Paeds SAQs · growth-development-and-behaviour
Developmental regression — formative SAQs
Formative SAQs on urgent recognition and work-up of developmental regression.
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SAQ 1 (10 marks)
A 22-month-old previously used several words and pointed to request. For 3 months he has been silent, with reduced social engagement. He walks well and is afebrile. [1] [7]
- Define developmental regression and distinguish it from delay. (3) [1]
- Outline your bedside assessment priorities. (4) [1] [3]
- List immediate actions and referrals while awaiting specialist review. (3) [1] [14] [17]
Model answer
Regression is loss of a previously acquired skill; delay is failure to acquire skills on time. [1] Confirm a skill ledger with examples and tempo; examine neurology and head growth; assess seizures, hearing/vision access, safeguarding and caregiver concern. [1] [3] Arrange urgent hearing assessment and developmental/neurology pathways as indicated; start interim supports; name owners for results; safety-net further loss, seizures and reduced alertness. [1] [14] [17]
References8ShowHide
- [1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
- [3]Moeschler JB Comprehensive evaluation of the child with intellectual disability or global developmental delays. Pediatrics, 2014.PMID 25157020
- [4]Bonkowsky JL Leukodystrophies in Children: Diagnosis, Care, and Treatment. Pediatrics, 2021.PMID 34426533
- [6]Neul JL Rett syndrome: revised diagnostic criteria and nomenclature. Annals of neurology, 2010.PMID 21154482
- [7]Pickles A Loss of language in early development of autism and specific language impairment. Journal of child psychology and psychiatry, and allied disciplines, 2009.PMID 19527315
- [9]Loo KK Diagnostic Overshadowing: Insidious Neuroregression Mimicking Presentation of Autism Spectrum Disorder. Journal of developmental and behavioral pediatrics : JDBP, 2022.PMID 35943376
- [14]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
- [17]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428