Developmental Delay/Intellectual Disability Diagnostic Evaluation Clinical Pathway — Primary Care
Developmental Delay/Intellectual Disability Diagnostic Evaluation Clinical Pathway — Primary Care
Subspecialty Referral Considerations
Consider referral to Genetics for:
Any structural anomalies or dysmorphic features.
Consider referral to IMGC for:
Family history of ID/DD or known genetic disorder.
Consider referral to Developmental-Behavioral Pediatrics for:
- Concerns about autism (including significantly reduced or lack of engagement, non-verbal > 2 years of age or other significant communication deficits, and/or persistent repetitive behaviors).
- Concerns about significant behaviors (including aggression toward self or others).
For concerns about ASD, families can call the CHOP Autism Integrated Care Program.
For concerns about behavior, families can call the CHOP DBP Intake line (215-590-7550).
For both programs, wait times for evaluations may be prolonged. Age restrictions apply and some children will be referred to other community resources.
Consider referral to Neurology for:
Children with DD/ID, particularly if there is any concern for neurological findings (as listed in History and Physical Exam), including but not limited to hypotonia, weakness, seizure, abnormal movements, and/or developmental regression.
Consider referral to Metabolism for:
- Recurrent vomiting with or without poor feeding
- Failure to thrive
- Liver dysfunction, including elevated liver enzymes
- Dietary preferences such as aversion to protein
- Loss of skills (regression), especially if provoked by fevers or illness
- Coarse facial features
- Hypotonia