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Etiologic yield of single domain developmental delay: a prospective study.
M I Shevell1, A Majnemer, P Rosenbaum
1Department of Neurology/Neurosurgery, School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada.
The Journal of Pediatrics
|November 4, 2000
Summary
Diagnosing the cause of developmental delay in young children varies significantly. While causes are rarely found for developmental language disorder, over half of isolated motor delay cases have identifiable, often preventable, etiologies.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Clinical Genetics
Background:
- Single domain developmental delay affects young children, encompassing developmental language disorder and isolated motor delay.
- Specialty diagnostic evaluations are crucial for identifying underlying etiologies.
- Understanding the etiologic yield is vital for guiding medical management and parental counseling.
Purpose of the Study:
- To determine the diagnostic yield of specialty evaluations for young children with single domain developmental delay.
- To compare the etiologic yield between developmental language disorder and isolated motor delay.
- To identify factors predicting successful etiologic diagnosis in pediatric developmental delay.
Main Methods:
- Prospective enrollment of children under 5 years with single domain developmental delay referred to pediatric neurology or developmental pediatrics.
- Etiologic yield assessed through clinical assessments and physician-ordered laboratory studies.
- Analysis of diagnostic outcomes for developmental language disorder versus isolated motor delay groups.
Main Results:
- Developmental language disorder had a low etiologic yield (4.1%), with non-audiometric investigations being uninformative.
- Isolated motor delay showed a higher etiologic yield (59%), with over half of identified causes being potentially preventable.
- Physical findings on initial assessment strongly predicted successful etiologic determination in isolated motor delay (P =.002).
Conclusions:
- The etiologic yield for single domain developmental delay significantly differs between developmental language disorder and isolated motor delay.
- Diagnostic evaluation is more fruitful for children with isolated motor delay, often impacting management and recurrence risk.
- Further research into specific etiologies for developmental language disorder may be warranted.