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GLOBAL DEVELOPMENTALDELAY
Arif Handiarsa
MS PPDS I Ilmu Kesehatan Ana !aultas Ked"teran #ni$ersitas Gad%ah
Mada&S#P dr' Sard%it" Y"()aarta
*uli +,-.
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Introduction
An estimated 12-16% of children have adevelopmental and/or behavior disorder
Only 30% are identified before schoolentrance
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Surveillance and Screening
AAP recommends f"rmal s/reenin(at 01 -21 and +. "r 3, m"nths1
and if /"n/erns raised 4)5arent65h)si/ian durin( r"utinesur$eillan/e
AAP also recommends all -2 m"nth"lds 4e s/reened 7ith an autism8s5e/i9/ t""l
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Deteksi Dini PenyimpanganPerkembangan
Tanya 5erem4an(an anak dengan KPSP
(Kuesioner Pra Skrining Perkembangan) mulaiumur 3 bulan,
minimal tiap 3 bln sampai umur t!n minimal tiap " bulan umur # " t!n$
Tanya 5enden(aran anak dengan TDD (tesdaya dengar) mulai umur 3 bln minimal tiap 3 bln sampai umur % t!n minimal tiap " bulan sampai umur " t!n
Tes 5en(lihatan anak dengan TDL (tes daya
li!at) mulai umur 3 ta!un, tiap " bulan$
Tanya (an((uan 5erilau dengan KMME (kuesioner masala! mental emosional), :HAT (c!ecklist &or autisme in toddler) dan :"nners
untuk 'angguan Pemusatan Per!atian dani eraktitas
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• Seorang anak tidak mencapai
ta!ap perkembangan yangdi!arapkan sesuai denganumurnya$
D*+A
• Keterlambatanperkembangan pada aspekatau lebi! (motorik kasar
atau !alus, bicara atauba!asa, kogniti&, sosial ataupersonal)
• -mur . / ta!un (%0#30)
'lobal
developmental delay
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ETIOLOGY
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ID*1TI2IATI41 42 T* I+D 5ITP4T*1TIA+ D*+4P6*1TA+ D*+A
H ISTORY
P7*1ATA+ P4ST1ATA+
P7*S*1T 2A6I+
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Anamnesis
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Investigations
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Treatment
Speec! and language t!erapy4ccupational t!erapy
P!ysical t!erapy and re!abilitation
including mobility and postural support2amily counseling and support
8e!avioral intervention
*ducational assistance
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Prevention
Primar) 5re$enti"n 9
Avoidance o& prenatal e:posure to alco!ol or ot!erto:ins
-se o& prenatal multivitamins, especially &olic acid Appropriate prenatal care
1e;born screening programs &or metabolicdisease
7outine c!ild!ood immuni
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Se/"ndar) 5re$enti"n treatingan underlying
condition to reduce potential cognitive
=adaptive dys&unction
• surveillance in a c!ild at risk &or lead
e:posure• dietary restriction in metabolic
diseases
• t!yroid !ormone replacement in a
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Tertiar) 5re$enti"n 9• *arly identication o& a>ected
individuals
• Access to and provision o&appropriate compre!ensive servicesand resources
• Treatment o& comorbid conditions
• Prevention and treatment o&psyc!osocial disorders$
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TE&IMAKASIH
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7ett Syndrome
• &ett s)ndr"me is aneurodevelopmental disorder o& t!egrey matter o& t!e brain
• &emales more commonly t!an males
• caused by mutations in t!e gene6*P located on t!e ?
c!romosome$ 6*P is &ound neart!e end o& t!e long arm o& t!e ?c!romosome at ?@
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• Development appears to be normaluntil "=% mont!s$
• At around "#% mont!s t!ere is aperiod o& developmental stagnation&ollo;ed by a developmentalregression ;!ere language and
motor milestones regress, purpose&ul!and use is lost, and ac@uireddeceleration in t!e rate o& !ead
gro;t! (resulting in microcep!aly in
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• 7epetitive !and movements, suc! as;ringing andBor repeatedly putting!ands into t!e mout!
• People ;it! 7ett syndrome are proneto gastrointestinal disorders and upto C0 !ave sei
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Denision
'lobal delay can be dened assignicant delay in t;o or moredevelopmental domains9 gross and nemotor speec! and language cognitionpersonal and social development oractivities o& daily living$
+ 6cDonald, A 7ennie, E Tolmie, P 'allo;ay, 7 6c5illiam$Investigation o& global developmental delay$ CC". Arch Dis Child