Abstract
BACKGROUND: Developmental delays in gross motor, fine motor, language or social skills can affect children's growth and well-being. This study aimed to determine the prevalence of overall and domain-specific delays and identify associated risk factors among Malaysian children aged 6-59 months using recent national data. METHODS: This population-based, cross-sectional study used data from the National Health and Morbidity Survey 2022, focusing on children aged 6-59 months. Data were collected through face-to-face interviews with caregivers, and physical assessments were conducted by trained nurses. Overall developmental delay was defined as failing an age-specific assessment in at least one of four domains: gross motor, fine motor, language, or social skills. Multivariable logistic regression, accounting for the complex survey design, was performed using SPSS version 23 to identify sociodemographic and health-related factors associated with developmental delays across all domains. RESULTS: Prevalence of overall developmental delay was 7.4%. Children aged 24-35 months (AOR: 2.40), boys (AOR: 1.44) and those with low birth weight (AOR = 1.76) were significantly at risk of overall developmental delay. By domain, social delay (4.1%) was the most prevalent delay, followed by language delay (2.7%), fine motor delay (1.9%) and gross motor delay (1.0%). Children aged 36-59 months were at higher risk of fine motor and language delays. Low birth weight was a strong predictor across all domains, with the greatest effect on gross motor delay (AOR: 3.75). Boys had higher odds of fine motor (AOR: 1.49), language (AOR: 1.77) and social delays (AOR: 1.55), while being overweight was specifically associated with gross motor delay (AOR: 2.79). CONCLUSION: Developmental delays are prevalent among Malaysian children, with low birth weight as a consistent risk factor across domains. Domain-specific assessment reveals distinct patterns and unique risk profiles that are masked by overall prevalence, underscoring the need for targeted early interventions.