300 Section - Predictors of Developmental Progress in Children with Developmental Delay: A Nearly 10-Year Longitudinal Analysis from a Medical Center in Taiwan

Objectives : Longitudinal outcomes of early intervention in children with developmental delay (DD) are crucial for optimizing clinical strategies. This study aimed to investigate the therapeutic effectiveness and identify independent predictors of developmental progress over a 10-year period using the Total Developmental Score (TDS).

Design: We conducted a retrospective review of clinical records from a medical center in Hsinchu in Taiwan from January 2016 through August 2025. Initially, 6,543 assessment entries from 4,235 individual patients were retrieved. Inclusion criteria were: (1) children diagnosed with DD; (2) at least two standardized developmental evaluations; and (3) complete data across all domains. After excluding single-assessment cases and those with missing values, a final cohort of n=1,386 children was analyzed. Developmental progress was defined as a decrease in TDS. Predictors were identified using multivariate logistic regression and age-stratified analysis (< 2, 2–4, and >4 years).

Results: Among the 1,386 children, the overall progress rate was 53.1%. The mean TDS significantly improved from 7.99 ± 2.03 to 7.33 ± 2.59 (p < .001). Logistic regression showed that initial language development was a strong positive predictor of progress (OR = 1.91, p < .001). In contrast, children with Autism Spectrum Disorder (ASD; OR = 0.125, p < .001) and Attention-Deficit/Hyperactivity Disorder (ADHD; OR = 0.252, p < .001) had significantly lower odds of improvement. Age-stratified analysis revealed that children in the < 2 years group (42.4%) demonstrated significantly lower progress rates compared to the 2–4 years (55.2%) and >4 years (54.4%) groups (p = .004).

Conclusion: Early intervention effectively promotes developmental progress, particularly in language-related domains. The age of 2 years appears to be a critical threshold, as children identified earlier may present with higher clinical severity. Tailored intervention strategies are warranted for high-risk subgroups, particularly those with ASD or ADHD, to optimize functional outcomes.