The etiologic or diagnostic yield of the neurologic examination in 60 children referred to a pediatric neurologist for evaluation of global developmental delay was determined at the Montreal Children’s Hospital-McGill University, Quebec, Canada. Examination at a mean age of 3.58 years revealed mild delay in development in 25, moderate delay in in 23, and severe delay in 12. EEG, MRI, metabolic screens, fragile X test and karyotype established an etiologic diagnosis in 38 (63%), including cerebral dysgenesis (17%), HIE (10%), chromosomal anomalies (10%), toxins (8%), and metabolic disorders (5%). 
COMMENT. Optimal management of children with developmental delay should include a neurologic examination and selected laboratory tests. An etiologic diagnosis provides physician and family with important information regarding risks of recurrence and choice of therapeutic intervention.