GLOBAL DEVELOPMENTAL

DELAY
Arif Handiarsa

MS PPDS I Ilmu Kesehatan Anak

Fakultas Kedokteran Universitas Gadjah
Mada
RSUP dr. Sardjito Yogyakarta
Juli 2014

Introduction
An estimated 12-16% of children have a
developmental and/or behavior disorder
Only 30% are identified before school
entrance

Surveillance and Screening

AAP recommends formal screening
at 9, 18, and 24 or 30 months,
and if concerns raised by
parent/physician during routine
surveillance
AAP also recommends all 18 month
olds be screened with an autismspecific tool

Deteksi Dini Penyimpangan

Perkembangan

Tanya perkembangan anak dengan KPSP

(Kuesioner Pra Skrining Perkembangan) mulai

umur 3 bulan,
minimal tiap 3 bln sampai umur 2 thn
minimal tiap 6 bulan umur 2 - 6 thn.

Tanya pendengaran anak dengan TDD (tes

daya dengar) mulai umur 3 bln
minimal tiap 3 bln sampai umur 1 thn
minimal tiap 6 bulan sampai umur 6 thn

Tes penglihatan anak dengan TDL (tes daya

lihat) mulai umur 3 tahun, tiap 6 bulan.

Tanya gangguan perilaku dengan KMME

(kuesioner masalah mental emosional), CHAT
(checklist for autisme in toddler) dan Conners
untuk Gangguan Pemusatan Perhatian dan
Hiperaktifitas

DELAY

Seorang anak tidak mencapai

tahap perkembangan yang
diharapkan sesuai dengan
umurnya.

Global
developme
ntal delay

Keterlambatan
perkembangan pada 2 aspek
atau lebih (motorik kasar
atau halus, bicara atau
bahasa, kognitif, sosial atau
personal)
Umur < 5 tahun (1%-3%)

ETIOLOGY

IDENTIFICATION OF THE CHILD WITH

POTENTIAL DELOPMENTAL DELAY
PRENATAL

POSTNATAL
HISTORY

PRESENT

FAMILY

Anamnesis

Investigations

Treatment
Speech and language therapy
Occupational therapy
Physical therapy and rehabilitation
including mobility and postural support
Family counseling and support
Behavioral intervention
Educational assistance

Prevention
Primary prevention :
Avoidance of prenatal exposure to alcohol or other
toxins
Use of prenatal multivitamins, especially folic acid
Appropriate prenatal care
Newborn screening programs for metabolic
disease
Routine childhood immunizations
Use of car seats and restraints
Prevention of motor vehicle accidents, violence,
and other trauma.

Secondary prevention treating

an underlying
condition to reduce potential cognitive

adaptive dysfunction
surveillance in a child at risk for lead
exposure
dietary restriction in metabolic
diseases
thyroid hormone replacement in a

Tertiary prevention :
Early identification of affected
individuals
Access to and provision of
appropriate comprehensive services
and resources
Treatment of comorbid conditions
Prevention and treatment of
psychosocial disorders.

TERIMAKASIH

Rett Syndrome
Rett syndrome is a
neurodevelopmental disorder of the
grey matter of the brain
females more commonly than males
caused by mutations in the gene
MECP2 located on the X
chromosome. MECP2 is found near
the end of the long arm of the X
chromosome at Xq28

 Development appears to be normal

until 618 months.
At around 6-18 months there is a
period of developmental stagnation
followed by a developmental
regression where language and
motor milestones regress, purposeful
hand use is lost, and acquired
deceleration in the rate of head
growth (resulting in microcephaly in

 Repetitive hand movements, such as

wringing and/or repeatedly putting
hands into the mouth
People with Rett syndrome are prone
to gastrointestinal disorders and up
to 80% have seizures
They typically have no verbal skills
Skoliosis, growth failure, and
constipation are very common and
can be problematic.

Definision
Global delay can be defined as
significant delay in two or more
developmental domains: gross and fine
motor; speech and language; cognition;
personal and social development; or
activities of daily living.

L McDonald, A Rennie, J Tolmie, P Galloway, R McWilliam.

Investigation of global developmental delay. 2006. Arch Dis Child;