Identifying disorder in a child's developmental pattern is particularly important for the early identification of developmental language disorders and autistic spectrum disorders, and for distinguishing these conditions from others such as mental retardation. 2 Progress in these domains is interrelated. Achievement of mile-stones in some areas, is dependent on progress in others. Stanley Greenspan, M.D., notes that communication is the outward expression of emotion. 3 Interactive play skills require communication abilities and visuomotor problem solving skills.
Language develops in the context of interpersonal relation-ships.
While difficulties may arise in only one main developmental domain, often problems in multiple areas might be overlooked if the interrelatedness of various developmental skills is not recognized. Concern about speech delay in a preschool-aged child is a common problem encountered in the primary care setting. The differential diagnosis of speech and language delay includes hearing loss, developmental language disorders, autistic spectrum disorders and mental retardation. Accurate diagnosis is important because treatment strategies will be different, including the educational strategies that will benefit the child. Careful questioning of parents and documentation of language milestones is helpful in early identification of significant problems.