D2.177 - Developmental Problems and Maternal Perception of Child Vulnerability in Children Aged 2–5 Years Diagnosed with Asthma

Early childhood asthma may influence neurodevelopment and caregivers’ perceptions of child vulnerability. This study aimed to compare developmental screening outcomes and perceived child vulnerability between preschool children with asthma and healthy controls, and to examine associations with asthma control.

In this case–control study, children aged 2–5 years with physician-diagnosed asthma (n=100) and age-matched healthy controls (n=100) were evaluated. Development was evaluated across five domains (communication, gross motor, fine motor, problem solving, personal/social; pass/fail per domain) using the Age and Stages Questionnaires. Perceived vulnerability was assessed using a child vulnerability scale (vulnerable defined as score ≥10). Asthma control was assessed with TRACK. Group comparisons used appropriate parametric/non-parametric and categorical tests (two-sided p<0.05). Ethics approval and parental consent were obtained.

Age, gestational age, birth weight, and sex distribution were similar between groups. Overall developmental delay (fail in ≥1 domain) did not differ between asthma and controls (18/100 vs 21/100; p=0.592); fail in ≥2 domains was also similar (17/100 vs 11/100; p=0.221). Communication delay was more frequent in the asthma group (12% vs 4%; p=0.037), while other domains did not differ significantly. Perceived vulnerability scores were markedly higher in asthma (median 18 [IQR 16–20] vs 6 [IQR 2–9]; p<0.001), and 96% of children with asthma vs 20% of controls had scores ≥10 (p<0.001). Vulnerability score showed a weak positive correlation with the number of delayed domains (r=0.153; p=0.031). Within the asthma group, uncontrolled asthma was associated with higher delay rates (fail in ≥1 domain: 15/41 vs 3/59; p<0.001; fail in ≥2 domains: 15/41 vs 2/59; p<0.001).

Preschool children with asthma had substantially higher perceived vulnerability and a higher rate of communication delay compared with controls, whereas overall developmental delay rates were similar. Poor asthma control was strongly associated with developmental delays, supporting routine developmental surveillance and targeted support in children with uncontrolled asthma.