developmental problem Management
• Motor
o Educate parents about poor correlation between motor delays and
intelligence
o Refer to Physiotherapy and Occupational therapy
o Educate parents on developmental targets and techniques for
helping achieve specific milestones
- e.g. adequate ‘Tummy Time’ to facilitate development of head
control, rolling over, etc.
• Language
o Audiology assessment
o Referral to local early intervention services
o Speech and language (SLP) evaluation
o Enroll child in nursery school
o Educate parents regarding language facilitation techniques
- make noises or sing and repeat sounds the child says
- ask questions/make comments that lead to a response
- label objects and emphasize action words
- read to the child
- use simple, slow language
• Cognitive
o Thorough history:
- Pregnancy (obstetrical history, exposures, complications)
- Birth (gestational age, complications, delivery, resuscitation)
- Family History (parents, siblings, consanguinity)
- Social History (identify deprived environments)
o Physical exam including head growth, dysmorphic features,
neurologic exam
o Hearing/vision assessment
o Other tests as indicated: karyotype, blood lead levels, metabolic
screen, TSH, CT/MRI
o Find appropriate schooling/community living
o Help family find support groups, funding, respite
• Emotional/Social
o Early intervention with early intervention therapists
o Provide opportunities for increased contact with other children e.g.,
play groups, structured daycare
o Refer to specific therapeutic groups
o If applicable, remove child from deprived environment with help of
children’s aid society