Development: age related acquisition of new skills, that are cumulative, directional and malleable

• correct for prematurity until 2yo
• define delay as global or specific to developmental areas
• repeat assessments over months to measure rate of development of new skills
• Behavioural problems occur with greater frequency in children with developmental disabilities. This may include attention difficulties, hyperactivity, stereotypic or self-injury behaviour.

neuroplasticity

• most rapid in first 1000 days, peaking age 3

• pruning occurs until 20yo and is genetically and experientially driven

• negative life events affect brain structure

• early intervention modifies synaptogenesis and pruning processes

• Milestones

• Warning signs

Isolated speech delay most common isolated delay

History

• Developmental milestones: Enquire systematically about milestones for the four developmental areas.
  • Ascertain the extent of delay and which areas are affected
  • allow for prematurity <2 years. Beyond that catch-up rarely occurs
  • Loss in skills suggests a neurodegenerative condition
  • Ask about vision and hearing concerns