+ve family members

Prenatal Antenatal screening tests

U/S
Triple blood test
Amniocentesis
Birth asphyxia / Neonatal encephalopathy

Perinatal IV haemorrhage / PV leucomalacia / Post-haemorrhagic hydrocephalus

Dysmorphic features
Abnormal tone, feeding, mobement, seizures, visual inattention
Global developmetal delay

Infancy Delayed / Asymetric motor

Vision or hearing concerns
Neurocutaneous / dysmorphic features
Speech and language delay

Preschool Abnormal gait

Poor social communication
Problems with balance and coordination

School age learning difficulties

Attention and Hyperactivity
Specific learning difficulties e.g. Dyslexia , Dyspraxia
Social communication difficulties

Any age Acquired brain injury

Loss of skills

Figure 1Features suggestive of Neurodevelopmental concerns

 Genetic Vascular Metabolic
Prenatal
Teratogenic Congenital infection Neurocutaneous
Chromosome/DNA Occlusions Hypothyroidism Alcohol Rubella syndromes
disorders Haemorrhage Phenylketonuria Drug abuse CMV Tuberous sclerosis
Cerebral dysgenesis Toxo Neurofibromatosis
HIV

Extreme prematurity
Perinatal
Birth asphyxia Metabolic
IV haemorrhage Hypoxic - ischaemic encephalopathy Symptomatic hypoglycemia
PV leucomalacia Hyperbilirubinaemia

Infection Anoxia
Postnatal
Trauma Metabolic Vascular
Meningitis Suffocation Head injury Hypoglycemia Stroke
Encephalitis Near drowning Inborn errors of
Seizures metabolism

Other
Unknown 25%

Figure 2 Causes of Abnormal development and Learning difficulty

 Abnorma
l
Develop
ment

Global Categorised: Specific

Slow but Hearing

All fields: steady Motor Speech Social/ Vision
Impairment
and Commun Cognitiv Specific
ication e Learning Visual
Plateau Language Refractiv
Gross CP skills skills/Ge Difficulty Sensorineural Squint Impairm
e errors
neral ent
Vision learning Conducti Hyperme
Regression difficulty Develop
and Fine ve tropia
metal
Autistic Coordina
Hearing Spectrum tion Myopia
and Disorder Disorder
Speech
Dyslexia Astigmat
ism
Language and
Cognition Dyscalcu Amblyop
lia, ia
Dysgrap
hia
Social and
Behvioural
Disorder
of
executive
function
 Abnormal
Development

Severity Categorised

Slow but
Mild Moderate Plateau
steady

Severe Profound Regression

Global Specific

Speech
All fields: Motor Vision
and Social/ Cognitive Specific Hearing
Language Communica skills/ Learning Impairment
tion General Difficulty Refractive
Gross CP Squint Visual
learning errors
skills Impairment
difficulty Sensorineural
Vision, Developmeta Hypermetropia
Autistic l
Fine Coordination
Spectrum Conductive
Disorder Disorder
Myopia
Hearing,
Speech Dyslexia
Astigmatism

Language,
Cognition Dyscalculia, Amblyopi
Dysgraphia a

Social, Disorder
Behvioural of
executive
function