12 13 Among the survivors, >250 million under-5 children from low- and middle-income countries (LMICs) are not fulfilling their developmental potential in cognitive, motor and social-emotional domains due to poor nutrition, poverty and conflicts. In the last few decades, successful implementation of WHO’s key health services 11 regarding ‘The Countdown to 2015 Initiatives’ resulted in the reduction of the neonatal mortality rate from 37 deaths per 1000 live births in 1990 to live births in 2016, worldwide with a projection of further future reductions. 10 This further accentuates the significance of early identification to initiate appropriate interventions and/or rehabilitations with the intention of preventing further delays, stimulating emerging skills and creating a more encouraging and protective surroundings. This is because the affected children require substantial resources and increased cost over their lifespan compared with those without such conditions. 8 9 There is a long-term financial impact on society in terms of healthcare, educational support and other special services related to developmental delay and/or disability. As a predictive of above-mentioned learning, movement and behavioural disorders, it is possible to identify developmental delay to a great extent during the preschool period (ie, before the age of 5 years) with the help of well-validated screening tools. 2 7 Examples of developmental disabilities include autism spectrum disorder, behavioural disorders, cerebral palsy, Down syndrome, fetal alcohol syndrome, intellectual disability and so on.

Apart from developmental delay, developmental disability is considered as a severe, chronic disability originating at birth or during childhood, expected to continue indefinitely, and substantially restricts the individual’s functioning in several major life activities. 4–6 Although the condition itself may not be permanent, it can provide a foundation for recognising children who might have more severe and permanent health conditions, that is, developmental disabilities. 1–3 Complications at birth including premature birth brain trauma and encephalitis severe medical problems after birth inborn metabolic errors genetic or chromosomal abnormalities inadequate stimulation malnutrition iron deficiency anaemia chronic illness adverse environmental, familiar and psychological states may lead to developmental delay.

Developmental delay is a condition where children exhibit significant variation in achieving developmental milestones as expected for their actual or adjusted age.

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