Children aged 3 to 5 years attending public and private kindergartens in Damietta were included. Stratified random sampling was used to ensure representation from urban and rural areas.

Motor Delay: Gross and fine motor stimulation, balance training, coordination activities.

Language Delay: Speech exercises, articulation therapy, and parent-guided interaction tasks.

Social/Emotional Delay: Group play, role-playing exercises, and emotion recognition tasks.

Therapy was conducted twice weekly for 6 months by licensed pediatric physical therapists. Progress was monitored monthly and documented in structured logs reviewed by the clinical supervisor.

Assessment of developmental outcomes was conducted using the Denver II Developmental Screening Test. Each child was evaluated individually in a quiet, well-lit environment to minimize distractions and ensure optimal performance. The test was administered according to standardized guidelines, covering four developmental domains: personal-social, fine motor-adaptive, language, and gross motor skills. Age-appropriate items were selected based on the child's chronological age line, and each item was scored as "pass," "fail," "refusal," or "no opportunity" based on the child's performance. The assessment was carried out by a trained examiner to maintain consistency and reliability. Pre- and post-intervention scores were recorded and compared to determine improvement in developmental domain outcomes.

Developmental progress was assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3), a parent-completed screening instrument. Caregivers were provided with the age-appropriate questionnaire and given clear instructions on how to complete it based on their child's typical behavior. The ASQ-3 evaluates five developmental domains: communication, gross motor, fine motor, problem-solving, and personal-social skills. Each item was rated by the parent as "yes," "sometimes," or "not yet," and corresponding scores were calculated for each domain. The completed questionnaires were reviewed by the researcher to ensure accuracy and completeness. Pre- and post-intervention scores were compared to determine changes in developmental performance

Parent satisfaction with the therapy program was evaluated using a structured questionnaire developed for the study. The questionnaire was administered to caregivers at the end of the intervention period in a quiet setting, with clear instructions provided to ensure accurate responses. It included multiple items assessing satisfaction with different aspects of the program, such as perceived effectiveness, ease of implementation, therapist-parent communication, and overall experience. Responses were recorded using a Likert scale ranging from "very dissatisfied" to "very satisfied." The collected data were reviewed for completeness, and total satisfaction scores were calculated and analyzed to determine the overall level of parent satisfaction with the therapy program.