Developmental delays are relatively common. In fact, of the nearly 4 million babies born every year, 20% will have some form of developmental delay condition.
As a parent, this statistic may sound scary and overwhelming. But don’t panic–most delays are not severe and there are many ways that you can help your child reach their full potential.
This article will briefly explain how children develop, address the types of developmental delays, and provide tips on how to help your child thrive in their own developmental journey.
In this article:
How do we measure child development?
Developmental milestones
Developmental milestones are tasks or skills that most children can do by a certain age. Generally, children achieve developmental milestones in a set pattern: for example, they crawl, then stand, then walk.
Monitoring milestones is a way of tracking a child's development and making sure that they are progressing neurotypically.
The four developmental domains
Pathfinder Health divides child milestones into four major developmental domains:
(1) motor/movement,
(2) social and emotional,
(3) speech and language,
(4) cognitive.
Each one of these areas is equally important in helping your child reach full developmental maturity.
Motor
Motor milestones involve the growth and changes in a child’s body, including physical abilities, coordination, and balance. Gross motor skills involve the large muscles in the body, such as those in the arms, legs, and torso. Fine motor skills involve the small muscles in the hands and fingers as well as those in the mouth, tongue, and jaw.
Speech and language
Speech and language development is the process of building communication skills, both verbal and non-verbal (gestures and facial expressions). It includes acquiring vocabulary (both understanding and using words), learning how to put words together to make sentences, and comprehending others’ communication.
Social and emotional
Social and emotional milestones reflect your child's developing interactions and relationships with others, especially their relationship with you, which provides the foundation of social and emotional development. These milestones also include awareness and understanding of themselves and their own emotions.
Cognitive
Cognitive development involves the way a child thinks, learns, and solves problems. It includes skills such as reasoning, understanding cause and effect, thinking abstractly, and engaging in make-believe play.
Developmental screening
Developmental screening refers to a formal assessment of the milestones that your child has achieved at a very specific point in time, which provides important insights into how they are developing, where they might need additional help, and what might come next.
The American Academy of Pediatrics (AAP) recommends every child receive developmental and behavioral screening at 9, 18, and 30 months and autism screening at 18 and 24 months. The AAP has approved three different screening tools for regular development screenings:
The Ages and Stages Questionnaire Version 3 (“ASQ-3”)
The Survey of Well-being of Young Children ("SWYC")
The Parents' Evaluation of Developmental Status (“PEDS”)
You can read more about the different formats and pluses and minuses of these screening tools in Pathfinder's article ASQ-3 vs. SWYC vs. PEDS: Which Screening Tool is Best?
What are developmental delays?
What is the difference between a developmental red flag, delay, and disability?
For some of the most significant developmental milestones, failure to achieve the milestone by a certain age range constitutes a "red flag," meaning it may indicate a developmental delay and warrants further evaluation.
Note that there is a difference between a developmental delay and simply being late to achieve a milestone.
For all milestones, there is an age range where the majority of children will achieve the milestone, so being at the later end of the range is not a red flag in itself.
For example, most children walk between 12 and 15 months, so not walking at 15 months is not a red flag. However, by 18 months nearly all late walkers will have taken their first steps if there is no underlying developmental delay.
It is likewise important to understand the difference between developmental delays and true developmental disabilities:
A developmental delay simply means that a child has not achieved certain developmental milestones by the expected age. Many delays are only temporary and may not require any treatment--the child simply outgrows it. However, a child who has an ongoing delay or delays in multiple developmental areas may need treatment to help them reach their best developmental outcome.
A developmental disability is a long-term, chronic mental or physical condition with a specific diagnosis that requires treatments, therapies, and/or accommodations. Developmental disabilities include:
Autism
Down syndrome
Dyslexia
Cerebral palsy
Intellectual disability
For the purposes of this article, we will be focusing on developmental delays. Just keep in mind that a developmental delay may or may not be the first sign of a larger developmental disability.
Types of developmental delay
Developmental delays are categorized based on the four developmental domains described above:
Motor delays
Motor delays can affect a child’s gross or fine motor skills.
Gross motor delays might cause a baby to struggle with holding up their head, rolling, or crawling or interfere with an older child’s ability to walk, climb stairs, or throw a ball.
Fine motor delays can affect finger muscles and can lead to difficulty grasping small objects, using a spoon, or writing. They can also affect the small muscles in the mouth, tongue, and jaw and interfere with the physical actions of speech.
Motor delays also affect a child’s ability to process sensory information and can manifest in a child’s inability to track an object with both eyes or respond to loud sounds.
Speech and language delays
Speech and language delays can affect a child’s ability to both communicate with and understand other people.
A child with a language delay might have trouble with receptive language–understanding words and concepts. Or they might struggle with expressive language–the ability to communicate their thoughts.
A child with a speech delay might have trouble articulating words and being understood by others.
Social and emotional delays
Social and emotional delays affect how a child interacts with other people and interprets others’ emotions. They might have trouble reading social cues, maintaining conversations, or dealing with change or frustration.
Social and emotional delays can make it difficult for a child to regulate their own emotions, so they might have extended tantrums when faced with a socially or emotionally demanding situation.
Signs of social and emotional delays also include indifference to other people and failure to point or return gestures such as waves and smiles.
Cognitive delays
Cognitive delays are delays in a child's ability to think, learn, and remember. They can affect a child's ability to communicate, understand social norms, follow simple instructions, and solve problems.
In its more severe form, cognitive delay is referred to as intellectual disability.
A cognitive delay might manifest as a delay in any other developmental category. For example, late crawling, trouble speaking, and weak listening skills can all be signs of cognitive delay.
Other signs include a lack of age-appropriate self-help skills, such as using the toilet, and difficulty paying attention and sitting still.
Global delays
“Global delay” is used in reference to children under age five to describe a significant delay in two or more of the developmental domains discussed above or activities of daily living (using the toilet, eating, getting dressed, etc).
In approximately 62% of children with global delay, the cause of the delay is unknown. Because it refers to delays in multiple areas of functioning, global delay does not have its own specific set of symptoms.
Causes of developmental delay and disability
There are many potential causes of developmental delay and disability. These causes include, but are not limited to:
Premature birth and/or low birthweight
Maternal infections, such as chickenpox and rubella, or exposure to toxins during pregnancy
Genetic conditions, such as Down syndrome, fragile X syndrome, cerebral palsy, and muscular dystrophy
Maternal drug or alcohol use during pregnancy
Oxygen deprivation at birth
Nutritional deficiencies
Certain childhood diseases, such as whooping cough and meningitis, if untreated
Exposure to environmental toxins, such as lead and mercury
Physical abuse or neglect
It is important to remember that these are factors that may cause a developmental delay in some children. They do not always result in delays.
Medical professionals continue to research the impact of other potential factors, such as food allergies, on child development.
There are many other childhood health concerns that do not, on their own, cause developmental delays but can contribute to delays if they are left untreated. These include, but are not limited to:
Lack of sleep, although sleep disorders may be a symptom of a developmental delay condition
Be sure to consult with your healthcare provider if your child experiences any of these concerns.
How can parents support their children's development?
Early identification optimizes child outcomes
The first 5 years after your child’s birth are particularly crucial to their health, well-being, and the overall trajectory of their life.
In fact, 90% of your child's brain develops by age five. This is the time when the foundations for future learning, health, and behavior are established.
Because a child's brain grows so much during the first five years, this is the time when it has the highest neuroplasticity (the brain’s ability to essentially "rewire" itself to function in a different way). This flexibility means that treatment has the greatest impact during the early years, especially birth to age three.
While developmental delays may sound scary, it's important to remember that early identification and proper support provide many benefits for infants and toddlers with developmental delays or disabilities and can even change your child's developmental path.
Early intervention services can help your young child learn the skills they need to be successful in school and life, reducing the need for more costly special education and related services later on. The key is to identify concerns at the earliest possible age.
Services available to young children and their families
There are numerous publicly-funded and private resources, services, and support programs available to babies and young children with developmental delays and disabilities, as well as their families.
These include:
- Occupational therapy. Helps children with fine motor skills, sensory processing, and self-care skills
- Physical therapy. Helps children with gross motor skills such as crawling, walking, and jumping
- Speech and language therapy. Helps children with speech production and language development, including addressing hearing impairment and weak mouth or tongue muscles
- Behavioral therapy. Helps children learn socially appropriate behaviors
- Applied behavior analysis ("ABA"). Designed for children with autism spectrum disorder; helps develop communication, self-help, and social skills, among others
If your healthcare provider detects a concern, they can refer you to the appropriate type of specialist or services.
Additionally, parents can self-refer to Early Intervention Services (EIS), free programs provided by the states. A doctor's referral is not required for EIS. You can even seek EIS before your child receives a diagnosis--it is available to any child with a certain degree of developmental delay, as defined by the particular state.
You can find more information and links to EIS on the Pathfinder Health app or the CDC website.
Keeping delays in perspective
Most importantly, remember that if your child does receive a diagnosis of developmental delay or disability, they are still the same child.
A diagnosis simply puts a name on the challenges that they are already experiencing and can provide the means of accessing the best possible treatment and services for both your child and your family.
However, sometimes there is no precise diagnosis, and this is also okay. Nearly 25% of the US population has an IQ of 90 or less, which is categorized as low average or borderline intelligence.
People in this 25% generally function well and hold jobs, they just might have to work a bit harder than other people. In fact, most of them are never flagged as being developmentally delayed, simply a “slow reader” or “bad at math.”
This statistic is not intended to cause alarm. Rather, it shows that “delay” or “disability” is just a label. Instead of viewing development in a binary way–”delayed” or “not delayed”–we should understand that there is a spectrum of neurodiversity, with every person having their own natural skills and challenges.
So how can you help your child?
Screening and early intervention are vital to ensuring that they reach their full developmental potential. But sometimes parental advocacy isn’t the complete answer.
Even when a child has reached their full potential, that potential won’t always be a varsity athlete or academic star, regardless of the amount of intervention that they receive. Instead, parents must remember that every child has their own strengths and weaknesses.
Once they have addressed their child's weaknesses as much as they can, parents should focus on encouraging their natural strengths, whether that's artistic talent or the ability to make friends. This helps to build a child’s confidence, which in turn helps them be more resilient in the face of life’s challenges.
How Pathfinder Health can help
As a parent, you have an essential role to play in your child's development. Don't worry, you don't need to hover over them to spot every single milestone--developmental monitoring does not have to feel obsessive or anxiety-provoking.
By regularly using the Pathfinder Health app, you can feel reassured that you are keeping track of the developmental milestones that you do observe--when they happen, how frequently they occur, and what else to look for.
Moreover, by uploading brief videos of your child several times a month, you can harness all of the developmental knowledge of Pathfinder Health's smart detection to help you detect more subtle developmental milestones that you might not notice otherwise.
But most importantly, Pathfinder Health can help you feel the peace of mind that comes from knowing you are doing everything you can. Sometimes, even with doing “everything you can” and accessing early intervention, your child may still be behind in one or more areas.
We understand that it’s difficult to live with this type of uncertainty. We all want answers and specific guidance on what we can do to help our children. But sometimes, all we can do is embrace their strengths and love them for who they are.
And Pathfinder Health can help here too. We offer simple activities that you can do with your child to continue to encourage their overall development without pushing them too hard in challenging areas and undermining their self-confidence.
Most importantly, these activities help you spend quality time with your child and strengthen your bond.
The Takeaway
If your child is diagnosed with a developmental delay, don’t despair–there are many resources available that can help them catch up on their milestones.
Timely and appropriate access to these services can make a big difference in your child's life and in some cases even help them catch up with their peers.
And even if they are diagnosed with a developmental delay or disability, there are many treatments and therapies that can make a big difference in your child's life and help them reach their fullest potential.
To learn more about how you can fully support your child's development, visit Pathfinder Health. We offer guidance and tools to empower you to help and encourage them at every step!
Sources:
1. Centers for Disease Control and Prevention, Causes and Risk Factors of Cerebral Palsy, available at https://www.cdc.gov/ncbddd/cp/causes.html
2. Choo YY, Agarwal P, How CH. Developmental delay: identification and management at primary care level. Singapore Med J. 2019 Mar; 60(3): 119–123.
3. Habibullah H, Albradie R, Bashir S. Identifying pattern in global developmental delay children: A retrospective study at King Fahad specialist hospital, Dammam (Saudi Arabia). Pediatr Rep. 2019 Dec 2; 11(4): 8251.
4. Zablotsky B, Black LI, Maenner MJ, Schieve LA, Danielson ML, Bitsko RH, Blumberg SJ, Kogan MD, Boyle CA. Prevalence and Trends of Developmental Disabilities among Children in the US: 2009–2017. Pediatrics. 2019; 144(4):e20190811.
