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Facts about DEVELOPMENTAL delay

What is a Developmental Delay?

Child development refers to the physiological and cognitive changes that occur during infancy and adolescence. Throughout typical development, children acquire physical, social, and cognitive skills within predictable time periods. Developmental delays occur when a child does not reach these defined developmental milestones by the expected age. Developmental delays are seen in one or more skill areas. When a delay is present in one of these skill areas it is likely to influence development in other areas as well.

• Communication skills – babbling, saying simple words, repeating, understanding

• Gross and fine motor skills – rolling over, crawling, pulling to stand, walking, picking up objects

• Adaptive skills – feeding, dressing, toileting

• Social and Emotional skills– interacting with others, sharing

• Cognitive skills– naming pictures, following simple directions, developing appropriate play skills

At well child exams pediatricians assess children’s progress in all 5 areas of development. The doctor can detect clues to potential problems during the medical examination and through a discussion with parents on the child’s abilities and routines. Parents are often the first to detect early signs of developmental delay. Understanding age-based developmental milestones helps parents monitor their child’s progress and identify potential areas of concern. By working with their pediatricians, parents can ensure that their children are diagnosed as early as possible. If you feel your child might have a developmental delay, discuss these concerns with your pediatrician. Together you can review the child’s developmental progress and evaluate the need for additional assessments.

Risk Factors

Risk factors for developmental delays can be both genetic and environmental. Children with genetic abnormalities such as Down Syndrome and Fragile X syndrome have developmental delays associated with their conditions. Development can also be influenced by a number of environmental factors. (1)

• Exposure to harmful agents either before or after birth

• Poor nutrition of mother during pregnancy

• Exposure to toxins (lead or drugs) in utero

• Infection passed from the mother to baby during pregnancy (measles, HIV)

• Premature birth

• Severe poverty

• Poor nutrition

• Neglect

Delays across all areas of development are referred to as global delays.(2) Global delays are characterized by lower than normal cognitive functioning and significant challenges in communication, social skills, self-care, and academics. A number of conditions can put a child at risk for global delays.

• Prematurity

• Cerebral malformations

• Chromosomal disorders

• Infections

• Metabolic disorders

• Hypothyroidism

• Hydrocephalus

• Rhett Syndrome

The risk factors of developmental delay have a cumulative impact. As the number of risk factors increases, a child is put at greater risk for developmental delay. However, a developmental delay is not necessarily a lifelong condition. Appropriate interventions and treatment can diminish or sometimes eliminate the delay entirely.

Supporting the Child’s Success

A developmental evaluation, an in-depth examination to asses the child’s skills, can identify and measure developmental delays. The evaluation is used to create a profile of the child’s strengths and weaknesses in all developmental areas. The results of the evaluation will help identify important components of the child’s treatment program. Physicians, therapists, teachers, and parents can work together to develop an appropriate, consistent intervention plan that meets the unique needs of the child.

The treatment plan for a child with developmental delays will target the skill areas of concern while highlighting the child’s strengths and interests. Therapy sessions are often prescribed to develop speech, gross motor movements, and fine motor skills. Parents should take an active role in their child’s treatment program. This involves not only disclosing important information to professionals, but also contributing to the therapy goals. Young children are unlikely to retain skills only presented during short, periodic therapy sessions. Therefore, parents and caregivers must learn how to integrate therapy into everyday life and support the child’s progress between formal therapy sessions. An integrated therapy model in the educational setting allows professionals to provide services to the child within the classroom by consulting with teachers on activities that will continuously support the child’s developmental progress. Ideally, parents, medical professionals, child care providers, and educators all contribute to the child’s success by incorporating activities that promote skills development.(3)

Next Steps

Once a child has been diagnosed with a developmental delay, the process of improving those skills can begin. The period after a diagnosis should be a time of learning. Parents can access resources on the various forms of developmental delay and their related treatment options. It may take time to see improvement in the child’s abilities, so parents must be patient and consistent as they support their child.

Families may wish to consult with a counselor to address the issues that can arise within the family dynamic when a child has a developmental delay. As the child gets older, a psychologist may be able to help the child cope with the diagnosis as well.

Additional Developmental Delay resources:

Developmental Delay Handouts (English/Español)