Developmental history

When assessing a child or adult with possible developmental delay or disability, take time to discuss the parents’ or person’s concerns in detail, and take a comprehensive developmental history (see A guide to comprehensive history taking when establishing cause and developmental pattern of a disability). Consider how the child or adult interacts, and what skills they show, in different environments (eg preschool, workplace). This information may be available from a (pre)school or workplace report, but sometimes direct observation is needed.

Observations the GP makes in their surgery can inform specialist assessments and diagnosis, and should be included with the referral.

Table 1. A guide to comprehensive history taking when establishing cause and developmental pattern of a disability
Relevant factors	Considerations
antenatal
previous obstetric history of the mother	spontaneous abortions, stillbirths, neonatal deaths
antepartum bleeding	placental abruption, placenta praevia
infections	rubella status, rash, fever, nonspecific illness, known exposure
drug ingestion	medication, alcohol, nicotine, illicit drugs
labour and delivery	child’s gestation, presentation, mode of delivery, obstetric complications and their management
neonatal
condition at, and soon after, birth	Apgar scores, resuscitation required, weight, length, head circumference, congenital anomalies, health in the neonatal period
jaundice	degree of jaundice, treatment used
infection	site of infection, antibiotics used
feeding difficulties	duration, management
infancy
feeding	feeding difficulties, muscle tone
behaviour	irritability, sleep patterns
childhood and adolescence
behaviour	irritability, sleep patterns, eating
play	social interests and skills (compared with peers), make-believe play, range of interests and activities
developmental milestones	smiling, sitting, walking, first words attending school, puberty
schooling	details of schooling (eg attendance, type of school) academic achievements or concerns
general	parental concerns about development, hearing or vision; serious head injury or neurological problem (eg epilepsy, meningitis)
current abilities
ability pattern	education, self-care, language, social, motor, sensory (eg hearing and vision), behaviour
interests and hobbies	activities enjoyed by the person (eg walking)
family history
general	parents’ education, family history of conditions (developmental, psychiatric or genetic) that may affect developmental progress