Child neurodevelopment at 3 years of age: a follow-up in the Italian NASCITA birth cohort

►Aim. The aim of the study was to identify children at risk of neurodevelopmental disorders through the use of validated instruments by family paediatricians and parents. ►Methods. As part of the NASCITA cohort study, the development of 148 children was evaluated. Family pediatricians (FPs) conducted assessments using the CDC Learn the Signs, Act Early Milestones Checklist, while parents completed the Strengths and Difficulties Questionnaire (SDQ). Children were considered at risk if their total score was ≥ 12 on the CDC or > 14 on the SDQ. Univariate and multivariate analyses were performed to assess which variables were associated with a higher likelihood of warning signs (WS). ►Results. In all, 14% of children showed WS for developmental disorders at 36 months, a lower percentage than the 24-month assessment (16%): for two out of three children, WS disappeared between 24 and 36 months of age. Persistent WS were observed in 5% of children. Key risk factors identified include older maternal age at delivery (OR 8.93, 95% CI: 1.87 - 42.62) and maternal unemployment (OR 4.75, 95% CI: 1.40 - 16.09), while reading aloud emerged as a protective practice, emphasizing its potential in early interventions. ►Conclusions. These results highlight the need for continuous monitoring of WS and the importance of positive parental practices in mitigating developmental risks. Early identification by primary care pediatricians is crucial in addressing developmental concerns early and improving long-term outcomes.