Abstract Objective: To assess the feasibility of a shared approach combining the clinical expertise of family pediatricians and parents perspectives in identifying potential disorders in children using standard clinical practice tools. Study design: Within the NASCITA birth cohort, in addition to the family pediatricians clinical evaluation, the M-CHAT-R was completed by parents to assess the childs language, social skills, behavior, and sensory areas. Parents were also asked to complete the PSI-SF to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. Results: The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatricians assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR=2.42, 95%CI: 1.20-4.86) and having sleep disorders (OR=2.48, 95% CI 1.19-5.71) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR=3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). Conclusions: Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.

The authors have declared no competing interest.

This work was supported by resources from the Laboratory for Mother and Child Health and by an economic contribution by the Associazione Amici del Mario Negri (Grant number: N/A). The Associazione Amici del Mario Negri had no role in the design and conduct of the study.

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The study was approved by the Fondazione IRCCS Istituto Neurologico Carlo Besta's Ethics Committee (February 6th, 2019, protocol n. 59).

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