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IntroductionRoutine developmental surveillance is fundamental for timely identification of developmental delays. We explored sex-related differences in milestone attainment rate and evaluated the clinical need for sex-specific developmental scales.MethodsThis is a retrospective cross-sectional study, utilizing data from a national child surveillance program. The study included children from birth to six years of age, assessed between 2014-2021 (n=643,958 and n=309,181 for the main and validation cohorts, respectively).We measured the differences between sexes in normative attainment age of 59 milestones from four developmental domains and calculated the projected error rates when conducting unified vs. sex-specific surveillance.ResultsGirls preceded boys in most milestones of all domains. Conducting developmental surveillance using unified rather than sex-specific scales resulted in potential missing of girls at risk of developmental delay (19.3% of failed assessments), and false alerts for boys (5.9%).ConclusionThese findings suggest that using sex-specific scales may improve the accuracy of early childhood developmental surveillance. |
