Developmental delay: global diagnostic approach — OSCE

Station brief (candidate)

• Explain that findings suggest global developmental delay: multi-domain lag, not a final gene name.
• Screen for regression, seizures and safeguarding red flags.
• Outline hearing/vision checks and same-day early intervention.
• Explain modern genetic evaluation principles at a parent level and seek consent for next steps.
• Agree review timing and safety-net advice with teach-back.
• Avoid blame and false “wait and see” reassurance. [1] [2] [3]

Role-player notes

You are a worried parent. You fear you “caused this” by working full time. You become defensive if blamed, and cooperative if the doctor names a clear plan and starts help now. You ask whether you must wait for genetic results before speech therapy. [1] [6]

Expected candidate performance

• Uses plain language: “behind in more than one skill area.” [1]
• Does not delay therapy for genetics. [1] [3]
• Mentions hearing and vision explicitly. [1]
• Mentions genetic testing as parallel aetiology work-up with consent, not as a barrier to care. [2] [4]
• Safety-nets regression, seizures and acute change. [7]
• Offers written plan / teach-back; trauma-informed tone. [6] [7]

Marking anchors

Common errors

• “Wait and see until three.” [3]
• Starting speech therapy only after microarray returns. [1]
• No hearing plan. [1]
• Overpromising a single test will “explain everything.” [2] [4]