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KMID : 0391520160240040190
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Journal of the Korean Child Neurology Society
2016 Volume.24 No. 4 p.190 ~ p.199
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Longitudinal Follow-up Study of Children with Developmental Delay: Single Center Experience
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Chung Hee-Jung
Kim Jeong-A
Eom So-Yong
Kim Seong-Woo
Song Jung-Eun
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Abstract
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Pupose: Early detection of developmental delay is important because early intervention can reduce the disabilities that may arise in the future, as well as reduce social burdens and costs. In this study, we reviewed the changes of the diagnosis of patients who were followed up more than 2 times in the patients who visited the NHIS Ilsan Hospital Developmental Delay Clinic. In the cases whose final diagnosis were autism spectrum disorder (ASD), intellectual disability (ID), developmental language disorder (DLD), we performed this study to investigate the predictive factors of these diseases that can be discriminated in advance in order to provide appropriate early intervention.
Methods: From August 2007 to July 2013, 168 patients who visited the NHIS Ilsan Hospital (total 733 patients) more than 2 times were included. All patients visited three departments (Pediatric Neurology, Rehabilitation & Psychiatry) at the same time according to a multidisciplinary approach. Speech evaluation, development & IQ test, social and emotional evaluation and hearing test were performed routinely. K-CARS, MRI, EEG, chromosome, and metabolic study were selected according to the patients. Review of medical records of children was performed retrospectively.
Results: 1) The mean age of children at 1st and follow-up visit was 2.78 years (4-97 months) and 4.81 years (24-136 months) each. The mean follow-up period was 4.81 years (24-136 months). 2) The most common chief complaints of patients was language delay (71.5%). 3) The difference between the tentative diagnosis and the final diagnosis was mainly observed in the GDD and DLD patients. Eventually, the final diagnosis ID was diagnosed more in the GDD than in the DLD (65.3% vs 42.3%), but the diagnosis ASD was diagnosed similarly (16.3 vs 19.2%). 4) Long-term prognosis was better for patients with DLD who has higher nonverbal cognitive developmental quotient (C-DQ >70) at initial visit. 5) Result of the canonical coefficients by discrimination analysis showed that C-DQ (0.7436) was the strongest discriminating factor that predict the three groups, followed by SMS (0.6239), M_Q (0.6070), and eye Contact (0.4743), CARS (-0.3148), Rec_Q (0.2984), and P_Q (0.2629).
Conclusion: Regular follow-up of experienced doctor is very important when a patient is delayed. If language delay is prominent compared to other areas & if discriminating factors of ASD are detected, it is advisable to initiate intensive early intervention with long-term periodic follow-up even if it does not meet the diagnostic criteria of ASD with long-term periodic follow-up.
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KEYWORD
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Developmental delay, Longitudinal follow up, Autism spectrum disorder, Intellectual disability, Developmental language disorder
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