This document discusses development deviance and dissociation, the etiology of developmental disorders, signs and symptoms, diagnostic tests, and management. It notes that 70% of developmental disorders in developed countries are caused by antenatal factors like genetic disorders or infections, or perinatal/neonatal factors like brain injuries. Diagnostic tests include neuroimaging, metabolic testing, genetic studies, and electrophysiological tests. Management involves a multidisciplinary team and early intervention to help children reach their maximum potential.

1. z
Development deviance and dissociation
 Deviance:- deviance is the acquisition of milestone in a sequence that is
different from usual .
for example,
Children with cerebral palsy may so early standing with support
secondary to increase extension tone this may also be seen in normally
developing children. Children may not cruel and directly start walking
from sitting and standing without support.
 Dissociation:- it is defined as the equally season of development and
milestone in various domains at different rate. For example isolated
speech delay with normal development in other spares as in patients
with congenital hearing loss.

2. z Etiology
 70% people with development disorder in develop countries:-
 1.Antenatal factor :- chromosomal disorder, down syndrome, cortical
malformation, intrauterine infection , inborn error of metabolism.
 2. perinatal, neonatal:- hypo toxic encephalopathy, after meningitis or
encephalitis, hypoglycemic brain injury, hypothyroidism, after head
trauma.
 3. Postnatal:- deficiency of vitamin b1
. - Iodine or b1, toxins (lead).

3. z
 Seizures, vision abnormalities, hearing impairment,
speech disorders, feeding problem, behavioral
problem, sleep disturbance, contracture, bed sores.

4. z
Diagnostic test
Diagnostic test in evaluation of development delay:-
 Neuroimagine- specifically if abnormal head size and abnormalities on
neurological examination.
 Metabolic test:- ammonia by carbonate lactate sugar blood urine test
 Genetic study:- development delay without a non case irrespective of
dysmorphic features.
 Thyroid function test ( blood and urine laid micronutrients level ) indicated
clinically.
 Electro physiological test:- where indicated electro encephalogram, visual
evolve response brain stem walk response audiometry nerve conduction
studies and electromyography.

5. z
Management
 A child with developmental delay is managed by a multidisciplinary
team comprising of a pediatric neurologist, geneticist, psychologist,
psychiatrist, occupational and physiotherapist, speech therapist ,
audiologist, ophthalmologist, nutritionist and social worker.
Early intervention is important to achieve the maximum
potential.

6. z

7. z

8. z

9. z

10. z

11. z

12. z

13. z

14. z

15. z

16. z

17. z

18. z

19. z

20. z

21. z

22. z

23. z

24. z

25. z

26. z

27. z

28. z

29. z

30. z

31. z

32. z

33. z

34. z

35. z

36. z