Differential Diagnosis for Developmental Delays in a 12-Month-Old Girl
Single Most Likely Diagnosis
- E) Normal development: At 12 months, the range of normal development is wide. The girl's ability to pull to stand, cruise, say "mama" and "dada," and point to get attention are all within the expected developmental milestones for her age. Not walking independently, not naming body parts, not engaging in pretend play, and not eating with a spoon can also be considered within the normal range at this age, as these skills typically develop between 12 to 18 months.
Other Likely Diagnoses
- B) Gross motor delay: Given that she is not walking independently at 12 months, this could suggest a gross motor delay, although the range for starting to walk independently is between 9 to 15 months.
- C) Language delay: Saying only "mama" and "dada" without more complex babbling or attempting to mimic words might indicate a language delay, but at 12 months, this could still be within the normal range.
- A) Fine motor delay: Picking up cereal with fingers and not eating with a spoon could indicate fine motor delay, but these skills are also expected to develop over the next few months.
Do Not Miss Diagnoses
- Cerebral Palsy: Although less likely, cerebral palsy could present with developmental delays, including gross motor, fine motor, and language delays. It's crucial to monitor for any signs of spasticity, dystonia, or ataxia.
- Hearing Impairment: Could lead to language delay and should be considered if the child does not respond to sounds or shows significant delay in language development.
- Autism Spectrum Disorder (ASD): While early signs can be subtle, lack of engagement in pretend play, limited language, and not pointing to share interest could be early indicators. However, diagnosis at 12 months would be preliminary and requires further evaluation.
Rare Diagnoses
- Genetic Disorders: Such as Down syndrome, which can present with developmental delays across multiple domains.
- Metabolic Disorders: Certain metabolic disorders can affect development, but these would typically be accompanied by other systemic signs and symptoms.
- Neurodegenerative Disorders: Extremely rare in this age group and would likely be accompanied by regression of previously acquired skills or other significant neurological findings.