Version June 2024
| Feature | Clinical implications |
| General observations and appearance | |
| Sadness, anxiety, attention span, impulsivity, activity | Indicators of emotional or behavioral problems that may affect learning |
| Ability to communicate and respond to instructions | Measure of language skills other than phonologic processing |
| Stigmata of genetic syndromes (eg, Klinefelter, Turner, fragile X) | Klinefelter syndrome: Tall stature, small testes Turner syndrome: Short stature, webbed neck, micrognathia, short metacarpals, nail dysplasia widely spaced nipples Fragile X syndrome: Narrow face, large jaw, long, prominent ears, large testes (after puberty) |
| Growth parameters | |
| Head circumference | Head circumference <10th percentile may suggest fetal alcohol syndrome |
| Height and weight | Height and weight <10th percentile may suggest fetal alcohol syndrome; short stature is a feature of Turner syndrome; tall stature is a feature of Klinefelter syndrome |
| Skin | |
| Café-au-lait spots, ash leaf spots, adenoma sebaceum | Signs of neurocutaneous disorders associated with learning problems (eg, neurofibromatosis, tuberous sclerosis) |
| Tympanic membranes | |
| Signs of recurrent or chronic otitis media | May be associated with hearing impairment |
| Genitalia | |
| Delayed sexual maturation | May be associated with Turner syndrome, Klinefelter syndrome |
| Small testes | Suggestive of Klinefelter syndrome |
| Large testes (after puberty) | Suggestive of fragile X syndrome |
| Sensory screening | |
| Hearing assessment | Hearing impairment may affect learning |
| Vision assessment | Vision impairment may affect learning |
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