The Quality Standards Subcommittee ...

The Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society have released a practice parameter in succession global developmental delay. "Evaluation of the Child with Global Developmental Delay" appears in the February 2003 issue of Neurology

Global developmental delay is for the use of all and affects 1 to 3 percent of children. Included in the practice parameter are the following elucidation points:

* Routine metabolic screening is not indicated in the initial evaluation of a child with global developmental delay.

* level in the absence of dysmorphic features or features suggestive of a specific syndrome routine cytogenetic studies and molecular testing for the fragile X mutation are recommended

* The diagnosis of Rett syndrome should be considered in girls with unexplained moderate to simple developmental delay.

* Additional genetic studies (eg subtelomeric chromosomal rearrangements) also may be considered in single outed children.

* Evaluation of serum lead plains should be restricted to those children with identifiable risk factors for excessive lead exposure

* Thyroid studies ne not be undertaken (unles clinically indicated) if the child underwent newborn screening.

* An electroencephalogram is not praiseed as part of the initial evaluation unles there are historical features suggestive of epilepsy or a specific epileptic syndrome Routine neuroimaging, with magnetic resonance imaging preferr to comput tomography, is attract favor toed particularly if abnormalities are raise on physical examination.

* Because of the increased incidence of visual and auditory impairments, children with global developmental delay may bear appropriate visual and audiometric assessment at the time of diagnosis.

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group