Functional decline in people with developmental disability

Functional decline can occur in people with developmental disability and warrants prompt investigation. It is important to rule out common health problems that may be contributing to the person’s decline in functional status; for examples of differential diagnoses, see Differential diagnoses of functional decline in people with developmental disability.

If a cause cannot be found for functional decline, refer for further assessment (eg paediatrician or neurologist in children; general or rehabilitation physician, or geriatrician in adults).

Table 1. Differential diagnoses of functional decline in people with developmental disability
[NB1]
Potential causes and examples of functional decline in people with developmental disability are as follows:
psychiatric or psychological disorder
depression adjustment disorder anxiety grief psychosis delirium dementia catatonia abuse or trauma
sensory impairment
hearing loss vision loss
medical condition
hypothyroidism iron deficiency anaemia arthritis cardiac failure infection sleep apnoea coeliac disease malnutrition epilepsy and seizures neuromuscular cause (eg polymyalgia rheumatica, neuroleptic malignant syndrome) spinal disease (eg atlantoaxial instability, cervical canal stenosis) frailty
drug adverse effect
confusion, dizziness or nausea related to anticholinergic drugs psychotropic drugs polypharmacy
Note: NB1: This list is not exhaustive.