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Background: Developmental delay in early childhood is a significant concern with multifaceted causes and implications. The Bayley Scales of Infant and Toddler Development (BSID-III) is widely used for developmental assessment, but its use in Iranian children has been understudied. This study aimed to evaluate the developmental delays of Iranian children aged 1 to 42 months, investigate the association between parental education and these developmental outcomes, and compare developmental outcomes between the BSID-III and the Ages and Stages Questionnaire, Third Edition (ASQ-3). These findings contribute to informing clinical practices, policy makers, and early intervention programs aimed at promoting optimal development for all children. Methods: In this cross-sectional study, 707 Iranian children from Yazd, Iran, with suspected developmental delays were recruited from two health centers. Trained examiners administered the Persian-adapted and validated version of the BSID-III following standardized procedures. We hypothesized differences in BSID-III scores compared to normative samples, considering age, gender, and parental education. Additionally, comparisons between BSID-III scores and the validated Iranian version of ASQ-3 outcomes were explored to gain further insights. Results: The study sample exhibited varying rates of developmental delays across Cognitive (15.8%), Receptive Communication (20.1%), Expressive Communication (18.4%), Fine Motor (13.6%) and Gross Motor (15.7%) domains. Additionally, Age-related differences were observed, particularly in Receptive and Expressive Communication, where older children showed higher rates of delays. Gender differences were also significant in the Language Scale, with females showing slightly higher rates of normal development. Moreover, parental education emerged as a significant factor, with higher levels associated with a reduced occurrence of developmental delays. Furthermore, comparisons between BSID-III results and ASQ-3 outcomes highlighted discrepancies, suggesting an imperfect alignment between measures. The analysis demonstrated fair agreement for Cognitive-Problem Solving and Gross Motor development, but poor agreement for Fine Motor development, highlighting the complexity of developmental assessment and the need for cautious interpretation of test results. Conclusions: This study enhances our understanding of developmental assessment in Iranian children with suspected delays by emphasizing culturally sensitive adaptations for assessment tools alongside recognizing how parental education influences developmental trajectories. Future research with diverse, longitudinal samples is warranted to gain a more comprehensive picture. [ABSTRACT FROM AUTHOR]

Abstract Background Developmental delay in early childhood is a significant concern with multifaceted causes and implications. The Bayley Scales of Infant and Toddler Development (BSID-III) is widely used for developmental assessment, but its use in Iranian children has been understudied. This study aimed to evaluate the developmental delays of Iranian children aged 1 to 42 months, investigate the association between parental education and these developmental outcomes, and compare developmental outcomes between the BSID-III and the Ages and Stages Questionnaire, Third Edition (ASQ-3). These findings contribute to informing clinical practices, policy makers, and early intervention programs aimed at promoting optimal development for all children. Methods In this cross-sectional study, 707 Iranian children from Yazd, Iran, with suspected developmental delays were recruited from two health centers. Trained examiners administered the Persian-adapted and validated version of the BSID-III following standardized procedures. We hypothesized differences in BSID-III scores compared to normative samples, considering age, gender, and parental education. Additionally, comparisons between BSID-III scores and the validated Iranian version of ASQ-3 outcomes were explored to gain further insights. Results The study sample exhibited varying rates of developmental delays across Cognitive (15.8%), Receptive Communication (20.1%), Expressive Communication (18.4%), Fine Motor (13.6%) and Gross Motor (15.7%) domains. Additionally, Age-related differences were observed, particularly in Receptive and Expressive Communication, where older children showed higher rates of delays. Gender differences were also significant in the Language Scale, with females showing slightly higher rates of normal development. Moreover, parental education emerged as a significant factor, with higher levels associated with a reduced occurrence of developmental delays. Furthermore, comparisons between BSID-III results and ASQ-3 outcomes highlighted discrepancies, suggesting an imperfect alignment between measures. The analysis demonstrated fair agreement for Cognitive-Problem Solving and Gross Motor development, but poor agreement for Fine Motor development, highlighting the complexity of developmental assessment and the need for cautious interpretation of test results. Conclusions This study enhances our understanding of developmental assessment in Iranian children with suspected delays by emphasizing culturally sensitive adaptations for assessment tools alongside recognizing how parental education influences developmental trajectories. Future research with diverse, longitudinal samples is warranted to gain a more comprehensive picture.