What is developmental delay?
Delay in any of the 4 developmental domains
What is GLOBAL developmental delay?
Delay in 2 or more of the 4 developmental domains
What are the 4 developmental domains?
- Gross motor
- Fine motor
- Social and emotional
- Speech and language
What conditions can cause a GLOBAL developmental delay? (5 things)
- Down’s Syndrome
- Fragile X syndrome
- Fetal alcohol syndrome
- Rett syndrome
- Metabolic disorders
What conditions can cause a Gross Motor developmental delay? (5 things)
- Cerebral palsy
- Visual impairment
- Spina bifida
- Ataxia
- Myopathy
What conditions can cause a Fine Motor developmental delay? (4 things)
- Cerebral palsy
- Visual impairment
- Dyspraxia
- Muscular dystrophy
What conditions can cause a Language developmental delay? (6 things)
- Cerebral palsy
- Learning disability
- Autism
- Hearing impairment
- Neglect
- Specific social circumstances (e.g exposure to multiple languages / siblings do all the talking)
What is the Red Flag of the Social developmental domain?
Not smiling by 10 weeks
What are the Red Flags of the Gross Motor developmental domain? (2 things)
- Not sitting unsupported by 12 moths
- Not walking by 18 months
What is the Red Flag of the Fine Motor developmental domain?
Showing hand preference before 12 months
What is the Red Flag of the Speech and Language developmental domain?
Not knowing 2-6 words by 18 months
What should happen to a child if any of the Red Flags of development are detected?
Refer for Paediatric Specialist Assessment
What is the point of investigating developmental delay? (3 things)
To determine:
- Cause
- Prognosis
- Possible treatments
What are the first line investigations for Global Developmental Delay? (7 things)
- FBC
- UnE
- Creatinine kinase
- TFT
- LFT
- Vit D
- Hearing Test
What causes of Developmental Delay are you looking for when checking FBCs? (2 things)
- Iron deficiency
- Folate / B12 deficiency
What causes of Developmental Delay are you looking for when checking UnEs? (2 things)
- Renal failure
- Hyponatraemia
What cause of Developmental Delay are you looking for when checking Creatinine Kinase?
Duchenne Muscular Dystrophy
What cause of Developmental Delay are you looking for when checking TFTs?
Congenital hypothyroidism
What cause of Developmental Delay are you looking for when checking LFTs?
Metabolic disorders
What cause of Developmental Delay are you looking for when checking Vit D?
Vit D deficiency –> Motor delay
What cause of Developmental Delay are you looking for when checking Hearing Tests?
Hearing impairment –> isolated speech and language delay
What are the second line investigations for Developmental Delay? (5 things)
- Karyotyping
- DNA analysis
- Metabolic screens
- MRI
- EEG
