Management of a child with fine motor delay

1)  Take a detailed Personal and family and social history

2)  Perform a detailed physical examination

3) Assess for possible chromosomal abnormality
a. Karyotype
b. Testing for fragile X

4) Brain imaging- CT/MRI scan- depending on the severity and clinical findings

5) Metabolic screen- if you  suspect metabolic condition
a.  urine organic acid screen, quantitative serum amino acids, serum lactate and ammonia levels, capillary or arterial blood gas, thyroid function studies

6) Ophthalmology referral if  you suspect metabolic condition

7) other investigations- Full blood count  to exclude anaemia, Lead levels if history suggestive, Thyroid function tests

Team involved in the management with fine motor delay
• Community paediatrician
• Occupational therapist
• Physiotherapist
• Geneticists
• School teacher/nurse
• General practitioner