According to recent statistics, in the US as many as 1 in 4 children from birth to age 5 years are at moderate or high risk for developmental, behavioral, or social delay.¹ Early detection of delay is crucial for determining which children require close surveillance and intervention.^2-5 Early intervention has been proven to be critical in optimizing language, cognitive, motor, socioemotional development, and educational success, alongside prevention of additional future developmental delay.^6-13

Although the short-term neurological complications of Shigella spp. are well described, potential neuropsychiatric outcomes have not been studied yet. We investigated the association between early childhood shigellosis and subsequent ADHD. This is a retrospective population-based cohort. Using a large Health Maintenance Organization database, the prevalence of ADHD was investigated among children aged 5–18 years who underwent stool culture prior to the age of 3 years. Of 52,761 children with a stool culture examined, 5,269 (9.98%) had Shigella-positive results. The rate of ADHD was 10.6% and 8.6% among children with Shigella-positive and Shigella-negative stool cultures, respectively (p < .001). Adjusted odds ratio for ADHD after controlling for gender and socioeconomic status was 1.21 (CI 1.13–1.29, p < .001). The younger the child was during Shigella gastroenteritis, the higher was the association with ADHD (p < .001). Early childhood shigellosis is associated with an increased rate of long-term ADHD.

Background: The early years of children’s lives are critical for their healthy development. Although children’s growth and development rates may vary, a significant delay during early childhood could indicate a medical or a developmental disorder. Developmental surveillance is used worldwide by healthcare providers in routine encounters, as well as by educators and parents, to elicit concerns about child development. In this work, we used a national dataset of developmental assessments to describe temporal trends of milestone attainment rates and associations between milestone attainment and various sociodemographic factors. Methods: The study included 1,002,700 children ages birth until 6 years with 4,441,689 developmental visits between the years 2016 and 2020. We used the Israeli developmental scale to assess the annual rates of failure to attain language, social and motoric milestones by the entire population, as well as by subgroups stratified by sociodemographic factors. In addition, we evaluated the rates of parental concern for child development and of the nurse’s report of development inadequate for age. We used multivariable logistic regression to analyze the impact of different sociodemographic factors on the odds of failure to attain milestones, while controlling for confounding. Results: Milestone failure rates progressively increased over the examined years in all developmental domains, and most prominently in the language domain. Conversely, the rates of parental concern for developmental delay remained constant. In multivariable analysis, higher risk of milestone attainment failure was observed in children whose mothers were divorced, unemployed, immigrant, had lower education, of Bedouin origin or were over 40 years old when giving birth. Conclusions: This report describes national trends of child development in the gross motor, fine motor, language, and social domains. A periodic report of these trends should be published to objectively evaluate subgroups in need for intervention, and to assess the effectiveness of intervention programs in attempt to maximize the developmental potential of children in Israel.