Diagnosis and Management of Global Development Delay: Consensus Guidelines of Growth, Development and Behavioral Pediatrics Chapter, Neurology Chapter and Neurodevelopment Pediatrics Chapter of the Indian Academy of Pediatrics
Indian Pediatrics
Juneja, M., Gupta, A., et al. (2022).
Indian Pediatrics, 59(5), 401-415.
This clinical practice guideline provides recommendations regarding the diagnosis and management of global developmental delay. The intended audience is pediatricians in India. This summary highlights recommendations relevant to the scope of SLP and audiology practice.
Indian Academy of Pediatrics
Juneja et al. (2022) recommend the following regarding screening in children with suspected global developmental delay (GDD): <br />
<ul>
<li><span style="color: #333333;">"Developmental screening using standardized screening tools should be done at 9-12 months, 18-24 months of age, and at school entry" (p. 404). </span></li>
<li><span style="color: #333333;">"For high risk infants, in addition to surveillance, developmental screening should be done at 4-6 months, 9-12 months, 18-24 months and yearly till 5 years of age; and once at school entry" (p. 404). </span></li>
<li><span style="color: #333333;">"Screening for comorbidities like behavioral problems, epilepsy, cerebral palsy, visual and hearing impairment, and sleep disturbances with appropriate referrals should be done to ensure timely intervention" (p. 410). </span></li>
<li><span style="color: #333333;">"Vision and hearing screening are recommended in all cases, especially before subjecting the child to standardized tests of development" (p. 406). </span></li>
<li><span style="color: #333333;">"Children diagnosed as GDD should be screened for ASD at 18- 24 months (as per the routine ASD screening guidelines for all children), and if screen negative, again at 3 years of age" (p. 404). </span></li>
</ul>
"Investigations should always follow a careful history and detailed examination to plan targeted testing, wherever required" (p. 406).
Juneja et al. (2022) recommend the following regarding early intervention for children with global developmental delay: <br />
<ul>
<li><span style="color: #333333;">"Early intervention for infants at risk of developmental delay should start in the neonatal intensive care unit (NICU) with neurodevelopmentally supportive care" (p. 410). </span></li>
<li><span style="color: #333333;">"Early intervention should be initiated soon after the delay is recognized, instead of waiting for a formal diagnosis" (p. 410). </span></li>
</ul>
"It is strongly recommended that the family should be counselled regarding the diagnosis, etiology, anticipated comorbidities, investigations, management, prognosis and follow-up; once at the time of initial diagnosis, and again whenever more etiological information is available/etiology is established" (p. 411).
"Regular follow-up targeting all the developmental domains and associated comorbidities should be done. Consultation with a team of experts led by a developmental pediatrician/ pediatric neurologist may be considered, if possible. Apart from this, primary pediatrician may also play an important role in supporting the family and ensuring the compliance to therapies" (p. 411).
"Children with GDD should receive preschool education services in the least restrictive environment that is possible and appropriate to address their needs" (p. 410).
