Developmental Delays: What You Need to Know

By Amanda Morin
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At a Glance

  • All kids develop skills at different rates.

  • There are five main areas of development in which kids can have delays.

  • A developmental delay is more than being “a little behind” in one area of development.

“How old was yours when she first rolled over?”

“Mine has been talking in complete sentences for months!”

Conversations about meeting milestones is common among proud parents and caregivers. It’s exciting to see your child learn new things and explore the world. As your child develops, you want to share the news with people. It’s also common to compare what your child can do to other kids—or even compare them to what your older kids did around the same age.

But it can be nerve-racking to see or hear about other kids passing milestones before your child does. You may be concerned about developmental delays, and what they mean. Here’s what you need to know.

The Five Areas of Skill Development

Not meeting developmental milestones at the same rate as other kids isn’t always a reason to worry. Not all children 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.

Kids develop skills in five main areas of development:

  1. Cognitive (or thinking) skills: This is the ability to think, learn and solve problems. It’s how kids explore the world around them with their eyes, ears, and hands. In babies, this looks like curiosity. In toddlers, it also includes things like learning to count, naming colors, and learning new words.

  2. 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.

  3. Speech and language skills: This is the ability to use and understand language. For babies, this includes cooing and babbling. In older children, it includes understanding what’s said and using words correctly and in ways others can understand.

  4. 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 kids use them to do things like jump, run, and climb stairs.

  5. Daily living activities: This is the ability to handle everyday tasks. For children, that includes eating, dressing, and bathing themselves.

Minor differences in these milestones usually aren’t cause for concern. For example, a baby who isn’t rolling over by 4 months may be just a little behind in that one skill. But babies at that age who, for example, aren’t rolling over, can’t hold their heads up, don’t push up when lying on their tummy, and aren’t babbling are behind in more than one area of development. That could be a sign of a developmental delay.

Basics About Developmental Delays

A developmental delay is more than just being “slower to develop” or “a little behind.” It means a child is continually behind in gaining the skills expected by a certain age. A developmental delay can happen in just one area or in a few. A global developmental delay is when kids have delays in at least two areas.

Many parents and caregivers worry that their child’s delays are somehow their fault. But developmental delays are typically caused by things beyond your control.

For example, teaching a child more than one language doesn’t lead to speech or language problems. But a speech delay can be caused by temporary hearing loss from multiple ear infections, which aren’t uncommon in babies and toddlers.

There’s no one cause of developmental delays, but there are some risk factors to consider. They include:

  • Complications at birth: Being born too early (prematurely); low birth weight; not getting enough oxygen at birth

  • Environmental issues: Lead poisoning; poor nutrition; exposure to alcohol or drugs before birth; difficult family situations; trauma

  • Other medical conditions: Chronic ear infections; vision problems; illnesses, conditions, or injuries that have a significant and long-term effect on a child’s day-to-day activities

If your child isn’t meeting multiple milestones as quickly as expected, your doctor may suggest doing an early intervention evaluation to get a better sense of what’s going on. The results can guide the types of services and supports that could help your child if your child needs them.

And as one mother shares, even though it can be “heartbreaking” to hear the results of an evaluation, in the end, it’s better to focus on next steps and ways to help.

Developmental Delay vs. Developmental Disability

Doctors sometimes use the terms developmental delay and developmental disability to mean the same thing. They’re not the same thing, though.

Developmental disabilities are issues that kids don’t outgrow or catch up from, though they can make progress. They aren’t the same as learning disabilities, but they can make learning more difficult. Conditions that can cause developmental disabilities include Down syndrome, Angelman syndrome, autism, fetal alcohol spectrum disorders (FASD), and brain injuries.

Sometimes it’s hard to determine if a young child has a delay or a disability, and why. That’s one reason doctors may use the words interchangeably.

Even when it’s not clear what’s causing the delay, early intervention often helps kids catch up. But in some cases, kids still have delays in skills when they reach school age.

In young kids, delays can be an early sign of learning differences. But it can be hard to make the link until kids start school. That’s when teachers see how kids do in areas like math, reading, and spelling. They can also see how well kids focus in class.

Some schools have early screening programs that look at all kids. This allows schools to help more children at an earlier age. Schools can also do testing to learn more about kids’ skills and how they think and solve problems. The results can help to determine if kids need extra support.

If you’re worried about your child’s development, share your concerns with your child’s doctor. If you’re interested in an evaluation, the doctor can give you a referral to an early intervention agency in your state. And learn more about:

Key Takeaways

  • Having developmental delays means a child is continually behind in gaining the skills expected by a certain age.

  • There’s no one specific cause of developmental delays.

  • Early detection and intervention is important in helping kids develop skills.

About the Author

About the Author

Amanda Morin 

worked as a classroom teacher and as an early intervention specialist for 10 years. She is the author of The Everything Parent’s Guide to Special Education. Two of her children have learning differences.

Reviewed by

Reviewed by

Elizabeth Harstad, MD, MPH 

is a developmental behavioral pediatrician at Boston Children’s Hospital.

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