From the Guidelines
If developmental milestones are not being met, you should first consult with your child's primary care provider or pediatrician, who can perform a comprehensive developmental assessment and determine if further evaluation is needed 1. This initial assessment is crucial in identifying potential developmental delays and determining the best course of action.
Next Steps
If concerns persist, the primary care provider may refer you to:
- Developmental specialists such as developmental pediatricians, child neurologists, or child psychologists who specialize in developmental disorders
- Early intervention programs, which are available in all states for children under age 3 with developmental delays, and can provide services like speech therapy, physical therapy, and occupational therapy 1
- School districts, which offer evaluations and services for children over age 3 Additionally, you can contact your state's public health department for resources or organizations like the American Academy of Pediatrics for guidance.
Importance of Early Identification and Intervention
Early identification and intervention are crucial because a child's brain has the greatest plasticity in the early years, making treatments more effective 1.
Recommended Screenings
Regular developmental screenings are recommended at 9,18, and 30 months, with autism-specific screening at 18 and 24 months, to catch delays early 1. It is essential to note that each medical home must develop its own local resources and network of subspecialists for assistance with the diagnosis and management of young children with suspected motor delay 1. By prioritizing early identification and intervention, you can help ensure the best possible outcomes for your child's development and quality of life.
From the Research
Referral Options for Developmental Milestones
If developmental milestones are not met, there are several options for referral:
- A general pediatrician-staffed Behavioral/Developmental Access Clinic (BDAC) can provide comprehensive developmental evaluations for children under 5 years old 2
- Primary care physicians can assess for developmental delay and refer to a developmental pediatrician if necessary 3
- Children with global developmental delay can be referred to a multidisciplinary team led by a developmental pediatrician or pediatric neurologist 4
Evaluation and Assessment
Evaluation and assessment for developmental delay should include:
- A general and systemic examination, including plotting growth centiles, hearing and vision assessment, and baseline blood tests if deemed necessary 3
- Standardized developmental tests to assess developmental domains 4
- Vision and hearing screening should be done in all cases prior to standardized tests of development 4
- Neuro-imaging, biochemical and metabolic investigations, and genetic tests may be recommended based on clinical indicators and suspicion of a genetic syndrome 4
Follow-up and Management
Follow-up and management for children with developmental delay should include:
- Regular targeted follow-up with a team of experts led by a developmental pediatrician or pediatric neurologist 4
- Multidisciplinary intervention initiated soon after the delay is recognized, even before a formal diagnosis is made 4
- Detailed structured counselling of family regarding the diagnosis, etiology, comorbidities, investigations, management, prognosis, and follow-up 4