Developmental assessment in CAP — structured clinical viva

This is a delayed multi-domain developmental presentation after prolonged wait-and-see — classic viva on process excellence rather than a single label.[1]

Assessment structure. Developmental history; domain milestones; observation; adaptive interview (conceptual/social/practical); multi-informant (parents/teachers); hearing/vision; select screens; formal cognitive and adaptive psychometrics as indicated; ASD multi-source evaluation if social-communication concerns.[1][3][5]

Key teaching lines. Surveillance ≠ screening ≠ diagnostic testing. Screens (for example historical M-CHAT-R/F pathway) flag risk; they do not diagnose. ID needs intellectual and adaptive deficits.[2][3]

Formulation. Integrate prematurity/medical risk if present, language/cognitive profile, school ecology, family strengths, perpetuating system delay, protective factors → 4P/biopsychosocial product that drives plan.[4]

Plan. Close referral loops to early intervention and education supports; treat psychiatric comorbidity later on its merits with developmental adaptations; no medication to manufacture milestones.[5][6]