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Chapter 5. Developmental Assessment and Interventions Prepared by David Bellinger, PhD, MSc., and Leonard Rappaport, MDChapter 5. Developmental Assessment and Interventions Table 5.1. Summary of Recommendations for Developmental Assessment and Interventio



Make long term developmental surveillance a component of the management plan for any child with a blood lead level (BLL) $ 20 Fg/dL, while recognizing that this will not necessarily result in referral for diagnostic assessment or intervention. Also consider developmental surveillance for a child who has a BLL that does not exceed 20 Fg/dL but who has other significant developmental risk factors. Do not base decisions regarding developmental assessment or intervention on a child’s age at the time the child is found to have an elevated blood lead level (EBLL). If you wish to refer a child with an EBLL for intervention services, consider referring that child to early intervention/stimulation programs. Include a history of a child’s EBLL in the problem list maintained in the child’s medical record. • Do not stop developmental surveillance when a child with an EBLL reaches age 6 or when the child’s blood lead level is reduced. A responsible party (e.g., the child’s PCP) should provide ongoing developmental surveillance of that child after the EBLL case is closed. In the developmental surveillance of children with EBLLs: — Watch for emerging difficulties at critical transition points in childhood: first, fourth, and sixth/seventh grades. — Watch for behaviors that interfere with learning, such as inattention and distractibility. Refer children experiencing neurodevelopmental problems for a thorough diagnostic evaluation. Be advocates for the child

Topics: Managing Elevated Blood Lead Levels Among Young Children 79Chapter 5. Developmental Assessment and I
Year: 2013
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