Developmental delay

Question 1

Developmental delay history

Answer 1

• Age
• Presenting complaint
  
  • Does the mother have any concerns about development?
  • Determine developmental milestones reached in each category
    
    • Gross motor
    • Fine motor / Vision
    • Speech / Hearing
    • Social
• Pregnancy history
  
  • Complications (APH, HTN)
  • Prenatal diagnoses (e.g. Down Syndrome)
  • Infections (e.g. TORCH)
  • Exposures (e.g. Fetal Alcohol Syndrome)
• Birth history
  
  • Term / Premature
  • Normal delivery
  • Complications
    
    • Severe jaundice (kernicterus)
  • SCBU
  • Did the child feed well from the outset?
• Past medical history + medications
  
  • Meningitis?
• Family history
  
  • Developmental delay
  • Genetic abnormalities, syndromes
  • Consanguinity
• Social history
  
  • Neglect?
  • Who looks after the child?
  • Usually well and happy?

Question 2

Differentials of delay in motor development

Answer 2

• Delayed motor maturation (normal)
• Cerebral palsy (hypertonia)
• Duchenne muscular dystrophy (X-linked)
• Down’s (hyotonia)