KML Tang, TYK Chen, VWY Lau, mmf Wu

Abstract

Objective: To determine the cognitive outcome of young children with global developmental delay at primary school entry and to examine the parental preference of primary school placement for these children in Hong Kong. Method: A retrospective cohort study was done in Child Assessment Service of the Department of Health. Cognitive outcomes of children with various degrees of developmental delay at initial diagnosis were reassessed before their primary school entry in the year 2004 and the parental choice of primary school placement was also analysed. Results: 493 children were included in the study. At the initial diagnosis, 60.4% (298) of children were diagnosed to have borderline developmental delay, while 39.6% (195) children were found to have significant developmental delay reaching mental retardation (MR) level. At pre-primary reassessment, among those children with borderline delay, 42.0% (125) were found to have normal intelligence (IQ); 26.9% (80) were found to have limited IQ; while 31.1% (93) were found to have MR. On the other hand, among those with significant developmental delay, 81.0% (158) were found to have MR, while only 9.2% (18) and 9.8% (19) were found to have limited and normal IQ respectively. Half (49.0%) of the parents with children of limited IQ declined remedial service in mainstream schools; while around 40.0% (37.9%) of the parents with children of MR insisted their children to be integrated into normal schools. Conclusion: Children diagnosed to have borderline developmental delay during the preschool period had nearly half the chance in catching up of cognitive function at the pre-primary school stage. However, if a child had significant delay at initial diagnosis, there was more than 80.0% chance that the child would have cognitive impairment at primary school level. Since a substantial proportion of parents with MR children favored school placement in mainstream schools, the need for providing support to mainstream schoolteachers in managing the educational needs of these children must be addressed.