Developmental Delay

Question 1

What is it?

Answer 1

Delay - slow skill acquisition in any 4 domains

Question 2

Time patterns

Describe slow and steady
Plateau
Regression

Answer 2

Development doesn’t stop but doesn’t;t reach expected levels

Development stops and remains steady

Development stops then goes backwards

Question 3

Causes

Global - organic, non-organic

Answer 3

Chromosomal/genetic (e.g. Down's)
Autism 
Cerebral palsy 
Rett's
Metabolic - Hypothyroidism 
In-utero - rubella, alcohol, hypoxic brain injury 

Neglect
Postnatal depression

Question 4

Causes

Gross motor

Answer 4

Cerebral palsy
Dysplasia of the hip
Spina bifida
Neuromuscular disorders - e.g. Duchenne muscular dystrophy

Question 5

Causes

Fine motor

What does hand preference under 18 months point to?

Answer 5

Visual loss
Neuromuscular disorders

Hemiplegia or brachial plexus injury

Question 6

Causes

Speech and hearing

Answer 6

Hearing loss including glue ear, CNS infection
Anatomical or motor problems
Autism

Question 7

Causes

Social, emotional and behavioural

Answer 7

Maternal depression
Autism
Child abuse

Question 8

Developmental testing:

What is the Denver chart?

Tests related to speech and language delay?

What can be done to test for autism?

What tests are done in genetic testing?

Answer 8

Formal developmental assessment

SALT and hearing tests

Educational psychology assessment

Array comparative genomic hybridization (aCGH)
Flurescence in situ hybridisation (FISH)
Karyotyping

Question 9

Management

MDT involved in child development service

School

Devices to manage impairments

When should the children be reassessed?

Answer 9

Paediatrician 
SALT 
OT 
Clinical psychology 
Physiotherapy 
Health visitor 
Dietician 

Special schooling should be discussed but if they can manage in mainstream school, then that’s fine.

Special computers
Walking frames
Motorised wheelchairs

Periodically