The child with developmental delay: An approach to etiology.
OBJECTIVE
To describe an approach to history, physical examination and investigation for the developmentally delayed child.


METHODS
A review of electronic databases from 1997 to 2001 was done searching for articles relating to the approach to or investigations of children with developmental delay. Five studies, including a review of a consensus conference on evaluation of mental retardation, were chosen because of their general approaches to developmental delay and/or mental retardation, or specific evaluations of a particular laboratory investigation.


CONCLUSIONS
A diagnosis or cause of mental retardation can be identified in 20% to 60% of cases. Evaluation of the developmentally delayed child should include a detailed history and physical examination, taking special care to record a three-generation pedigree, as well as to look for dysmorphic features. If no other cause is apparent, routine investigations should include a chromosome study and fragile X studies. Further investigations are warranted depending on the clinical features.
Meschino
Wendy S
WS
Department of Genetics, North York General Hospital, Toronto, Ontario. wmeschin@nygh.on.ca