Psychomotor retardation is not an illness or disorder in itself, but the clinical manifestation of central nervous system pathologies due to genetic disorders and environmental factors, with special incidence in the child’s psychomotor development. The term PMD was used to define the child’s progress in different areas (language, motor, manipulative, social …) during the first 24-36 months; we have to define, therefore, the PMR as the slow or abnormal acquisition of the first developmental milestones.
For the typification of psychomotor retardation, we must previously know the normal psychomotor development. In general: every child who at one and a half years of age does not say any word and/or does not walk should be referred to a neuropediatrician to rule out any serious problem (which does not happen in most cases, so the family should not be alarmed).
The detection of a developmental problem must be early and corresponds in the first instance to the parents, also to the personnel of day-care centers and schools and the pediatricians of Primary Care. It must be determined whether the child is at biological risk, and whether a developmental disorder or neurological problem exists.
Three options are considered:
Normal or probable developmental delay; possibility of hyperstimulation.
Pathological psychomotor delay, which can be global or from specific areas: motor, cognitive, social or isolated from language.
Doubtful. In some cases the evolution in successive consultations allows to clarify the question. The diagnosis is oriented, and often established exclusively, through the clinical history and exploration. Family, obstetric and perinatal history, psychomotor development, physical examination, and social contact and behavior of the child are assessed. Analysis of these data guides the conduct of follow-up examinations, where necessary. It should be noted that most of the data obtained from the anamnesis and examination and most of the complementary examinations are subject to appropriate interpretation, and therefore ultimately depend on the expertise of the clinician in charge. Often the evolution allows the diagnosis to be made more precise.