Global developmental delay — MCCQE Part 1 MCQ

Correct answer: E — Arrange hearing/vision testing and developmental/paediatric assessment with targeted investigations

Arrange hearing/vision testing and developmental/paediatric assessment with targeted investigations is best because delay in multiple domains suggests global developmental delay. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Hearing and vision issues must be excluded in developmental delay.

Reference: Canadian Paediatric Society developmental delay statement