Pediatrics Resident Children's Hospital Colorado Aurora, Colorado, United States
Background: Many studies have described the COVID-19 pandemic’s impact on children. Studies focused on early childhood development have varied in results. Most have reported worse developmental outcomes during the pandemic compared to pre-pandemic evaluations while others have seen no differences. There is a paucity of literature assessing the pandemic’s impact on multiple developmental assessment points from infancy to toddlerhood in a diverse population. Objective: We aim to determine whether Ages and Stages Questionnaire (ASQ-3) screening scores from 2 to 24-months of age changed during the pandemic among children attending a low-income, university-affiliated primary care clinic. Design/Methods: This is a retrospective cohort study conducted at one primary care clinic primarily serving a low-income and minority population. This study was granted exemption from the associated institutional IRB. The study population consists of three groups which experienced variable impacts from the pandemic: (1) children born before 3/1/2018 (control), (2) children born 3/1/2018-3/1/2020, and (3) children born after 3/1/2020. ASQ-3 questionnaires were independently collected during well child visits. Patients were excluded if they did not have a complete 24-month ASQ-3 scanned into their chart. Data being collected includes all ASQ-3 domain scores from 2-24 months, patient demographics, birth history, insurance, and head circumferences with associated percentile at each well visit. Statistical analysis is planned once all data is collected with each group having at least 200 individuals. Timeline completion of data collection is ~2 months as (~1/6 remains) and statistical analysis is ~2 months. The primary outcome will be differences in average ASQ-3 domain scores at 24 months between the three study cohorts. To compare longitudinal scores at different ages, all raw scores will first be converted to z-scores. Longitudinal mixed effects models will examine the trajectories of ASQ-3 scores over time by comparing the average intercepts and slopes between study cohorts.
