From the Guidelines
A 12-month-old with developmental delays should be referred to a pediatric developmental specialist or a multidisciplinary developmental evaluation center, starting with their primary care pediatrician for initial screenings and referrals. According to the American Academy of Pediatrics 1, early identification and intervention are crucial because a child's brain has the greatest plasticity in the first few years of life, making therapies more effective. The sooner interventions begin, the better the outcomes typically are, as they can address delays before they compound and potentially prevent secondary developmental issues.
Key Considerations for Referral
- The primary care pediatrician can conduct initial screenings and provide referrals to specialists such as developmental pediatricians, pediatric neurologists, speech-language pathologists, occupational therapists, or physical therapists 1.
- Early intervention services in the state or region are essential, as these programs provide specialized therapies and support for children under age 3 with developmental concerns 1.
- A comprehensive evaluation might also involve audiologists to assess hearing and pediatric ophthalmologists for vision assessment, as sensory issues can impact development 1.
Importance of Multidisciplinary Approach
- A multidisciplinary team approach is necessary to address the individual needs of the child, including developmental and medical evaluations 1.
- The composition of the evaluation team should be tailored according to the specific evaluations deemed necessary, and may include a developmental pediatrician, pediatric neurologist, pediatric psychologist, and/or geneticist 1.
Next Steps
- The primary care pediatrician should refer the child to a developmental pediatrician, pediatric neurologist, or other specialists as needed, and consider referral to early intervention services 1.
- The child's family should be informed about the importance of early intervention and the potential benefits of therapies and support services 1.
From the Research
Referral Options for a 12-Month-Old with Developmental Delays
When considering where to refer a 12-month-old with developmental delays, several options are available based on the nature of the delays and the expertise required for assessment and intervention.
- Developmental Pediatrician: A referral to a developmental pediatrician is often the first step for children with suspected developmental delays, including global developmental delay, motor delay, or speech and language delays 2.
- Pediatric Neurologist: For children with suspected neurological conditions contributing to their developmental delays, a referral to a pediatric neurologist may be appropriate 3, 4.
- Geneticist: Although less common as an initial referral, geneticists play a crucial role in evaluating children with developmental delays, especially when there is a suspicion of genetic disorders 2.
- Early Intervention Programs: Early intervention (EI) programs are designed for children with developmental delays and can provide a comprehensive approach to addressing motor, cognitive, and social-emotional development. These programs often involve occupational therapists, physical therapists, and speech-language pathologists 5.
Considerations for Referral
The decision on where to refer a child with developmental delays should be based on the specific needs of the child and the nature of the delays. Factors to consider include:
- The type of developmental delay (e.g., global, motor, speech and language)
- The presence of any underlying medical conditions
- The need for multidisciplinary assessment and intervention
- Access to local resources and specialists
Evidence for Effective Referral and Intervention
Studies have shown that early referral and intervention can significantly impact the outcomes for children with developmental delays 6, 5. The use of standardized screening tools, such as the Ages and Stages Questionnaire, can help identify children who require further evaluation and referral 6. Additionally, interventions that incorporate a comprehensive approach, including sensory and cognitive activities, have been shown to be effective in improving developmental domains and parent-child interactions 5.