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Cognitive developmental delay

Last edited: 4/13/2026

Overview

Cognitive developmental delay refers to a condition where children exhibit significantly below-average cognitive abilities compared to their peers, often impacting learning, problem-solving, and adaptive behaviors 1710.

Diagnosis

  • Key Criteria: Delayed milestones in cognitive, language, motor, or social-emotional development 110.
  • Recommended Tests: Developmental screening tools (e.g., Ages and Stages Questionnaire, Early Years Foundation Stage Profile) 314.
  • Genetic Testing: Considered for unexplained delays to identify chromosomal abnormalities or genetic mutations 222426273639.
  • Comprehensive Assessment: Includes history, physical examination, and multidisciplinary evaluation 1840.

    • Management

  • Early Intervention Services: Intensive support programs tailored to individual needs 20212345.
  • Parent Training Interventions: Programs like Parent-Child Interaction Therapy (PCIT) to enhance parenting skills 29.
  • Phonological Remediation: Targeted interventions focusing on specific phonological deficits 4648.
  • Assistive Technology: Utilization of communication aids for children with significant delays 51.

    • Special Populations

  • Pediatrics: Early identification and intervention are crucial for better outcomes 41020.
  • Comorbidities: Consideration of nutritional deficiencies (e.g., vitamins B6, B12, folate) impacting development 9.
  • Adverse Childhood Experiences (ACEs): Recognize and address the impact of ACEs on developmental delay 5.

    • Key Recommendations

  • Implement Routine Developmental Screening: Use standardized tools to identify delays early 314 (Evidence: Strong).
  • Provide Early and Intensive Intervention Services: Tailored interventions significantly improve functional capabilities 2021 (Evidence: Moderate).
  • Consider Genetic Testing for Unexplained Delays: To identify underlying genetic causes 2224 (Evidence: Moderate).
  • Engage Parents in Intervention Programs: Enhance parental skills through structured training programs 29 (Evidence: Moderate).
  • Monitor Nutritional Status: Address deficiencies in essential vitamins impacting cognitive development 9 (Evidence: Moderate).

    • References

    1 Outhwaite LA. Understanding early inequalities: Multiple dimensions of children's developmental contexts predict age 3 outcomes. The British journal of developmental psychology 2026. link 2 Ghassabian A, Etzel T, Ames JL, O'Connor TG, Buckley JP, Shahin S et al.. Prenatal exposure to organophosphate ester flame retardants and child cognition: Findings from the environmental influences on child Health Outcomes cohort. Environmental pollution (Barking, Essex : 1987) 2026. link 3 Mooney KE, Welch C, Palliser G, Cheung RW, Nielsen D, Eddy LH et al.. An assessment of the teacher completed 'Early Years Foundation Stage Profile' as a routine measure of child developmental health. PloS one 2025. link 4 Souza RCVE, Dos Santos LC. Development and behavior screening of 4-year-old Brazilian children: prevalence and associated factors. Journal of tropical pediatrics 2025. link 5 Nivens C, Schwarz EB, Rodriguez R, Hoyt-Austin A. Adverse Childhood Experiences and Developmental Delay in Young US Children. Maternal and child health journal 2024. link 6 Hatherly K, Glista D, Testani D, Brunton L, Cunningham BJ. A scoping review of virtual synchronous intervention studies in preschool rehabilitation. Disability and rehabilitation 2024. link 7 Crotty JE, Martin-Herz SP, Scharf RJ. Cognitive Development. Pediatrics in review 2023. link 8 Treviño MS, Cherry KE, Njoroge WFM, Gerstein ED. Young Children's Development and Behavior: Associations with Timing of Household Food Insecurity in a Racially and Ethnically Diverse Early Head Start Sample. Journal of developmental and behavioral pediatrics : JDBP 2023. link 9 Freitas-Costa NC, Andrade PG, Normando P, Nunes KSS, Raymundo CE, Castro IRR et al.. Association of development quotient with nutritional status of vitamins B6, B12, and folate in 6-59-month-old children: Results from the Brazilian National Survey on Child Nutrition (ENANI-2019). The American journal of clinical nutrition 2023. link 10 Juneja M, Gupta A, Sairam S, Jain R, Sharma M, Thadani A et al.. Diagnosis and Management of Global Development Delay: Consensus Guidelines of Growth, Development and Behavioral Pediatrics Chapter, Neurology Chapter and Neurodevelopment Pediatrics Chapter of the Indian Academy of Pediatrics. Indian pediatrics 2022. link 11 Reid N, Page M, McDonald T, Hawkins E, Liu W, Webster H et al.. Integrating cultural considerations and developmental screening into an Australian First Nations child health check. Australian journal of primary health 2022. link 12 Berland S, Haukanes BI, Juliusson PB, Houge G. Deep exploration of a . Journal of medical genetics 2022. link 13 Messerli-Bürgy N, Kakebeeke TH, Meyer AH, Arhab A, Zysset AE, Stülb K et al.. Walking onset: a poor predictor for motor and cognitive skills in healthy preschool children. BMC pediatrics 2021. link 14 Çelen Yoldaş T, Karakaya J, Özdemir G, Engin Erdal A, Özmert EN. Comparison of the Parents' Evaluation of Developmental Status and Ages and Stages Questionnaire Developmental Screening Tests in a Eurasian Country. Journal of developmental and behavioral pediatrics : JDBP 2021. link 15 Chödrön G, Barger B, Pizur-Barnekow K, Viehweg S, Puk-Ament A. "Watch Me!" Training Increases Knowledge and Impacts Attitudes Related to Developmental Monitoring and Referral Among Childcare Providers. Maternal and child health journal 2021. link 16 McBride GR, Stephenson KAJ, Comer G, Flanagan O. The Use of Oral Midazolam to Facilitate the Ophthalmic Examination of Children with Autism and Developmental Disorders. Journal of autism and developmental disorders 2021. link 17 Chando S, Craig JC, Burgess L, Sherriff S, Purcell A, Gunasekera H et al.. Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMC pediatrics 2020. link 18 Demerdzieva A, Pop-Jordanova N. History Information's are Indispensable in Developmental Assessment of Children. Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) 2020. link 19 Carbonieri J, Lúcio PS. Vocabulary assessment in Brazilian children: a systematic review with three instruments. CoDAS 2020. link 20 Richardson ZS, Scully EA, Dooling-Litfin JK, Murphy NJ, Rigau B, Khetani MA et al.. Early Intervention Service Intensity and Change in Children's Functional Capabilities. Archives of physical medicine and rehabilitation 2020. link 21 Barker RM, Romski M, Sevcik RA, Adamson LB, Smith AL, Bakeman R. Intervention focus moderates the association between initial receptive language and language outcomes for toddlers with developmental delay. Augmentative and alternative communication (Baltimore, Md. : 1985) 2019. link 22 Richardson ZS, Khetani MA, Scully E, Dooling-Litfin J, Murphy NJ, McManus BM. Social and Functional Characteristics of Receipt and Service Use Intensity of Core Early Intervention Services. Academic pediatrics 2019. link 23 Barger B, Rice C, Wolf R, Roach A. Better together: Developmental screening and monitoring best identify children who need early intervention. Disability and health journal 2018. link 24 Shashi V, Pena LD, Kim K, Burton B, Hempel M, Schoch K et al.. De Novo Truncating Variants in ASXL2 Are Associated with a Unique and Recognizable Clinical Phenotype. American journal of human genetics 2016. link 25 Magnusson D, Palta M, McManus B, Benedict RE, Durkin MS. Capturing Unmet Therapy Need Among Young Children With Developmental Delay Using National Survey Data. Academic pediatrics 2016. link 26 Hashemi B, Bassett A, Chitayat D, Chong K, Feldman M, Flanagan J et al.. Deletion of 15q11.2(BP1-BP2) region: further evidence for lack of phenotypic specificity in a pediatric population. American journal of medical genetics. Part A 2015. link 27 Barber JC, Rosenfeld JA, Graham JM, Kramer N, Lachlan KL, Bateman MS et al.. Inside the 8p23.1 duplication syndrome; eight microduplications of likely or uncertain clinical significance. American journal of medical genetics. Part A 2015. link 28 Mimouni-Bloch A, Yeshaya J, Kahana S, Maya I, Basel-Vanagaite L. A de-novo interstitial microduplication involving 2p16.1-p15 and mirroring 2p16.1-p15 microdeletion syndrome: Clinical and molecular analysis. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society 2015. link 29 Garcia D, Bagner DM, Pruden SM, Nichols-Lopez K. Language Production in Children With and At Risk for Delay: Mediating Role of Parenting Skills. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 2015. link 30 Gierut JA, Morrisette ML. How to meet the neighbors: Modality effects on phonological generalization. Clinical linguistics & phonetics 2014. link 31 Tan TX. Developmental delays at arrival, early intervention enrollment, and adopted Chinese girls' academic performance and internalizing problems in adolescence. The Journal of genetic psychology 2014. link 32 Nakane T, Kousuke N, Sonoko H, Yuko K, Sato H, Kubota T et al.. 6p subtelomere deletion with congenital glaucoma, severe mental retardation, and growth impairment. Pediatrics international : official journal of the Japan Pediatric Society 2013. link 33 McManus BM, Robert S, Albanese A, Sadek-Badawi M, Palta M. Predictors of receiving therapy among very low birth weight 2-year olds eligible for Part C early intervention in Wisconsin. BMC pediatrics 2013. link 34 Gierut JA, Morrisette ML. Density, frequency and the expressive phonology of children with phonological delay. Journal of child language 2012. link 35 Filges I, Röthlisberger B, Boesch N, Weber P, Wenzel F, Huber AR et al.. Interstitial deletion 1q42 in a patient with agenesis of corpus callosum: Phenotype-genotype comparison to the 1q41q42 microdeletion suggests a contiguous 1q4 syndrome. American journal of medical genetics. Part A 2010. link 36 Türköver BB, Sayar C, Toksoy G, Elçioğlu N. A report of a patient with duplication of 7p13-->pter and deletion of 2p23-->pter due to a maternal 2p;7p translocation. The Turkish journal of pediatrics 2009. link 37 van Bon BW, Mefford HC, Menten B, Koolen DA, Sharp AJ, Nillesen WM et al.. Further delineation of the 15q13 microdeletion and duplication syndromes: a clinical spectrum varying from non-pathogenic to a severe outcome. Journal of medical genetics 2009. link 38 Kim C, Disare K, Pfeiffer M, Kerker BD, McVeigh KH. Effects of individual and neighborhood characteristics on the timeliness of provider designation for early intervention services in New York City. Journal of developmental and behavioral pediatrics : JDBP 2009. link 39 Battaglia A, Hoyme HE, Dallapiccola B, Zackai E, Hudgins L, McDonald-McGinn D et al.. Further delineation of deletion 1p36 syndrome in 60 patients: a recognizable phenotype and common cause of developmental delay and mental retardation. Pediatrics 2008. link 40 Czarnecki ML, Ferrise AS, Jastrowski Mano KE, Garwood MM, Sharp M, Davies H et al.. Parent/nurse-controlled analgesia for children with developmental delay. The Clinical journal of pain 2008. link 41 . Early identification of developmental delays pays major dividends. Disease management advisor 2006. link 42 Rauch A, Hoyer J, Guth S, Zweier C, Kraus C, Becker C et al.. Diagnostic yield of various genetic approaches in patients with unexplained developmental delay or mental retardation. American journal of medical genetics. Part A 2006. link 43 Ilyukhina VA, Kozhushko NY, Matveev YK, Ponomareva EA, Chernysheva EM, Shaptilei MA. Transcranial micropolarization in the combined therapy of speech and general psychomotor retardation in children of late preschool age. Neuroscience and behavioral physiology 2005. link 44 Barlow JA. Phonological change and the representation of consonant clusters in Spanish: a case study. Clinical linguistics & phonetics 2005. link 45 Tétreault S, Parrot A, Trahan J. Home activity programs in families with children presenting with global developmental delays: evaluation and parental perceptions. International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation 2003. link 46 Barlow JA, Gierut JA. Minimal pair approaches to phonological remediation. Seminars in speech and language 2002. link 47 Morrisette ML, Gierut JA. Lexical organization and phonological change in treatment. Journal of speech, language, and hearing research : JSLHR 2002. link) 48 Rvachew S, Nowak M. The effect of target-selection strategy on phonological learning. Journal of speech, language, and hearing research : JSLHR 2001. link) 49 Gierut JA. Syllable onsets: clusters and adjuncts in acquisition. Journal of speech, language, and hearing research : JSLHR 1999. link 50 Grantham-McGregor SM, Ani CC. The role of micronutrients in psychomotor and cognitive development. British medical bulletin 1999. link 51 Reinhartsen DB, Edmondson R, Crais ER. Developing assistive technology strategies for infants and toddlers with communication difficulties. Seminars in speech and language 1997. link 52 Nessim AA. Correlation of mild pre-school developmental delay and subsequent learning abilities: a health and education perspective. Public health 1994. link80117-7) 53 Collignon P, Philip N, Simonin G, Mattei JF, Giraud F. Dysmorphology report: on the association of microcephaly and preaxial polydactyly. Another example of Howard-Young syndrome. Genetic counseling (Geneva, Switzerland) 1992. link 54 Gillette Y. Family-centered early intervention: an opportunity for creative practice in speech-language pathology. Clinics in communication disorders 1992. link 55 Thomsen SG, Petersen MB, Andersen EA, ostergaard GZ, Lindenberg S. A case of the ring 20 syndrome. Annales de genetique 1989. link 56 Titelbaum DS, Hayward JC, Zimmerman RA. Pachygyriclike changes: topographic appearance at MR imaging and CT and correlation with neurologic status. Radiology 1989. link 57 Campion J, Wohlfarth R. Theory and research in practice: an opportunity group for young children with developmental difficulties. Child: care, health and development 1989. link 58 McConachie H, Lingam S, Stiff B, Holt KS. Giving assessment reports to parents. Archives of disease in childhood 1988. link 59 Young ID, Trounce JQ, Levene MI, Fitzsimmons JS, Moore JR. Agenesis of the corpus callosum and macrocephaly in siblings. Clinical genetics 1985. link 60 Cohen MM, Charrow J, Balkin NE, Harris CJ. Partial trisomy 14 (q23 leads to qter) via segregation of a 14/X translocation. American journal of human genetics 1983. link 61 Malina RM. Menarche in athletes: a synthesis and hypothesis. Annals of human biology 1983. link 62 Brisson GR, Dulac S, Péronnet F, Ledoux M. The onset of menarche: a late event in pubertal progression to be affected by physical training. Canadian journal of applied sport sciences. Journal canadien des sciences appliquees au sport 1982. link 63 Sidhu LS, Grewal R. Age of menarche in various categories of Indian sportswomen. British journal of sports medicine 1980. link 64 Malina RM, Spirduso WW, Tate C, Baylor AM. Age at menarche and selected menstrual characteristics in athletes at different competitive levels and in different sports. Medicine and science in sports 1978. link

    Original source

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      Understanding early inequalities: Multiple dimensions of children's developmental contexts predict age 3 outcomes. — Outhwaite LA The British journal of developmental psychology (2026)
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      Prenatal exposure to organophosphate ester flame retardants and child cognition: Findings from the environmental influences on child Health Outcomes cohort. — Ghassabian A, Etzel T, Ames JL, O'Connor TG, Buckley JP, Shahin S et al. Environmental pollution (Barking, Essex : 1987) (2026)
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      An assessment of the teacher completed 'Early Years Foundation Stage Profile' as a routine measure of child developmental health. — Mooney KE, Welch C, Palliser G, Cheung RW, Nielsen D, Eddy LH et al. PloS one (2025)
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      Development and behavior screening of 4-year-old Brazilian children: prevalence and associated factors. — Souza RCVE, Dos Santos LC Journal of tropical pediatrics (2025)
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      Adverse Childhood Experiences and Developmental Delay in Young US Children. — Nivens C, Schwarz EB, Rodriguez R, Hoyt-Austin A Maternal and child health journal (2024)
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      A scoping review of virtual synchronous intervention studies in preschool rehabilitation. — Hatherly K, Glista D, Testani D, Brunton L, Cunningham BJ Disability and rehabilitation (2024)
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      Cognitive Development. — Crotty JE, Martin-Herz SP, Scharf RJ Pediatrics in review (2023)
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      Young Children's Development and Behavior: Associations with Timing of Household Food Insecurity in a Racially and Ethnically Diverse Early Head Start Sample. — Treviño MS, Cherry KE, Njoroge WFM, Gerstein ED Journal of developmental and behavioral pediatrics : JDBP (2023)
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      Association of development quotient with nutritional status of vitamins B6, B12, and folate in 6-59-month-old children: Results from the Brazilian National Survey on Child Nutrition (ENANI-2019). — Freitas-Costa NC, Andrade PG, Normando P, Nunes KSS, Raymundo CE, Castro IRR et al. The American journal of clinical nutrition (2023)
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      Diagnosis and Management of Global Development Delay: Consensus Guidelines of Growth, Development and Behavioral Pediatrics Chapter, Neurology Chapter and Neurodevelopment Pediatrics Chapter of the Indian Academy of Pediatrics. — Juneja M, Gupta A, Sairam S, Jain R, Sharma M, Thadani A et al. Indian pediatrics (2022)
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      Integrating cultural considerations and developmental screening into an Australian First Nations child health check. — Reid N, Page M, McDonald T, Hawkins E, Liu W, Webster H et al. Australian journal of primary health (2022)
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      Deep exploration of a — Berland S, Haukanes BI, Juliusson PB, Houge G Journal of medical genetics (2022)
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      Walking onset: a poor predictor for motor and cognitive skills in healthy preschool children. — Messerli-Bürgy N, Kakebeeke TH, Meyer AH, Arhab A, Zysset AE, Stülb K et al. BMC pediatrics (2021)
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      Comparison of the Parents' Evaluation of Developmental Status and Ages and Stages Questionnaire Developmental Screening Tests in a Eurasian Country. — Çelen Yoldaş T, Karakaya J, Özdemir G, Engin Erdal A, Özmert EN Journal of developmental and behavioral pediatrics : JDBP (2021)
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      "Watch Me!" Training Increases Knowledge and Impacts Attitudes Related to Developmental Monitoring and Referral Among Childcare Providers. — Chödrön G, Barger B, Pizur-Barnekow K, Viehweg S, Puk-Ament A Maternal and child health journal (2021)
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      The Use of Oral Midazolam to Facilitate the Ophthalmic Examination of Children with Autism and Developmental Disorders. — McBride GR, Stephenson KAJ, Comer G, Flanagan O Journal of autism and developmental disorders (2021)
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      Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). — Chando S, Craig JC, Burgess L, Sherriff S, Purcell A, Gunasekera H et al. BMC pediatrics (2020)
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      Vocabulary assessment in Brazilian children: a systematic review with three instruments. — Carbonieri J, Lúcio PS CoDAS (2020)
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      Early Intervention Service Intensity and Change in Children's Functional Capabilities. — Richardson ZS, Scully EA, Dooling-Litfin JK, Murphy NJ, Rigau B, Khetani MA et al. Archives of physical medicine and rehabilitation (2020)
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      Intervention focus moderates the association between initial receptive language and language outcomes for toddlers with developmental delay. — Barker RM, Romski M, Sevcik RA, Adamson LB, Smith AL, Bakeman R Augmentative and alternative communication (Baltimore, Md. : 1985) (2019)
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      Social and Functional Characteristics of Receipt and Service Use Intensity of Core Early Intervention Services. — Richardson ZS, Khetani MA, Scully E, Dooling-Litfin J, Murphy NJ, McManus BM Academic pediatrics (2019)
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      Better together: Developmental screening and monitoring best identify children who need early intervention. — Barger B, Rice C, Wolf R, Roach A Disability and health journal (2018)
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      De Novo Truncating Variants in ASXL2 Are Associated with a Unique and Recognizable Clinical Phenotype. — Shashi V, Pena LD, Kim K, Burton B, Hempel M, Schoch K et al. American journal of human genetics (2016)
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      Capturing Unmet Therapy Need Among Young Children With Developmental Delay Using National Survey Data. — Magnusson D, Palta M, McManus B, Benedict RE, Durkin MS Academic pediatrics (2016)
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      Deletion of 15q11.2(BP1-BP2) region: further evidence for lack of phenotypic specificity in a pediatric population. — Hashemi B, Bassett A, Chitayat D, Chong K, Feldman M, Flanagan J et al. American journal of medical genetics. Part A (2015)
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      Inside the 8p23.1 duplication syndrome; eight microduplications of likely or uncertain clinical significance. — Barber JC, Rosenfeld JA, Graham JM, Kramer N, Lachlan KL, Bateman MS et al. American journal of medical genetics. Part A (2015)
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      A de-novo interstitial microduplication involving 2p16.1-p15 and mirroring 2p16.1-p15 microdeletion syndrome: Clinical and molecular analysis. — Mimouni-Bloch A, Yeshaya J, Kahana S, Maya I, Basel-Vanagaite L European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society (2015)
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      Developmental delays at arrival, early intervention enrollment, and adopted Chinese girls' academic performance and internalizing problems in adolescence. — Tan TX The Journal of genetic psychology (2014)
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      6p subtelomere deletion with congenital glaucoma, severe mental retardation, and growth impairment. — Nakane T, Kousuke N, Sonoko H, Yuko K, Sato H, Kubota T et al. Pediatrics international : official journal of the Japan Pediatric Society (2013)
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      Interstitial deletion 1q42 in a patient with agenesis of corpus callosum: Phenotype-genotype comparison to the 1q41q42 microdeletion suggests a contiguous 1q4 syndrome. — Filges I, Röthlisberger B, Boesch N, Weber P, Wenzel F, Huber AR et al. American journal of medical genetics. Part A (2010)
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      A report of a patient with duplication of 7p13-->pter and deletion of 2p23-->pter due to a maternal 2p;7p translocation. — Türköver BB, Sayar C, Toksoy G, Elçioğlu N The Turkish journal of pediatrics (2009)
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      Developing assistive technology strategies for infants and toddlers with communication difficulties. — Reinhartsen DB, Edmondson R, Crais ER Seminars in speech and language (1997)
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      Correlation of mild pre-school developmental delay and subsequent learning abilities: a health and education perspective. — Nessim AA Public health (1994)
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      Dysmorphology report: on the association of microcephaly and preaxial polydactyly. Another example of Howard-Young syndrome. — Collignon P, Philip N, Simonin G, Mattei JF, Giraud F Genetic counseling (Geneva, Switzerland) (1992)
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      Family-centered early intervention: an opportunity for creative practice in speech-language pathology. — Gillette Y Clinics in communication disorders (1992)
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      A case of the ring 20 syndrome. — Thomsen SG, Petersen MB, Andersen EA, ostergaard GZ, Lindenberg S Annales de genetique (1989)
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      Pachygyriclike changes: topographic appearance at MR imaging and CT and correlation with neurologic status. — Titelbaum DS, Hayward JC, Zimmerman RA Radiology (1989)
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      Theory and research in practice: an opportunity group for young children with developmental difficulties. — Campion J, Wohlfarth R Child: care, health and development (1989)
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      Age of menarche in various categories of Indian sportswomen. — Sidhu LS, Grewal R British journal of sports medicine (1980)
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      Age at menarche and selected menstrual characteristics in athletes at different competitive levels and in different sports. — Malina RM, Spirduso WW, Tate C, Baylor AM Medicine and science in sports (1978)
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