Suggested Teaching Approaches forDevelopmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism

Format 1: Point of Care (~ 5 min)

Overview Resources available at time of patient contact, to help learner care for patient and advance own knowledge of the topic.

Suggested educational material “At-A-Glance” document (as revised), www.genetictools.org

UpToDate: Evaluation of Mental Retardation

National Guideline Clearinghouse: Practice parameter: Evaluation of the child with global developmental delay, www.guideline.gov

Roberts G, Palfrey J, Bridgemohan C. The medical evaluation of a child with developmental delay, Contemporary Pediatrics, March 2004;21:76. http://www.contemporarypediatrics.com/contpeds/article/articleDetail.jsp?id=108019

Mini-topics

Addressing common questions in clinical precepting.

Suggested approach Have unified access point with direct links to web-based resources available in the clinic precepting environment.

ACGME/RRC requirements Do these apply to topics covered in precepting?

Format 2: Morning Report (~ 20 min.)

Overview Brief informal discussion of case-based materials presenting major points regarding XXXX. Could be led by faculty or chief/senior resident.

Suggested educational material Genetic Tools teaching cases (www.genetictools.org). These cases include key issues, red flags, clinical care issues, risk assessment, genetic counseling and testing, interventions, and ethical/legal/social/cultural issues. Cases also include lists of additional resources as well as patient information and references to primary literature.

GeneticTools case 16: a two-year-old boy with developmental delay—discussion of Fragile X testing, http://www.genetests.org/servlet/access?id=8888892&key=LtUXnaB0k0AZL&fcn=y&fw=YT5f&filename=/tools/cases/fragilex-16/index.html

GeneticTools case 17: a 30-year-old woman planning to become pregnant asks about implications of her sister’s learning disability—discussion of 22q11.2 deletion syndrome testing ihttp://www.genetests.org/servlet/access?id=8888892&key=LtUXnaB0k0AZL&fcn=y&fw=YT5f&filename=/tools/cases/22q11del-17/index.html

GeneticTools case 18: a diagnosis of 22q11.2 deletion syndrome in a newborn, http://www.genetests.org/servlet/access?id=8888892&key=LtUXnaB0k0AZL&fcn=y&fw=U3zp&filename=/tools/cases/22q11del-18/index.html

Suggested pre-reading All attendees:

GeneticTools cases 16, 17, and 18

Revised 3/31/2006 Page 1 of 4Susie Ball, MSCentral Washington Genetics Program

Suggested Teaching Approaches forDevelopmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism

National Guideline Clearinghouse: Practice parameter: Evaluation of the child with global developmental delay

Discussion leader:

UpToDate: Evaluation of Mental Retardation

Suggested approach On inpatient teaching service (family medicine, pediatrics) with morning report or teaching rounds, select young patient with developmental delay for presentation. Assign a team member to briefly present the case (3–5 minutes). Assign team pre-reading of GeneticTools cases 16, 17, and 18, and set date for case presentation. Direct discussion toward the issue of developmental delay detection and evaluation of etiology. Provide brief overview as discussion leader of the three cases in the case reports.

Suggested discussion topics

What is the value of confirming / diagnosing an etiology for DD?

What are “red flags” suggesting the possibility of an inherited DD syndrome?

What is the first step in evaluation of a child with DD?

What social issues might be important in inherited causes for DD?

ACMG/RRC requirements ??

Evaluation ??

Revised 3/31/2006 Page 2 of 4Susie Ball, MSCentral Washington Genetics Program

Suggested Teaching Approaches forDevelopmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism

Format 3: Noon Conference (~ 1 hour)

Overview Formal lecture-style presentation of information on developmental delay and the approach to the evaluation of a child with global developmental delay.

Suggested educational material “At-A-Glance” document (as revised), www.genetictools.org

UpToDate: Evaluation of Mental Retardation

National Guideline Clearinghouse: Practice parameter: Evaluation of the child with global developmental delay, www.guideline.gov

Contemporary Pediatrics: The medical evaluation of a child with developmental delay

Suggested pre-reading National Guideline Clearinghouse guideline for evaluation of the child with global developmental delay: www.guideline.gov

Suggested approach Select noon conference slot every 3 years for this topic. Assign faculty with interest in topic to review current information. Selected faculty will need to be familiar with topic in order to effectively present topic and field questions. Limit presentation to 45 minutes, allowing 15 minutes for discussion of questions and / or cases of interest.

Suggested content areas:

Overview of DD

Compare / contrast DD/MR/autism

Review developmental screening / testing tools

Outline evaluation of a child with DD

Outline genetic testing available and appropriate for a child with DD/MR/autism.

Discuss social issues that may arise after diagnosing an inherited cause for DD/MR/PDD/autism in a family

ACGME/RRC requirements ??

Evaluation ??

Format 4: Self-Directed Learning

Overview Web-based module covering the basics of DD/autism in a case-based format. May be used at learner’s convenience and takes about 30 minutes.

Suggested educational material AAFP Annual Clinical Focus Autism video module (Note: requires high-speed Internet access),

Revised 3/31/2006 Page 3 of 4Susie Ball, MSCentral Washington Genetics Program

Suggested Teaching Approaches forDevelopmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism

www.aafp.org/x39858.xml

UpToDate: Evaluation of the Child with Mental Retardation

Suggested pre-reading GeneticTools cases 16, 17, and 18

Suggested approach Assign resident to complete review of module during appropriate first-year rotation (family medicine, pediatrics).

ACGME/RRC requirements ??

Evaluation Brief written post-test

Other Resources (more detail)

GeneReviews, www.genereviews.org

March of Dimes, www.marchofdimes.com

Revised 3/31/2006 Page 4 of 4Susie Ball, MSCentral Washington Genetics Program