Hi, this is Tom, and in this episode I'm going to be going through developmental delay,

and you can find notes at 0.0.5.com slash delay, and in the 0 to Finals Pediatrics book. And you can find

flashcards and questions to train your knowledge at

members.0.0.0.com. So let's jump straight in. Children develop at different rates, and there's

flexibility in when they achieve their milestones. A child who is slow to achieve all milestones,

or lags behind on a specific developmental domain

may have underlying pathology.

Let's start by talking about global developmental delay.

The term global developmental delay applies when a child under five years displays significantly delayed

development in two or more domains. Often it's idiopathic, meaning there's no specific underlying

cause. Possible underlying causes include antinatal conditions, for example fetal alcohol syndrome

and congenital rubella syndrome occurring during pregnancy, perinatal conditions occurring around the time of birth,

for example, prematurity and hypoxic ischemic encephalopathy, postnatal conditions occurring

after the child's born, for example meningitis and traumatic brain injuries, genetic conditions,

for example, Down syndrome and fragile X syndrome, and metabolic disorders,

for example, phenyl ketone urea.

Let's talk about gross motor delay.

Key red flags for gross motor delay include not sitting unsupported by nine months, not walking by 15 months in girls or 18 months in boys,

abnormal muscle tone and hypotonia or excessive muscle tone indicates central pathology, and hypotonia, or reduced muscle

tone indicates central or peripheral pathology, and abnormal reflexes.

Brisk reflexes indicate central pathology, reduced or absent reflexes indicate problems with the peripheral nerves or the muscles.

Causes of a specific delay in gross motor development include cerebral palsy, ataxic disorders, myopathy, for example, muscular dystrophy,

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