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Developmental delay and learning difficulties: spotting problems early so young children can get the help they need

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What did the project achieve?

“As a direct outcome of this project, the PARCA-R questionnaire provides a quick, inexpensive and easy way for health professionals and researchers to assess the development of all two-year-old children,” says Professor Samantha Johnson of the University of Leicester. “We hope this will help families access the support they might need to maximise their children’s life chances.”

Assessing the development of children in the first few years of life is crucial for identifying children at risk of lifelong developmental problems. The Parent Report of Children’s Abilities-Revised (PARCA-R) is a questionnaire about a child’s development at two years of age that parents can complete in around 15 minutes. In 2017, the use of this tool was recommended by the National Institute for Care Excellence (NICE) to find out if children who were born prematurely are at risk of developmental delay – but a lack of standardised scores has previously limited its wider use in the general population.

“By analysing PARCA-R data collected on thousands of children across the UK, we have now successfully developed a new standardised scoring system to compare how well a child is developing in relation to other children of the same age and sex,” says Professor Johnson. “We have also demonstrated its clinical validity, meaning that researchers and health professionals can confidently use this questionnaire to spot developmental problems in all children at 23 to 27 month of age.”

The team has published these results in a respected scientific journal and also created a new website where the PARCA-R questionnaire and the standardised scores can easily be downloaded for free. They have also developed an online standardised score calculator and worked with international colleagues to make available versions of the questionnaire in 14 different languages.

“The PARCA-R is now the only standardised parent-completed assessment of children’s development at two years of age,” says Professor Johnson. “The impact of this project is immediate as the new scores are freely available and the questionnaire is already being used in research and clinical practice internationally.”  

This research was completed on

Evidence suggests that one in 10 babies are diagnosed with developmental delay, which can have a long-term impact on their health and wellbeing.1 A team of researchers led by Dr Samantha Johnson at the University of Leicester plan to make it easier to spot developmental problems such as difficulties with learning or language early on. Dr Samantha Johnson and her collaborators are fine tuning an existing parental questionnaire so it can be used to assess the development of all young children quickly and efficiently. All children with developmental problems could then be offered the support they need to give them the best possible start in life.

How are children’s lives affected now?

“What happens in early childhood can affect a child’s health and wellbeing throughout their whole life,” says Dr Johnson. “That’s why it is so important to check children’s early development to identify those who need support. Getting doctors to check every single child would not be possible, so we need to find other ways to monitor children’s development.”

Parents know their children best. They tend to notice if their child doesn’t reach important developmental milestones as expected, for example if their child seems to be late to start walking or talking. They might also notice things that show up in the way children play, learn, speak, act and move that might be signs of early problems.

But children develop naturally at different rates, so it can be hard for parents to know if professional help is needed. The team aims to find a way to draw on parents’ understanding of their own children to identify those who need help.

How could this research help?

The researchers’ work focuses on an existing parental questionnaire, called the Parent Report of Children’s Abilities – Revised (PARCA-R). The PARCA-R is already being used successfully to spot moderate and severe developmental problems in two-year-old children who were born prematurely, but the researchers are developing it so that it’s suitable for use with all young children

At the end of this project, the team will make the questionnaire available free of charge online, so health professionals and researchers worldwide can use it with parents of all young children.

“The questionnaire will provide a quick, inexpensive and easy way to assess children’s development early, at around two years of age, and identify those who may need support,” says Dr Johnson. “That includes children whose development is delayed, and children who have problems with learning or language. We hope our work will mean children are offered timely intervention to reduce the lifelong impact of those difficulties and give children the best possible start in life.”


1. Parsons S et al. Disability among young children. Prevalence, heterogeneity and socio-economic disadvantage. Centre for Longitudinal Studies (CLS) Working Paper 2013/11. November 2013. http://www.cls.ioe.ac.uk/shared/get-file.ashx?itemtype=document&id=1763 Website accessed 23 August 2017.




Project Leader Dr Samantha J Johnson PhD CPsychol AFBPsS
Project Team Ms Louise Linsell MSc, Professor Dieter Wolke PhD Dipl-Psych CPsychol AFBPs, Professor Neil Marlow DM FRCP FRCPCH FMedSci, Professor Peter Brocklehurst MBChB MSc(Epid) FRCOG FFPH and Dr Bradley N Manktelow PhD CStat
Project Location Department of Health Sciences, University of Leicester
Project Location Other National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, School of Psychology, University of Warwick, Institute for Women's Health, University College London, Institute of Applied Health Research, University of Birmingham
Project duration 1 year
Date awarded 20 July 2017
Project start date 9 April 2018
Project end date 8 July 2019
Grant amount £70,698
Grant code GN2580


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