3 ytears female child born by section at term,because of non proress due to feto-pelvic disproportion.She had an apgar score of 8-9. She was kept in incubator for three ds because of LBW 1900 gms. Dicharged in good gen condition on breast milk, the baby shoud moderate floppiness.. and delay of developmental psychomotor milestones. thourough investigations including kary typing, aminoacid screaning,metabolic diseases did not show any abnormality, CBC,, WBCs,BS,liver and kidnye teast were all within normal values. I saw the child for the first time last week clinical examination ..10.5 kgs girl,with poor slugish spontaneus movement,, needs help to initiate standing and wlking,, proceedics wit assistance blood presure 100/65 mmHg ,Ht 93 cm and HC 48 cm her attitude seemed to be like autism children with poor interest with surroundin heart and lungs were within normal,abdomen soft non tender , no organomegaly the only abnormal finding was the shape of both wrists they looked like hsving lower radis fracture and a very small extra phalanx with with clear articular movement at that level to recieve a dignotic hint or suggetion I `be very thankfull and apreciate