“He hasn’t rolled over yet?”
“Aren’t kids usually talking by now?”
People may not mean to be insensitive when they ask questions like these. But it can be upsetting to see other kids passing milestones before your child does.
Not meeting these types of milestones may or may not be a sign that your child has a developmental delay. If it turns out he does have a delay, however, getting supports and services early may help him catch up more quickly. What follows may help you figure out whether it’s time for early intervention.
Basics About Developmental Delays
Kids don’t develop skills on a strict timetable. For example, some babies start walking as young as 9 months, while others don’t take their first steps until 15 months. Both of those babies are within the range of typical development.
Short-lived delays usually aren’t cause for concern. Kids catch up on their own. But a developmental delay is more than just being “slower to develop” or “a little behind.” It means your child is continually behind doing things other kids his age can.
For example, a baby who isn’t rolling over by 4 months may be just a little behind. But if he also isn’t able to hold his head up and push up when lying on his tummy, he’s a lot behind. That’s a sign of a developmental delay in motor skills. (If you’re noticing this in your child, there are many ways to help.)
The Difference Between a Developmental Delay and Developmental Disability
A developmental delay is not the same as a developmental disability. Doctors sometimes use those terms to mean the same thing, but they are very different.
Developmental disabilities: These are physical or mental issues, and kids don’t outgrow them. They create problems with learning and self-care. They aren’t learning disabilities. Conditions that can cause developmental disabilities include Down syndrome, Angelman syndrome, autism and brain injuries.
Developmental delays: These are not caused by lifelong physical and mental conditions. They may be signs of learning and attention issues, however. Early intervention can often help kids catch up. Some kids still have delays in skills when they reach school age. In that case they may be eligible to receive special education services.
If a child isn’t catching up as quickly as expected, a specialist may suggest doing an evaluation. An evaluation could pinpoint the source of the problem. It could also show what services and supports would meet his needs.
Areas of Skill Development and Possible Delay
A developmental delay can occur in just one area or in a few. A global developmental delay is when kids have delays in at least two areas.
Kids develop skills in five main areas of development:
- Cognitive (or thinking) skills: This is the ability to think, learn and solve problems. In babies, this looks like curiosity. It’s how your child explores the world around him with his eyes, ears and hands. In toddlers, it also includes things like learning to count, naming colors and learning new words.
- Social and emotional skills: This is the ability to relate to other people. That includes being able to express and control emotions. In babies, it means smiling at others and making sounds to communicate. In toddlers and preschoolers, it means being able to ask for help, show and express feelings and get along with others.
- Speech and language skills: This is the ability to use and understand language. For babies, this includes cooing and babbling. In older kids, it includes understanding what’s said and using words correctly and in ways that others can understand.
- Fine and gross motor skills: This is the ability to use small muscles (fine motor), particularly in the hands, and large muscles (gross motor) in the body. Babies use fine motor skills to grasp objects. Toddlers and preschoolers use them to do things like hold utensils, work with objects and draw. Babies use gross motor skills to sit up, roll over and begin to walk. Older children use them to do things like jump, run and climb stairs.
- Activities of daily living: This is the ability to handle everyday tasks. For children, that includes feeding, dressing and bathing themselves.
There is no one cause of developmental delays. Certain genetic conditions (such as Down syndrome or a cleft palate) cause delays. Other risk factors can also contribute:
- Complications at birth: Being born too early (prematurely) or with low birth weight or not getting enough oxygen at birth.
- Environmental issues: Lead poisoning, being exposed to alcohol or drugs before birth, poor nutrition and poverty.
- Other medical conditions: Chronic ear infections, for example, which can cause delays in speech and language development.
Sometimes parents worry that they might have contributed to their child’s delays. That’s usually not the case. For example, teaching a child more than one language does not lead to speech or language problems. Rather than worrying about causes of delays, it’s better to focus on next steps and ways to help.
The Link Between Developmental Delays and Learning and Attention Issues
In young kids, delays can be the first sign of learning and attention issues. For example, speech and language delays may point to a learning issue or a communication disorder.
It’s not always easy to make the link between delays and learning and attention issues until kids start school. That’s when teachers can see how kids do in areas like math, reading and spelling. They can also see how well kids focus in class.
The school can also do formal testing to find out more about trouble areas. The tests show how kids’ skills compare to those of their peers. They also show how kids think and solve problems. These are typically known as intelligence tests. They measure a child’s ability to learn—not what he already knows. Professionals use the results to help determine whether the child has a learning or attention issue.
Are you concerned about your child’s development? If so, speak with your child’s doctor. The doctor will refer your child to the early intervention agency in your state. Someone will screen your child’s skills. You’ll also learn about your options for further evaluation and help for your child. The earlier you put strategies in place to help your child build skills, the better.