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Etiologic determination of childhood developmental delay
M I Shevell1, A Majnemer, P Rosenbaum
1Department of Neurology/Neurosurgery, McGill University, Montreal, Quebec, Canada. michael.shevell@muhc.mcgill.ca
Brain & Development
|May 30, 2001
Summary
Determining the cause of developmental delay in young children varies by subtype. Global and motor delays have higher diagnostic yields, while language and autistic spectrum disorders are less likely to have a clear etiology found.
Area of Science:
- Pediatrics
- Neurology
- Genetics
Background:
- Developmental delay is a common concern in young children.
- Identifying the underlying cause (etiology) is crucial for targeted interventions.
- Referral to sub-specialty clinics is a standard diagnostic pathway.
Purpose of the Study:
- To assess the diagnostic yield of sub-specialty evaluations for children under five with developmental delay.
- To identify factors associated with successful etiological determination.
Main Methods:
- Prospective enrollment of 224 children under five with suspected developmental delay.
- Data collection on history, physical exam findings, and requested laboratory tests.
- Retrospective chart review at six months to determine etiological ascertainment.
- Bivariate and multivariate logistic regression analysis.
Main Results:
- Overall etiological yield was 31% (71/224).
- Yield varied significantly by subtype: Global Developmental Delay (55%), Motor Delay (59.1%), Developmental Language Disorders (4.2%), Autistic Spectrum Disorders (2%).
- Microcephaly, antenatal toxin exposure, and focal findings predicted yield in Global Developmental Delay.
- Physical findings and cerebral palsy complex predicted yield in Motor Delay.
Conclusions:
- Etiological yield in childhood developmental delay is highly dependent on the specific subtype.
- Systematic evaluation paradigms can be proposed but require validation.
- Further research is needed to improve diagnostic rates for certain developmental delay subtypes.