[
  {
    "article_id": 82,
    "article_title": "Developmental Delay",
    "sections": [
      {
        "title": "Clinical paths",
        "content": "**Initial Assessment**\n\nWhen global developmental delay is suspected, obtain a detailed developmental history covering all domains: gross motor, fine motor, speech and language (receptive and expressive), cognition, social-personal development, and activities of daily living.\n\nAdminister age-appropriate, standardised, norm-referenced developmental tests to quantify delay across domains. Calculate the developmental quotient for each domain (developmental age ÷ chronological age × 100). A developmental quotient below 70% indicates significant delay; between 70–85% indicates mild or borderline delay."
      },
      {
        "title": "Diagnosis",
        "content": "**Investigation**\n\nThe presence of global developmental delay should always prompt investigation into possible underlying causes. Genetic testing guidelines should be considered as part of the diagnostic workup.\n\n**Referral for Early Intervention**"
      },
      {
        "title": "Management",
        "content": "Refer every child with developmental concerns to:\n- Local early intervention programme or agency (ages 0–3 years)\n- Public school programme (ages ≥3 years)\n- Local therapy providers as appropriate\n\nThese services are entitled under the Individuals with Disabilities Education Act and should be accessed from as early as birth for known or high-risk conditions through age 21 years.\n\n**Ongoing Management**\n\nAs the child grows older and the clinical picture becomes clearer, transition from the umbrella term 'global developmental delay' to more specific descriptions of individual difficulties such as [[114|learning disability]], motor disorder, or communication difficulty. This allows for more targeted intervention and clearer prognostic information."
      }
    ]
  }
]