Table 3.
History and physical and neurodevelopmental exams
| History | Physical and neurodevelopmental exams |
|---|---|
| Family history | Physical exam |
| Three-generations review, looking for: | • Growth parameters |
| • Recurrent miscarriages | • Head shape |
| • Birth defects | • Fontanelle |
| • Infant deaths | • Cutaneous stigmata |
| • GDD/ID | • Spine |
| • Neurologic conditions | • Heart abnormalities |
| • Genetic conditions | • Abdomen check for organomegaly |
| • Ethnic background | • Limb abnormalities |
| • Consanguinity | • Genital abnormalities |
| Psychosocial history | Neurodevelopmental exam |
| • Parent language, education, employment | • Neurological exam |
| • Parental drug/alcohol abuse | • Congenital abnormalities |
| • Child care arrangements | • Dysmorphic features |
| • History of abuse or neglect and involvement of child protective services | • Current developmental level |
| Prenatal history | |
| • Prenatal ultrasound | |
| • Screening for fetal aneuploidy | |
| • Maternal diabetes or hypertension | |
| • Infections | |
| • Exposure to medications or toxins | |
| Birth history | |
| • Weight and height | |
| • Head circumference | |
| • Apgar score | |
| • Length of hospitalization | |
| Red flags suggestive of inborn errors of metabolism | |
| • Table 4 | |
| Developmental milestones | |
| • Regression or lack of milestones | |
| • Timing of parents’ first concern |
GDD Global developmental delay; ID Intellectual disability