Developmental Delay

Question 1

What is developmental delay?

Answer 1

Delay in any of the 4 developmental domains

Question 2

What is GLOBAL developmental delay?

Answer 2

Delay in 2 or more of the 4 developmental domains

Question 3

What are the 4 developmental domains?

Answer 3

1. Gross motor
2. Fine motor
3. Social and emotional
4. Speech and language

Question 4

What conditions can cause a GLOBAL developmental delay? (5 things)

Answer 4

1. Down’s Syndrome
2. Fragile X syndrome
3. Fetal alcohol syndrome
4. Rett syndrome
5. Metabolic disorders

Question 5

What conditions can cause a Gross Motor developmental delay? (5 things)

Answer 5

1. Cerebral palsy
2. Visual impairment
3. Spina bifida
4. Ataxia
5. Myopathy

Question 6

What conditions can cause a Fine Motor developmental delay? (4 things)

Answer 6

1. Cerebral palsy
2. Visual impairment
3. Dyspraxia
4. Muscular dystrophy

Question 7

What conditions can cause a Language developmental delay? (6 things)

Answer 7

1. Cerebral palsy
2. Learning disability
3. Autism
4. Hearing impairment
5. Neglect
6. Specific social circumstances (e.g exposure to multiple languages / siblings do all the talking)

Question 8

What is the Red Flag of the Social developmental domain?

Answer 8

Not smiling by 10 weeks

Question 9

What are the Red Flags of the Gross Motor developmental domain? (2 things)

Answer 9

1. Not sitting unsupported by 12 moths
2. Not walking by 18 months

Question 10

What is the Red Flag of the Fine Motor developmental domain?

Answer 10

Showing hand preference before 12 months

Question 11

What is the Red Flag of the Speech and Language developmental domain?

Answer 11

Not knowing 2-6 words by 18 months

Question 12

What should happen to a child if any of the Red Flags of development are detected?

Answer 12

Refer for Paediatric Specialist Assessment

Question 13

What is the point of investigating developmental delay? (3 things)

Answer 13

To determine:

1. Cause
2. Prognosis
3. Possible treatments

Question 14

What are the first line investigations for Global Developmental Delay? (7 things)

Answer 14

1. FBC
2. UnE
3. Creatinine kinase
4. TFT
5. LFT
6. Vit D
7. Hearing Test

Question 15

What causes of Developmental Delay are you looking for when checking FBCs? (2 things)

Answer 15

1. Iron deficiency
2. Folate / B12 deficiency

Question 16

What causes of Developmental Delay are you looking for when checking UnEs? (2 things)

Answer 16

1. Renal failure
2. Hyponatraemia

Question 17

What cause of Developmental Delay are you looking for when checking Creatinine Kinase?

Answer 17

Duchenne Muscular Dystrophy

Question 18

What cause of Developmental Delay are you looking for when checking TFTs?

Answer 18

Congenital hypothyroidism

Question 19

What cause of Developmental Delay are you looking for when checking LFTs?

Answer 19

Metabolic disorders

Question 20

What cause of Developmental Delay are you looking for when checking Vit D?

Answer 20

Vit D deficiency –> Motor delay

Question 21

What cause of Developmental Delay are you looking for when checking Hearing Tests?

Answer 21

Hearing impairment –> isolated speech and language delay

Question 22

What are the second line investigations for Developmental Delay? (5 things)

Answer 22

1. Karyotyping
2. DNA analysis
3. Metabolic screens
4. MRI
5. EEG