Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
A delay in reaching language, thinking, social, or motor skills’ milestones is called developmental delay. It can be caused by things like heredity, pregnancy complications, or premature birth. The cause isn’t always known.
Children reach developmental milestones at their own pace, and some move faster than others. Two siblings in the same family may reach milestones at different rates.
Minor temporary delays are usually no cause for alarm, but an ongoing delay or multiple delays in reaching milestones can be a sign there may be challenges later in life.
If parents or guardians suspect a child has a developmental delay, they should speak with their paediatrician. Developmental delay sometimes indicates an underlying condition that only doctors can diagnose.
Once a diagnosis is made, a plan for therapies or other early interventions is made to help the child progress and develop into adulthood.
CAUSES AND CHANCES OF DEVELOPMENTAL DELAY
According to the Centers for Disease Control and Prevention, about 17 percent of children between the ages of 3 and 17 have one or more developmental disabilities.
Most developmental disabilities occur before a child is born, but some can occur after birth, due to infection, injury, or other factors.
The causes of developmental delay can be difficult to pinpoint, and a variety of things can contribute to it. Some conditions are genetic in origin, such as Down syndrome.
Infection or other complications during pregnancy and childbirth, as well as premature birth, can also cause developmental delay.
Developmental delay can also be a symptom of other underlying medical conditions, including:
* Autism spectrum disorders (ASDs)
* Cerebral palsy
* Foetal alcohol spectrum disorders
* Landau Kleffner syndrome
* Myopathies, including muscular dystrophies.
* Genetic disorders, such as Down syndrome and Fragile X syndrome
Remember that children develop at different rates, so it’s possible that what is thought of as a delay might be normal for a child. However, if concerned, it is important to get the child evaluated by professionals.
FINE AND GROSS MOTOR SKILL DELAY
Fine motor skills include small movements, like holding a toy or using a crayon. Gross motor skills require larger movements, like jumping, climbing stairs, or throwing a ball. Children progress at different rates, but most children can lift their heads by 3 months old, sit with some support by 6 months old, and walk well before their second birthday.
By age 5, most children can stand on one foot for 10 seconds or longer, and can use a fork and spoon.
Exhibiting some of the following signs can mean that your child has delays in developing certain fine or gross motor functions:
* Floppy or loose trunk and limbs
* Stiff arms and legs
* Limited movement in arms and legs
* Inability to sit without support by 9 months old.
* Dominance of involuntary reflexes over voluntary movements
* Inability to bear weight on legs and stand up by about 1-year-old.
* Falling outside the normal range isn’t always cause for concern, but it’s worth getting a child evaluated.
SPEECH AND LANGUAGE DELAY
According to the National Institute on Deafness and Other Communication Disorders, the most active time for learning speech and language is the first 3 years of life, as the brain develops and matures. The language learning process begins when an infant communicates hunger by crying. By 6 months old, most infants can recognize the sounds of basic language.
At 12 to 15 months old, infants should be able to say two or three simple words, even if they aren’t clear.
Most toddlers can say several words by the time they are 18 months old. When they reach the age of 3, most children can speak in brief sentences.
Speech and language delays aren’t the same. Speaking requires the muscle coordination of the vocal tract, tongue, lips, and jaw to make sounds. A speech delay occurs when children aren’t saying as many words as would be expected for their age. A language delay occurs when children have difficulty understanding what other people say, or can’t express their own thoughts. Language includes speaking, gesturing, signing, and writing.
It can be hard to distinguish between speech and language delays in young children. A child who understands things and can express their needs (maybe by pointing or signing), but isn’t speaking as many words as they should, have an isolated speech delay.
Poor hearing can cause speech and language delay, so your doctor will usually include a hearing test during diagnosis. Children with speech and language delays are often referred to as speech-language pathologists.
Early intervention can be a big help.
AUTISM SPECTRUM DISORDER
Autism spectrum disorder (ASD) is a term used to describe several neurodevelopmental conditions. Autistic people may think, move, communicate, and process their senses differently from neurotypical people.
Autism is usually diagnosed in early childhood, and includes a noticeable delay in language and social development.
A pediatrician will ask about the child’s development at each of their well visits. In fact, the American Academy of Pediatrics recommends that all children be screened for symptoms of autism at 18 and 24 months using standardized screening tools.
Symptoms are sometimes obvious early on, but may not be noticed until a child reaches 2 or 3 years of age.
Signs and symptoms of ASD vary, but usually include delayed speech and language skills, and challenges communicating and interacting with others. Every autistic person is unique, so symptoms and the way people experience them vary greatly. Some symptoms include:
* Not being responsive to their name
* Dislike cuddling or playing with others.
* Lack of facial expression
* Inability to speak or difficulty speaking, carrying on a conversation, or remembering words and sentences.
* Repetitive movements
* Development of specific routines
* Coordination problems
There is no cure for ASD, but therapies and other approaches can help give a child the extra tools to communicate, relieve stress, and, in some cases, manage daily tasks.
IMPORTANT
Please note school-age children diagnosed with developmental delay may be eligible for public assistance in Guyana.
Check with a physician and the school to assist with filling out the forms. Specialized education, especially when started early, can help a child progress, and achieve more in school.
TREATMENT
Treatments for developmental delays vary according to the specific delay. Some treatments include physical therapy for help with motor skills’ delays, and behavioural and educational therapy for help with ASD and other delays.
In some cases, medications may be prescribed. An evaluation and diagnosis from a paediatrician is crucial to coming up with a treatment plan specially designed for the child.
PROGNOSIS
Many genetic and environmental factors figure into a child’s development, and can contribute to delays. Even women who have a healthy pregnancy and proper care during and after pregnancy can have children with developmental delays.
Although causes of delays can be hard to pinpoint, there are many treatments and support services available to help.
The sooner a child can be diagnosed, the better it will be for the child’s development into adulthood.
Next Week: Growth delays in children
