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Developmental delay: identification and management at primary care level
Ying Ying Choo1, Pratibha Agarwal1,2, Choon How How3,4
1SingHealth Polyclinics - Sengkang, Singapore.
Insights
Developmental delays affect 10%-15% of preschoolers. Early identification and assessment in primary care, including referrals and parent counseling, are crucial for timely intervention and support.
Area of Science:
- Pediatrics
- Child Development
Background:
- Developmental delays are prevalent in 10%-15% of preschool children.
- Global developmental delays impact 1%-3% of this population.
- Identification often occurs during routine check-ups or parental/preschooler concerns.
Purpose of the Study:
- To outline the primary care approach for assessing developmental delays in children.
- To emphasize the importance of timely follow-up and appropriate interventions.
Main Methods:
- Comprehensive assessment including physical examination, growth plotting, hearing and vision screening.
- Consideration of baseline blood tests and referral to a developmental pediatrician.
- Parental counseling and follow-up to ensure referral activation.
Main Results:
- For mild delays without red flags, advice on stimulation and a 3-month review may suffice.
- Systematic assessment aids in identifying children needing further specialist evaluation.
Conclusions:
- Primary care plays a vital role in the early detection and management of developmental delays.
- A structured approach ensures children receive necessary support and interventions.
- Follow-up and parental engagement are key components of effective developmental care.
Abstract:
Developmental delays are common in childhood, occurring in 10%-15% of preschool children. Global developmental delays are less common, occurring in 1%-3% of preschool children. Developmental delays are identified during routine checks by the primary care physician or when the parent or preschool raises concerns. Assessment for developmental delay in primary care settings should include a general and systemic examination, including plotting growth centiles, hearing and vision assessment, baseline blood tests if deemed necessary, referral to a developmental paediatrician, and counselling the parents. It is important to follow up with the parents at the earliest opportunity to ensure that the referral has been activated. For children with mild developmental delays, in the absence of any red flags for development and no abnormal findings on clinical examination, advice on appropriate stimulation activities can be provided and a review conducted in three months' time.
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