Developmental delay

Question 1

Clinical signs to aid investigation in developmental delay

Answer 1

• patterns of growth: height, weight, head circumference with centile plotting
• dysmorphic features: face, limbs, body proportions, cardiac, genitalia
• skin: neurocuntaneous stigmata, injuries, cleanliness
• CNS exam: abnormal posture/ asymmetry; wasting; power and tone; deep tendon reflexes; clonus; plantar responses; sensory examination; cranial nerves
• CV exam: abnormalities are associated with dysmorphic features
• Visual abnormalities or oculomotor
• Hearing: neontal hearing screen or hearing/ language problems
• Patterns of mobility, dexterity. hand dominance, communication and social skills, general behaviour
• cognition

Question 2

Types of delay

Answer 2

• Global: all domains are slowly developed. Usually apprent in first 2 years of life. Associated with cognitive difficulties
• Specific: one field or area of skill slowly acquired
• Both can be slow but steady; plateau effect or show regression
• Other features of developmental delay:
  
  • _​_gap between normal and abnormal becomes more apprent with age
  • may be presentation of WIDE VARIETY of underlying conditions
  • site and severity of brain damage
  • genetic implications for family

Question 3

Features at specific age groups suggesting neurodevelopmental concerns

Answer 3

Question 4

Conditions which may cause abnormal development and learning difficulties

Answer 4

Question 5

Investigations for developmental delay

Answer 5