According to the Centers for Disease Control and Prevention, about one in six children in the United States has one or another kind of developmental delay or developmental disability.
The identification and treatment of children with learning or developmental impairments is of great concern to parents as well as caregivers. Developmental disabilities encompass a broad range of conditions that result from cognitive (brain) and physical impairments.
- They are identified in early childhood and usually last throughout a person’s lifetime.
- These disabilities include intellectual disabilities, physical disabilities, language and learning disorders, vision impairment and hearing.
- Delays in these areas might be observed by parents at home, physicians during routine wellness checks or preschool teachers when monitoring play and learning activities.
Since a developmental delay can affect the further acquisition of appropriate skills in one or more areas, it is important to recognize possible delays, determine their causes and address them quickly.
Physical signs of possible developmental delay if the baby
- Doesn’t use or move their legs and arms.
- Seems to have trouble seeing or hearing things.
- Can’t hold their head up by the time they are three to four months old.
- Isn’t sitting well by 10 months of age.
- Doesn’t want to stand up, even when supported, by 12 months of age.
Behavioral signs of possible developmental delay if the baby
- Has an unusual cry, for example, a high-pitched squeal.
- Cries for more than three hours a day, especially after three to four months of age.
Social, emotional and communication signs of possible developmental delay if the baby
- Doesn’t seem to be interested in what’s happening around them.
- Doesn’t make eye contact.
- Doesn’t consistently respond to sounds.
- Isn’t babbling by nine months of age.
- Is using fewer than five words at 18 months of age.
If a delay is suspected, a full developmental assessment will be suggested. Developmental screenings can take place in a physician's office. The developmental evaluation should be conducted by a highly trained professional who can use the results to create a profile of the child's strengths and weaknesses across the range of five developmental areas.
- Physical development (fine motor skills, gross motor skills)
- Cognitive development (intellectual abilities)
- Communication development (speech and language)
- Social or emotional development (social skills, emotional control)
- Adaptive development (self-care skills)
Investigations conducted at the clinic for the diagnosis of developmental delays are
- Taking note of the child’s detailed history, head-to-toe examination and weight and height plotted in a graph.
- The head circumference (occipitofrontal circumference) to assess brain growth.
- Hearing assessment if there are concerns about hearing (such as poor response to name when called) by a trained audiologist. Various hearing tests and brain stem audiometry may be conducted.
- Vision assessment of the child who has a visible cataract, is not fixing the eyes on an object and has a history of frequent bumping into objects.
- Full blood count (possible iron deficiency), bone mineral profile and vitamin D levels (if rickets is suggested), thyroid function tests, urea levels and electrolyte levels are also measured.
- The child may be given a set of tests to perform to be assessed for self-care skills, cognitive development and speech development.
The results of a developmental evaluation will be used to decide if the child needs early intervention services and a treatment plan. Early intervention services are specifically tailored to meet a child's individual needs. They are especially important resources for children experiencing developmental delays. For example, early intervention services can include
- Assistive technology (devices a child might need)
- Audiology or hearing services
- Speech and language services
- Counseling and training for a family
- Medical services
- Nursing services
- Nutrition services
- Occupational therapy
- Physical therapy
- Psychological services
What are the causes of developmental delay in children?
Every child develops differently. Some may be quick to talk, but slow to walk. Some may enjoy interacting with their peers in a rough and tumble fashion, whereas others may seek out more solitary activities. Children exhibit developmental issues for a variety of reasons, including
- Genetics (such as Down syndrome)
- The mother engaging in poor prenatal practices (such as smoking, drugs, drinking alcohol)
- Head trauma (accidents or injuries) at birth or after birth
- Prenatal exposure by the mother to toxins (including environmental toxins) or the child’s exposure to toxins after birth
- Low birth weight
- Premature birth
- Untreated jaundice in newborns
- Infections, which are a common cause of disorders. For example, experts estimate that 25 percent of hearing loss is due to babies’ exposure to infections during pregnancy.
The child may appear to be developing as expected, but then seems to start losing certain skills. This regression could be caused by head injury. Children who have suffered head trauma, for example, may no longer speak the way they used to earlier. Sometimes, regression is a personal fight by children to take control of their environment. The child may sleep with a stuffed animal to feel secure after a death in the family, a divorce or relocation to a new home.
Developmental disabilities occur in people of all ethnicities, educational and socioeconomic backgrounds. It is estimated that more than five million Americans have developmental disabilities. Fortunately, there are many available resources locally and nationwide to help answer questions about developmental delays. Concerned caregivers who suspect a developmental delay should talk with their family pediatrician or find early childhood education programs for assessment options.
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Singapore Medical Journal: "Developmental Delay: Identification and Management at Primary Care Level." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441684/
Centers for Disease Control and Prevention: "Facts about Developmental Disabilities." https://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html