assessment of child with delayed speech

1. ASSESSMENT OF
CHILD WITH
DELAYED SPEECH
Marwa Elhady
FMG, Al-Azhar University

2. History and Examination
Onset
Congenital
/Genetic
disorder
acquired
Since birth:
Later in life:

3. History and Examination
Course
Delayed:
Difficult
language:
Loss of previous
skill:
• Congenital/genetic
• Neurologic disorder
• Deafness
• Communication disorders
• Articulation defect
• Specific language disorders
e.g. dyslexia
• Neurodegenerative d
• Landau kleffner epilepsy
• Psychic disorder
• Focal central/peripheral
defect

4. Perinatalhistory Antenatal:
SRORCH infection
Natal:
Perinatal asphyxia
Preterm labor
Post natal:
meningitis/encephalitis, CMV infection,
hyperbilirubenemia, head trauma, recurrent OM,
drug (e.g. aminoglycosides, streptomycin,
furosemide)

5. Developmental milestone:
Global delay:
suggest
neurological/genetic/
metabolic pathology
Isolated language delay:
suggest
focal CNS insult/ hearing/
articulation defect
Family history
Speech delay/disorder
Hearing loss
Learning disabilities
Genetic/chromosomal disorders

6. Dysmorphism or congenital malformation
History and Examination
of Other systems:

7. Ear abnormalities: suggest hearing loss
History and Examination
of Other systems:

8. Mouth, tongue, pharynx: tongue tie, cleft palate
Week cry, hoarseness: suggest vocal cord
History and Examination
of Other systems:

9. Neurological defect (Motor, sensory, cranial
nerves, coordination, mentality, seizures)
History and Examination
of Other systems:

10. Skin pigmentation: suggest neurocutaneous $
History and Examination
of Other systems:

11. Endocrinal : goiter suggest Pendred $
History and Examination
of Other systems:

12. Renal : recurrent gross hematuria suggest alport $
History and Examination
of Other systems:

13. Psychic disorders, psychic trauma, child abuse,
difficult communication (eye to eye contact)
History and Examination
of Other systems:

15. Investigation
• For underlying pathology
• Neuroimaging
• EEG
• Genetic study
• Hearing assessment
• Psychological assessment