Developmental Delay Toddler

It was a pleasure to see Emily Carter at the Children's Clinic on 1 November 2024 accompanied by both parents. Emily Carter is a 2-year-old referred for developmental delay. Concern for Emily Carter's development was first identified at 18 months by her mother. Specific concerns of limited vocabulary and difficulty with fine motor skills were highlighted on the Ages and Stages Questionnaire. At the time, Emily was referred to early intervention programs. At the time, Emily was not yet walking independently. Parents had not yet enrolled her in speech therapy due to concerns about her willingness to participate. Developmental Review Gross Motor: Emily is able to walk independently but struggles with running and jumping. She can climb stairs with assistance. Fine Motor: Emily can stack 3 blocks but struggles with using a pincer grasp. Speech and language: Emily has a vocabulary of approximately 10 words and is not yet using two-word phrases. Cognitive: Emily can follow simple instructions but struggles with problem-solving tasks. Social and emotional: Emily shows some interest in playing with other children but often becomes frustrated. Parents deny regression of any milestones. On review of systems, Emily has a normal feeding history, sleeps 11 hours per night, and has regular voiding and bowel movements. Past History: Emily was born at term via vaginal delivery. Maternal health during pregnancy was unremarkable. There were no complications during delivery. Newborn history was normal. Family History: There is a family history of speech delay on the father's side. Immunizations: Up to date. Medications: None. Allergies: No known allergies. Social History: Emily lives with both parents in a two-bedroom apartment. Both parents are employed. On Examination: Weight: 12 kg, Height: 85 cm, BMI: 16.6. Emily is alert and interactive. Behavioural observation: Emily was initially shy but became more engaged during the appointment. Investigations: None. Impression and plan: In summary, Emily Carter is a 2-year-old referred for assessment of developmental delay. Findings suggest delays in gross motor, fine motor, and speech and language development. We discussed with parents the option to enroll Emily in speech therapy and occupational therapy. Parents' preference was to proceed with both therapies. We will plan to schedule follow-up appointments with speech therapy and occupational therapy and review her progress in 6 months. Thank you for including me in Emily Carter's care and please do not hesitate to contact me should you have questions or concerns.