Developmental delay in children: evaluation and management

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By Paul H Lipkin MD and Mary O Leppert MD

Drs. Vera Joanna Burton and Jacqueline Weissman of the Kennedy Krieger Institute and the Johns Hopkins University School of Medicine explain methods for the identification and evaluation of delayed development in children. This clinical summary reviews core principles of development in children. Evaluation methods aimed at the identification of developmental problems in primary care and specialty care will be discussed. The specialty medical evaluation and management of children with identified developmental disorders will be reviewed, including recent recommendations about genetic testing.

Key points:

  • Development proceeds in an orderly, timed, and sequential process that occurs in a predictable fashion.
  • Developmental delay is abnormal development, which can be classified as delay, deviance, dissociation, and regression.
  • First-line genetic evaluation for developmental delay and autism spectrum disorders includes a chromosomal microarray and fragile X testing.
  • A child with a developmental disability should have an identified medical home as a child with special health care needs.

In This Article

Historical note and nomenclature
Clinical applications
References cited