Guideline sources The following summarized guidelines for the evaluation of developmental delay (DD) are prepared by our editorial team based on guidelines from the Canadian Task Force on Preventive Health Care (CTFPHC 2016). 1 2 2 2 2 Definition DD in a child is an inability to achieve developmental milestones in comparison to peers of the same age range. 2 Epidemiology DD is caused by genetic disorders (Down syndrome, fragile X syndrome), cerebral dysgenesis (microcephaly, hydrocephalus), vascular (occlusion, hemorrhage), drugs (cytotoxic, anti- epileptic), toxins (alcohol, smoking), early maternal infections (rubella, CMV), late maternal infections (varicella, HIV, malaria), prematurity, intrauterine growth retardation, perinatal asphyxia, metabolic dysfunction, postnatal infections, head injury, stroke, maltreatment, malnutrition, and maternal mental health disorder. 2 Disease course Various prenatal, perinatal, and postnatal causes may lead to mild, moderate, and severe DD ranging from a single domain to multiple domains including growth (weight, height), occipitofrontal circumference, speech, fine motor skills, visual, auditory, and bone development. Late detection of DD may result in poor outcomes resulting in learning difficulties, behavior problems, and functional impairments later on in life. 2 Prognosis and risk of recurrence DD is not associated with increased mortality. 2 https://web.pathway.md/diseases/recpbGoiBbwFo9sLA 1/2 6/29/23, 10:10 PM Developmental delay Pathway Guidelines 1. Screening and diagnosis Indications for screening: avoid screening for DD in children 1-4 years of age who have no apparent signs of DD, and whose parents and clinicians have no concerns about development. D Clinical findings Symptoms Past medical history Difficulties talking or talking late Genetic abnormality Difficulty communicating or socializing with others Metabolic disorders Phenylketonuria Difficulty with problem-solving or logical thinking Toxins Traumatic injury Having problems remembering things Inability to connect actions with consequences Inability to groom or dress oneself Learning and developing more slowly than other children same age Learning difficulties in school Lower than average scores on IQ tests References 1. Tonelli M, Parkin P, Brauer P et al. Recommendations on screening for developmental delay. CMAJ. 2016 May 17;188 8 579 87. Open 2. Ying Ying Choo, Pratibha Agarwal, Choon How How et al. Developmental delay: identification and management at primary care level. Singapore Med J. 2019 Mar; 60 3 119 123. Open https://web.pathway.md/diseases/recpbGoiBbwFo9sLA 2/2