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This page is informational and is not medical advice. The medications and approaches listed are examples of pediatric standards of care — your child's clinical team will choose what is right based on their full picture.

Seizures & epilepsy

Roughly 4 in 10 children with NEDBAS develop seizures.

Seizure type varies; most respond to standard pediatric anti-seizure medications. Choice of medication should be made by a pediatric neurologist based on the seizure semiology and EEG.

Levetiracetam (Keppra)
Common first-line for focal and generalized seizures in children.
Valproate
Broad-spectrum; weighed against side-effect profile in young children.
Lamotrigine
Often considered for focal epilepsy or as add-on therapy.
Vigabatrin or ACTH
Specific to infantile spasms if those occur.
Source: ILAE pediatric epilepsy guidelines
Developmental & educational supports

All children with developmental delay or intellectual disability.

Early intervention before age 3 has the strongest evidence base across neurodevelopmental conditions. School-age supports continue under IEPs in the US or EHCPs in the UK.

Speech & language therapy
Address expressive/receptive delay and feeding-related oral-motor needs.
Occupational therapy (OT)
Fine motor, sensory regulation, and activities of daily living.
Physical therapy (PT)
Gross motor milestones; especially valuable when hypotonia is present.
Special education services
Individualized plans calibrated to cognitive profile and school setting.
Source: AAP early intervention guidance
Spine & orthopaedic surveillance

Children with vertebral findings — required in SCDO7, watchful in NEDBAS.

Recessive SCDO7 carries a high risk of progressive scoliosis and fused ribs/vertebrae. Even children with NEDBAS should have spine examined as part of routine care given reported scoliosis in roughly a quarter of cases.

Annual spine examination
Pediatrician or orthopaedic specialist; earlier referral if curvature suspected.
Spine X-ray / MRI
Baseline imaging when vertebral anomalies are suspected on exam.
Bracing or surgery (when indicated)
Orthopaedic decisions follow standard scoliosis-management algorithms.
Feeding & nutrition

Infants and children with hypotonia, oral-motor difficulties, or growth concerns.

Feeding therapy and nutrition follow-up address poor weight gain, swallowing safety, and family stress around mealtimes.

Feeding therapy
Speech-language pathologist or specialist feeding clinic.
Dietitian review
Caloric and micronutrient adequacy; thickeners or fortifiers when appropriate.
G-tube placement
Reserved for severe feeding intolerance or unsafe swallow on video study.
Autism & behavioural supports

Children meeting criteria for ASD or with significant behavioural concerns.

DLL1-related ASD is supported with the same evidence-based interventions used for ASD generally — there is no DLL1-specific behavioural protocol.

Naturalistic developmental behavioural interventions (NDBIs)
ESDM, JASPER, and similar models for younger children.
Applied behaviour analysis (ABA)
Where chosen by the family; quality and goal-fit matter more than hours alone.
Sensory and communication supports
AAC devices, visual schedules, sensory accommodations.
Source: AAP autism management report
Multidisciplinary care team

Recommended for every child with a confirmed DLL1 diagnosis.

Coordinated care across specialties prevents gaps and reduces the burden on families running their own coordination.

Clinical geneticist
Confirms variant interpretation, leads recurrence-risk counselling.
Pediatric neurologist
Manages seizures, monitors development, orders imaging.
Developmental paediatrician
Coordinates therapies and educational planning.
Orthopaedic surgeon
When vertebral, rib, or scoliosis findings are present.
Care coordinator / patient navigator
Often the single most useful person for the family.
What to ask at your next appointment

A short list to bring with you.

  • 01Was the DLL1 variant in our child reported as pathogenic, likely pathogenic, or VUS?
  • 02Do we have NEDBAS, SCDO7, or a 6q27 deletion — and what does that mean for recurrence in future pregnancies?
  • 03Has a brain MRI been done, and should it be repeated?
  • 04Should we have a baseline spine X-ray?
  • 05What anti-seizure medication would you choose first if seizures begin?
  • 06Which therapies (speech, OT, PT) do you recommend starting now?
  • 07Are there research studies, registries, or natural-history programmes we could enrol in?
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