Patterns of Early Red Flag Identification Across Neurodevelopmental Conditions: A Qualitative Analysis of Parental Recognition Trajectories

Background: Neurodevelopmental disorders are characterized by impairments affecting motor, cognitive, behavioural, and social functioning. Early identification is essential for timely intervention and relies on parental observation and interpretation of developmental patterns. Despite an increase in developmental surveillance, parents are uncertain in recognizing early red flags, particularly in low- and middle-income countries. Methods: A qualitative descriptive study using semi-structured interviews was conducted with thirty mothers of children diagnosed with neurodevelopmental disorders. The interview focused on domains such as visibility of early red flags, recognition as an evolving interpretive process, contexts that delay recognition, health system responses that shape the timing of identification, and timing of red flag identification as an outcome. Data were collected, transcribed, and analyzed using thematic analysis within an interpretivist framework, aligned with the World Health Organization’s Nurturing Care Framework. Results: Five themes emerged from the analysis, indicating that parents frequently noticed early developmental differences during routine caregiving, and the interpretation of signs of concern evolved over time and influenced help-seeking and access to healthcare guidance. Conclusion: The study emphasizes the importance of pattern identification for the mothers of neurodevelopmental disorders. Strengthening caregiver awareness and improving healthcare guidance helps in making the healthcare pathway feasible without any delay.