Neurology - Developmental Delay

Question 1

Definition

Answer 1

A child who is very slow to achieve all milestones or lags behind on a specific developmental domain may have underlying pathology.
However when doing a developmental assessment of a child it is important to appreciate that children develop at different rates, there is flexibility in the milestones.

Question 2

Global developmental delay

Answer 2

Refers to a child displaying slow development in all developmental domains. This could indicate an underlying diagnosis such as:
- Down’s syndrome
- Fragile X syndrome
- Fetal alcohol syndrome
- Rett syndrome
- Metabolic disorders

Question 3

Gross motor delay

Answer 3

Refer:
- 12 months not sitting without support
- 18 months not walking
A delay that is specific to the gross motor domain may indicate underlying:
- Cerebral palsy
- Duchennes muscular dystrophy
- Ataxia
- Myopathy
- Spina bifida
- Visual impairment

Question 4

Fine motor delay

Answer 4

A delay that is specific to the fine motor domain may indicate underlying:
- Dyspraxia
- Cerebral palsy
- Visual impairment
- Congenital ataxia (rare)

Question 5

Language delay

Answer 5

A delay that is specific to the speech and language domain may indicate underlying:
- Specific social circumstances, for example exposure to multiple languages or siblings that do all the talking
- Hearing impairment
- Learning disability
- Neglect
- Autism
- Cerebral palsy

Management of language delay involves a referral to speech and language, audiology and the health visitor. Referral to safeguarding is required if neglect is a concern.

Question 6

Personal and social delay

Answer 6

A delay that is specific to the personal and social domain may indicate underlying:
- Emotional and social neglect
- Parenting issues
- Autism