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Suggested Teaching Approaches for
                 Developmental 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
                                                  National Guideline Clearinghouse: Practice parameter: Evaluation of the child with global developmental delay
                                          Discussion leader:
                                          UpToDate: Evaluation of Mental Retardation


Revised 3/31/2006                                                                                                                                Page 1 of 4
Susie Ball, MS
Central Washington Genetics Program
Suggested Teaching Approaches for
                 Developmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism

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 4
Susie Ball, MS
Central Washington Genetics Program
Suggested Teaching Approaches for
                 Developmental 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),
                                                www.aafp.org/x39858.xml
                                               UpToDate: Evaluation of the Child with Mental Retardation



Revised 3/31/2006                                                                                                                                Page 3 of 4
Susie Ball, MS
Central Washington Genetics Program
Suggested Teaching Approaches for
                 Developmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism

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 4
Susie Ball, MS
Central Washington Genetics Program

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Suggested Teaching Approaches For Dd

  • 1. Suggested Teaching Approaches for Developmental 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  National Guideline Clearinghouse: Practice parameter: Evaluation of the child with global developmental delay Discussion leader: UpToDate: Evaluation of Mental Retardation Revised 3/31/2006 Page 1 of 4 Susie Ball, MS Central Washington Genetics Program
  • 2. Suggested Teaching Approaches for Developmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism 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 4 Susie Ball, MS Central Washington Genetics Program
  • 3. Suggested Teaching Approaches for Developmental 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), www.aafp.org/x39858.xml  UpToDate: Evaluation of the Child with Mental Retardation Revised 3/31/2006 Page 3 of 4 Susie Ball, MS Central Washington Genetics Program
  • 4. Suggested Teaching Approaches for Developmental Delay / Mental Retardation / Pervasive Developmental Disorder / Autism 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 4 Susie Ball, MS Central Washington Genetics Program