# Social withdrawal behaviour in Nepalese infants and the relationship with future neurodevelopment; a longitudinal cohort study

## TL;DR

Nepalese infants who show social withdrawal have lower early language scores, but no long-term cognitive effects at 4 years.

## Contribution

This study identifies early social withdrawal as a predictor of early language delays but not later cognitive deficits.

## Key findings

- Socially withdrawn infants had lower Bayley-III language scores in early childhood.
- The association was mainly driven by expressive communication, not receptive communication.
- No differences were found in cognitive scores at 4 years between socially withdrawn and non-withdrawn children.

## Abstract

Social withdrawal in infants may be a signal of distress and a precursor for non-optimal development.

To examine the relationship between infant social withdrawal and neurodevelopment up to 4 years in Nepalese children.

A total of 597 Nepalese infants 6–11 months old were assessed with the modified Alarm Distress Baby Scale (m-ADBB), and of these, 527 with the Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III) during early childhood, and the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) and NEPSY-II subtests at 4 years. We examined whether social withdrawal defined by the m-ADBB was associated with neurodevelopmental scores in regression models.

Children socially withdrawn in infancy had lower Bayley-III language scores (-2.6 (95% CI -4.5, -0.7)) in early childhood. This association seems to be driven by the expressive communication subscale (-0.7 (95% CI -1.0, -0.3)), but not the receptive communication subscale (-0.2 (95% CI -0.6, 0.1)). There were no differences in the other Bayley-III scores or the WPPSI-IV and NEPSY-II scores at 4 years in children who were socially withdrawn or not.

Social withdrawal in infancy was reflected in early language development but not cognitive functioning at 4 years.

The online version contains supplementary material available at 10.1186/s12887-024-04658-6.