Silove Natalie, Collins Felicity, Ellaway Carolyn
Child Development Unit, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia.
J Paediatr Child Health. 2013 Jul;49(7):519-25. doi: 10.1111/jpc.12176. Epub 2013 Apr 19.
Children develop in the domains of cognition, speech and language, motor, personal skills, social skills and activities of daily living in a predictable and organised manner. Between 3000 and 9000 Australian children born in any one year may be diagnosed with global developmental delay. Paediatricians are often faced with the dilemma of 'who' and 'how' to investigate, as the yield is often considered to be low. 'Best practice' guidelines on the investigation of global developmental delay have been published, but the evidence available for the specific recommendations varies significantly and is based mostly on levels III and IV evidence (non-experimental descriptive studies and expert opinions). This paper discusses the current views and suggests a possible algorithm for clinical practice in Australia.
儿童在认知、言语和语言、运动、个人技能、社交技能以及日常生活活动等领域以可预测且有序的方式发展。每年出生的澳大利亚儿童中，可能有3000至9000名被诊断为全面发育迟缓。儿科医生常常面临“调查对象是谁”以及“如何进行调查”的两难境地，因为通常认为检查结果的阳性率较低。关于全面发育迟缓调查的“最佳实践”指南已经发布，但具体建议所依据的现有证据差异很大，且大多基于Ⅲ级和Ⅳ级证据（非实验性描述性研究和专家意见）。本文讨论了当前观点，并提出了一种适用于澳大利亚临床实践的可能方案。
