2.5yrs old , male pt , FT no NICU admission , no hospital admission , presented with global development delay . on exam pt has coarse facial feature , no anthropometric measures , pt is developentally delayed just sit with support , no single word , interact only with mother , bow leg , no +ve finding by systemic exam .
recommendation : 1. anthropometric measures 
2. bone age and skeletal survey 
3. slit lamb and fundus exam
3. basic lab include CBC , S ca ph ALP , LFT , S cr , Vit D2 l;evel , TFT 
4. metabolic screen ?? MPS 
fallow up with our endocrine and genetic OPC