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

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dc.contributor.authorJuneja, Monicaen_US
dc.contributor.authorGupta, Arpitaen_US
dc.contributor.authorSairam, Smithaen_US
dc.contributor.authorJain, Ridhimaaen_US
dc.contributor.authorSharma, Monikaen_US
dc.contributor.authorThadani, Anjanaen_US
dc.contributor.authorSrinivasan, Roopaen_US
dc.contributor.authorLingappa, Lokeshen_US
dc.contributor.authorAhmed, Shabinaen_US
dc.contributor.authorMultani, KSen_US
dc.contributor.authorBuch, Pankajen_US
dc.contributor.authorChatterjee, Nanditaen_US
dc.contributor.authorDalwai, Samiren_US
dc.contributor.authorKabra, Madhulikaen_US
dc.contributor.authorKapoor, Seemaen_US
dc.contributor.authorPatel, Prarthana Kharoden_US
dc.contributor.authorKM, Girishaen_US
dc.contributor.authorKulkarni, Madhurien_US
dc.contributor.authorKunju, PAMen_US
dc.contributor.authorMalhi, Prahbhjoten_US
dc.contributor.authorMeenai, Zafaren_US
dc.contributor.authorMishra, Devendraen_US
dc.contributor.authorMundkur, Nandinien_US
dc.contributor.authorNair, MKCen_US
dc.contributor.authorOommen, Samuel Philipen_US
dc.contributor.authorPrasad, Chhayaen_US
dc.contributor.authorSingh, Arunen_US
dc.contributor.authorSrivastava, Leenaen_US
dc.contributor.authorSuman, Praveenen_US
dc.contributor.authorThakur, Rahulen_US
dc.date.accessioned2023-08-25T06:39:30Z
dc.date.available2023-08-25T06:39:30Z
dc.date.issued2022-05
dc.description.abstractJustification: Global developmental delay (GDD) is a relatively common neurodevelopmental disorder; however, paucity of published literature and absence of uniform guidelines increases the complexity of clinical management of this condition. Hence, there is a need of practical guidelines for the pediatrician on the diagnosis and management of GDD, summarizing the available evidence, and filling in the gaps in existing knowledge and practices. Process: Seven subcommittees of subject experts comprising of writing and expert group from among members of Indian Academy of Pediatrics (IAP) and its chapters of Neurology, Neurodevelopment Pediatrics and Growth Development and Behavioral Pediatrics were constituted, who reviewed literature, developed key questions and prepared the first draft on guidelines after multiple rounds of discussion. The guidelines were then discussed by the whole group in an online meeting. The points of contention were discussed and a general consensus was arrived at, after which final guidelines were drafted by the writing group and approved by all contributors. The guidelines were then approved by the Executive Board of IAP. Guidelines: GDD is defined as significant delay (at least 2 standard deviations below the mean with standardized developmental tests) in at least two developmental domains in children under 5 years of age; however, children whose delay can be explained primarily by motor issues or severe uncorrected visual/ hearing impairment are excluded. Severity of GDD can be classified as mild, moderate, severe and profound on adaptive functioning. For all children, in addition to routine surveillance, developmental screening using standardized tools should be done at 9-12 months,18-24 months, and at school entry; whereas, for high risk infants, it should be done 6-monthly till 24 months and yearly till 5 years of age; in addition to once at school entry. All children, especially those diagnosed with GDD, should be screened for ASD at 18-24 months, and if screen negative, again at 3 years of age. It is recommended that investigations should always follow a careful history and examination to plan targeted testing and, vision and hearing screening should be done in all cases prior to standardized tests of development. Neuroimaging, preferably magnetic resonance imaging of the brain, should be obtained when specific clinical indicators are present. Biochemical and metabolic investigations should be targeted towards identifying treatable conditions and genetic tests are recommended in presence of clinical suspicion of a genetic syndrome and/or in the absence of a clear etiology. Multidisciplinary intervention should be initiated soon after the delay is recognized even before a formal diagnosis is made, and early intervention for high risk infants should start in the nursery with developmentally supportive care. Detailed structured counselling of family regarding the diagnosis, etiology, comorbidities, investigations, management, prognosis and follow-up is recommended. Regular targeted follow-up should be done, preferably in consultation with a team of experts led by a developmental pediatrician/ pediatric neurologist.en_US
dc.identifier.affiliationsDepartment ofPediatrics, Maulana Azad Medical College, New Delhien_US
dc.identifier.affiliationsDepartment ofPediatrics, Christian Medical College, Ludhianaen_US
dc.identifier.affiliationsNiramaya Hospital and Guidance Clinic, Chembur, Mumbai, Maharashtraen_US
dc.identifier.affiliationsUmmeed Child Development Centre, Mumbai, Maharashtraen_US
dc.identifier.affiliationsRainbow Children’s Hospital, Hyderabaden_US
dc.identifier.affiliationsIndian Academy of Pediatrics, Neurodevelopment Chapteren_US
dc.identifier.affiliationsDepartment of Pediatrics, MP Shah Government Medical College, Jamnagar, Gujaraten_US
dc.identifier.affiliationsDepartment ofPediatrics, MGM Medical College, Kolkata, West Bengalen_US
dc.identifier.affiliationsNew Horizons Child Development Centre, Mumbai, Maharashtraen_US
dc.identifier.affiliationsDivision of Genetics, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhien_US
dc.identifier.affiliationsGCS Medical College, Hospital and Research Centre, Ahmedabad, Gujaraten_US
dc.identifier.affiliationsDepartment of Medical Genetics, Kasturba Medical College, Manipal, Karnatakaen_US
dc.identifier.affiliationsMumbai Port Trust Hospital, Mumbai, Maharashtraen_US
dc.identifier.affiliationsDepartment of Pediatric Neurology, Medical College Thiruvananthapuram, Keralaen_US
dc.identifier.affiliationsDepartment of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarhen_US
dc.identifier.affiliationsUmmeid Group of Child Development Centers, Bhopal, Madhya Pradeshen_US
dc.identifier.affiliationsCenter for Child Development & Disabilities (CCDD) Bengaluru, Karnatakaen_US
dc.identifier.affiliationsNIMS-SPECTRUM-Child Development Research Centre (CDRC) NIMS Medicity, Thiruvananthapuram ,Keralaen_US
dc.identifier.affiliationsChristian Medical College, Vellore, Tamil Naduen_US
dc.identifier.affiliationsASHA, Centre for Autism and Intellectual Developmental Disorders, Chandigarhen_US
dc.identifier.affiliationsAll India Institute of Medical Sciences, Jodhpur, Rajasthanen_US
dc.identifier.affiliationsBharati Vidyapeeth Medical College & Hospital, Pune, Maharashtraen_US
dc.identifier.affiliationsChild Development Centre, Sir Gangaram Hospital, New Delhien_US
dc.identifier.affiliationsThe Children’s Neurodevelopmental Centre, Patna, Biharen_US
dc.identifier.citationJuneja Monica, Gupta Arpita, Sairam Smitha, Jain Ridhimaa, Sharma Monika, Thadani Anjana, Srinivasan Roopa, Lingappa Lokesh, Ahmed Shabina, Multani KS, Buch Pankaj, Chatterjee Nandita, Dalwai Samir, Kabra Madhulika, Kapoor Seema, Patel Prarthana Kharod, KM Girisha, Kulkarni Madhuri, Kunju PAM, Malhi Prahbhjot, Meenai Zafar, Mishra Devendra, Mundkur Nandini, Nair MKC, Oommen Samuel Philip, Prasad Chhaya, Singh Arun, Srivastava Leena, Suman Praveen, Thakur Rahul. 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. 2022 May; 59(5): 401-415en_US
dc.identifier.issn0079-6061
dc.identifier.issn0974-7559
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/225334
dc.languageenen_US
dc.publisherIndian Academy of Pediatricsen_US
dc.relation.issuenumber5en_US
dc.relation.volume59en_US
dc.source.urihttps://indianpediatrics.net/may2022/401.pdfen_US
dc.subjectDevelopmental assessmenten_US
dc.subjectDevelopmental screeningen_US
dc.subjectEarly interventionen_US
dc.subjectIntellectual disability.en_US
dc.titleDiagnosis 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 Pediatricsen_US
dc.typeJournal Articleen_US
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