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Table of contents

Developmental delay

Definition
DD in a child is an inability to achieve developmental milestones in comparison to peers of the same age range.
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Pathophysiology
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.
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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.
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Prognosis and risk of recurrence
DD is not associated with increased mortality.
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Key sources
The following summarized guidelines for the evaluation of developmental delay are prepared by our editorial team based on guidelines from the Canadian Task Force on Preventive Health Care (CTFPHC 2016).
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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.
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