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It was a pleasure to see Ella Chan (age 3 years 9 months) for followup in Developmental Clinic on January 9, 2014. She was accompanied to clinic today by her mother and her grandmother. Ella was last seen in November 2013, at which time she was diagnosed with global developmental delay. She has a preexisting seizure disorder which is well controlled on Depakote. She has underlying motor planning issues which affect her growth and fine motor movements and also affect her ability to plan out her oral movements necessary for expressive speech. She has delays in these areas as well. Her receptive speech is within normal limits. At the time of the initial assessment I had recommended that Ella’s hearing and vision be checked and that she continue with her speech therapy and her involvement in education and community programs. In the interim, medically, Ella has been well. She has remained seizure free (since March 2013) and is maintained on Depakote twice daily. She is followed by Dr. Langburt. Per her mother, Ms. Kim, Ella is to have a repeat EEG towards the summer of 2014. She continues to follow in Feeding Clinic and while she prefers fried foods, she will eat foods in different preparations that are healthier and her growth has been good. She is sleeping through the night. Ms. Kim brought in copies of Ella’s genetic testing which confirmed that she has had a microarray as well as SNA type 1C testing, both of which were negative for any abnormalities. I discussed with Ms. Kim that at a later time or should Ella’s clinical picture change, a reevaluation by Genetics may be indicated. Ella’s vision was assessed by Dr. Kerili of the Vision Institute and was within normal limits. Followup in 1 to 1.5 years was recommended. Ella’s h... ... middle of paper ... ...daycare to provide more supports for Ella in the classroom at this time, specifically occupational therapy and speech therapy supports. I am glad that Ella is continuing to receive speech therapy directly targeting her challenges. She may benefit from more occupational therapy down the road to help with her motor planning issues. Medically, Ella will be seen at Holland Bloorview in the next few months and she continues to receive her neurology care through Dr. Langburt. I recommended that Ella should have followup in 6 to 9 months by a developmental pediatrician to ensure that she is continuing to make the gains we expect. She should be seen sooner if there are any additional developmental concerns that emerge. She may require a rereferral. It was a pleasure to see the progress that Ella has made and I think you for the opportunity to be involved in Ella’s care.

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