When young children are slower to develop physical, emotional, social and communication skills than expected, it’s called developmental delay. Skills such as taking a first step, smiling for the first time and waving “bye-bye” are called developmental milestones. Children reach milestones in playing, learning, speaking, behaving and moving (crawling, walking, etc.). A developmental delay happens when your child is slow to reach one or more of these milestones.
Developing Skills –
Child development refers to how a child becomes able to do more complex things as they get older. Development is different than growth. Growth only refers to the child getting bigger in size.
When we talk about normal development, we are talking about developing skills like:
• Gross motor skills: using large groups of muscles to sit, stand, walk, run, etc., keeping balance and changing positions
• Fine motor skills: using hands to be able to eat, draw, dress, play, write, and do many other things
• Language skills: speaking, using body language and gestures, communicating, and understanding what others say
• Cognitive skills: thinking skills including learning, understanding, problem-solving, reasoning, and remembering
• Social skills: interacting with others, having relationships with family, friends, and teachers, cooperating and responding to the feelings of others.
Signs of developmental delay –
Every child develops differently, and there’s a big range of ‘normal’ in children’s development.
But as a general guide, you might be concerned about developmental delay if you notice that, over several months, your child isn’t developing motor, social or language skills at the same rate as other children the same age.
Babies are considered as developmentally delayed in gross motor domain if
• No Neck / Head control by 6 Months
• No independent Sitting by 8 Months
• No get to sitting by 10 Months
• No crawling / bottom shuffling by 12 months
• No independent walking by 18 months
Babies are considered as developmentally delayed in fine motor domain if
• Does not bring fingers to the mouth by 6 Months
• Does not move an object from one hand to other by 8 Months
• Does not pick up a small object with three fingers by 10 Months
• Does not pick an object using two fingers and thumb by 14 Months
• Does not put an object inside a cup by 15 Months
Babies are considered as developmentally delayed in speech and communication if
• There is no babbling by the age of 15 months
• There is no single word speaking by the age of 2 years
• The child is unable to speak in short sentences by the age of 3 years
• There is presence of poor pronunciation or articulation
• There is having difficulty putting words together in a sentence
Babies are considered as developmentally delayed in cognition / mental capacity if
• Slow to learn things like feeding , dressing / undressing, Toilet / potty training, etc
• Talking late or having trouble with talking
• Inability to connect actions with consequences
• Difficulty remembering things
• Difficulty with problem-solving or logical thinking
Babies are considered as developmentally delayed in social development if
• A baby doesn’t enjoy playing with caregivers and communicate with face and body by the age of 3 months or so
• A baby doesn’t respond to his or her name at the age of 7 months or so
• A baby does not differentiate stranger and known people by the age of 12 months or so
• A child does not imitate the behavior of others by the age of 2 years or so
• A child does not start to enjoy the company of other children and look forward to playing with them by the age of 2 years or more.
Causes of developmental delay –
There’s no one cause of developmental delays, but there are some risk factors. They include:
• Complications at birth: Being born prematurely; low birth weight; not getting enough oxygen at birth
• Environmental issues: Lead poisoning; poor nutrition; exposure to alcohol or drugs before birth; trauma
• Other medical conditions: Chronic ear infections; vision problems; illnesses, conditions, or injuries that have a significant and long-term effect on kids’ day-to-day activities
• Genetic factors : Children are at risk of acquiring developmental delay if they are born with a genetic or chromosomal abnormality such as Down’s Syndrome. This abnormal development may occur in the womb while the baby is still growing.
Developmental delay is generally diagnosed by an experienced pediatrician, developmental pediatrician and child developmental specialist based on strict developmental guidelines. Generally, parents / grandparents / relatives are the first who notice the delay. Unfortunately, the developmental delay is commonly considered as weakness of the body which is always not true.
Management/ Treatment –
While managing or treating the developmental delays, it is important to differentiate it from developmental deviation (Dissociated Development) and developmental regression (Loss of achieved milestones).
• Deviated development requires scientific parenting only as some degree of deviation corrects naturally.
• On the other hand, regression of milestones requires lot of investigations to know the exact cause of milestones loss. Lots of neuromuscular or neurodegenerative disorders have the phenomenons of developmental regression.
▪︎ In case of gross motor and fine motor delay, physical therapy in the form of play therapy, developmental therapy, physiotherapy and occupational therapy is immensely helpful.
▪︎ In case of cognition and communication delay, along with physical therapy, special education and speech therapy should be incorporated
▪︎ In case of global developmental delay, an early intervention program is highly recommended. Children with Sensory processing disorders, Developmental coordination disorders, Autism spectrum disorders, Auditory processing disorders require a different management or treatment plan.
There is no single medicine available which can cure or manage the developmental delay. Mostly medicines are prescribed to enhance immunity and general health. Nutritional support is an essential part of the management plan. Due to feeding disorder, a lot of children with developmental delay can be malnourished.
Always remember, developmental delays are symptoms, not the diagnosis. Diagnosis should be made along with therapeutic interventions to have a clear picture about the developmental profile, right treatment approaches, and outcome of the interventions. Don’t delay the interventions to get the diagnosis done. Wait and watch policy is not applicable to children with delayed milestones. It may be dangerous and harmful.
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