence of suspected developmental delay and behavioral problems among Brazilian children. Observational studies were searched without time restriction in Embase, Google Scholar, Lilacs, Open Grey, PsycINFO, PubMed, Scopus, and Web of Science databases. Meta-analyses were conducted to synthesize quantitative findings. The cross-sectional study was conducted in a capital city in Brazil and included 4-year-old children and their caregivers, who participated in an online consultation. Child development and behavior were assessed using a questionnaire validated for the Brazilian population. Generalized linear models were applied. Results: The review included 59 studies, and the meta-analysis estimated a prevalence of 26.2% for suspected developmental delay and 22.6% for behavioral problems. Significant differences were found according to the instruments used and Brazilian regions. The cross-sectional study included 418 children (median age: 48 months, IQR: 0). The prevalence of suspected developmental delay was 28%, and behavioral problems 39.5%. Male sex, part-time school attendance, and poorer behavioral scores were associated with lower developmental scores. Longer sleep duration and higher developmental scores were associated with fewer behavioral problems, while food insecurity and consumption of ultra-processed foods were related to worse behavioral results. Conclusion: The findings indicate high prevalence rates of suspected developmental delay and behavioral problems. Child sex, school attendance period, sleep duration, food insecurity, ultra-processed food consumption, and the interrelation between both outcomes were influencing factors. Considering the importance of early identification, it is essential to expand the use of culturally adapted and validated screening instruments in primary health care, strengthen professional training, promote intersectoral integration, and ensure access to adequate and quality food.