Profile of referrals for early childhood developmental delay to ambulatorysubspecialty clinics

The objective of this study was to determine the profile and pattern of ref erral to subspecialty clinics of young children with suspected developmenta l delay together with the factors prompting their referral. All children un der 5 years of age referred to either developmental pediatrics or pediatric neurology clinics at a single tertiary hospital over an 18-month period we re prospectively identified. Standardized demographic and referral informat ion were collected at intake, final developmental delay subtype diagnosed w as identified, and referring physicians were surveyed regarding factors pro mpting referral. A total of 224 children met study criteria. There was a ma rked male preponderance (166/224), especially among those with either cogni tive or language delay. Two delay subtypes, global developmental delay and developmental language disorder, accounted for two thirds of the diagnoses made. For slightly more than one third of the children (75/224), the delay subtype diagnosed following specialty evaluation was different from that in itially suspected by the referring physician. A mean delay of 15.5 months w as observed for the cohort as a whole between initial parental concern and specialty assessment. For referring physicians, the major factor prompting referral was the severity of the observed delay. The most important aspects of the specialty evaluation according to referral sources were the identif ication of a possible etiology and confirmation of delay. A profile of refe rrals and the rationale thereof for a cohort of children with suspected dev elopmental delay is presented that, although locale specific, has implicati ons for service provision and training.