November Week 1: Developmental Delay

Articles:

1. AAP policy statement. Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics. Vol. 118 No. 1 July 2006, pp. 405-420
2. Gerber, et al. Developmental Milstones: Motor Development. Peds in Review. 2010;31:267-277.
3. Feldman H, et al. Evaluation and Management of Language and Speech Disorders in Preschool Children. Peds in Review. 2005;26;131-142

Case 1:

A mother brings in her 3 children, age 9 months, 2 years, and 5 years old, for well visits. She reports the 9 month old is babbling, creeping, and can bang toys together. The 2 yo can say mama and dada nonspecifically, points at pictures in a book, uses a spoon and cup well. The 5 year old can draw a square, speak in full sentences, knows the days of the week, and cuts with scissors.

What tools are available for developmental surveillance and developmental screening? 
How is each child doing developmentally? 
What is your plan for each of them during this visit? 
Which category of development is the best indication of intellectual ability later?
What are risk factors for poor language development?

Case 2:

An 18 month old is brought to see you for his well visit. Mom reports he is doing well at home, has a good appetite, eats a variety of foods, has been walking since 14 months and runs well. She remarks, “he is so smart – whenever he’s hungry, he grabs my hand and puts it on the refrigerator door.”

What developmental screening will you do at this visit? 
What are you concerned about? 
What is your plan?

Case 3:
Which of the following patients need referral for further developmental assessment or services?

A 14 month old who is not yet walking but whose 3 older siblings walked by 10 months 
A 2 yr old boy in a bilingual household without single words. 
A 5 yr old with stuttering. 
A 6 yr old who writes 2 letters of his name backwards.