Motor development delay or regression , and unsteadiness in a child - NICE guidance - suspected neurological conditions - recognition and referral

Motor development delay or regression, and unsteadiness

Summary points from NICE guidance relating motor development delay or regression, and unsteadiness in children are:

New-onset gait abnormality

• refer immediately children with new-onset gait abnormality to acute paediatric services.

Motor development delay

Refer children to a child development service, and consider referring for physiotherapy or occupational therapy, in consideration of possible cerebral palsy, if they:

• are not sitting unsupported by 8months (corrected for gestational age) or
• are not walking independently by 15 months (girls) or 18 months (boys) (corrected for gestational age) or
• show early asymmetry of hand function (hand preference) before 1 year (corrected for gestational age).

If the child is a boy, consider measuring creatinine kinase level to exclude Duchenne muscular dystrophy before the boy has had a specialist review.

Motor development regression

• refer children with motor development regression to a paediatric neurodevelopmental service or paediatric neurology depending on locally agreed pathways.
• if the child is a boy, consider measuring creatinine kinase level to exclude Duchenne muscular dystrophy before the boy has had a specialist review.

Reference

1. NICE. Suspected neurological conditions: recognition and referral. NICE guideline NG127. Published May 2019, last updated October 2023.