3 Ways to help a child with developmental delay
As you watch your child grow and anticipate his milestones, it’s natural to wonder (and even worry about) whether his development is on track. (“Shouldn’t he be using pronouns by now?” or ” His sister could put on her own shirt by this age – why can’t he?”). These things may make start wondering can a child with developmental delays can catch up? But chances are he’s developing just fine on his own timeline.
In most instances, children reach each developmental milestone (like toilet training, riding a trike, and speaking clearly) right around the expected time. And if not, they catch up soon.
On the other hand, spotting potential problems sooner rather than later is important if your preschooler does have a genuine developmental delay.
Developmental delay definition
Doctors use this term when a child doesn’t reach developmental milestones within the broad range of what’s considered normal.
The delay might be in one or more areas: gross and fine motor skills (such as jumping and stacking blocks), communication and language skills (both “receptive,” which relates to understanding, and “expressive,” which relates to speaking), self-help skills (like toilet training and dressing), and social skills (such as making eye contact and playing with others).
“It’s important to remember that while development tends to unfold in a typical progression, children develop at different rates and in different ways,” says Claire Lerner, child development specialist at Zero to Three, a national nonprofit promoting the healthy development of children.
So, for example, one 25-month-old may have very advanced motor skills because she loves to explore and interact through movement but not have any interest in using a pencil, while another child the same age may be drawing stick figures but be less adept at motor skills.
“What’s most important to track is that the child is making forward progress in all domains,” explains Lerner.
What are the chances that my preschooler has a developmental delay?
Various studies have reported that 10 to 15 percent of children under the age of 3 had a developmental delay, such as difficulty learning, communicating, playing, or performing physical activities or practical skills.
Early intervention can make a huge difference for many children with developmental delays, yet one study found that only about 3 percent of kids were getting appropriate attention. That’s why it’s important for you to speak up if you suspect your child has a developmental delay.
Some disabilities disappear by the time a child heads to school, while other problems won’t be identified until later. About 15 percent of children under the age of 17 have disabilities such as speech and language impairments, an intellectual disability, learning disabilities, or emotional and behavioral problems.
Among children with developmental disabilities, about 40 percent have more than one developmental disability, and less than 2 percent have three or more.
Symptoms of Developmental delay
Most parents are pretty sensitive to the age at which their child reaches gross motor skill milestones, like walking and climbing stairs – and whether these achievements are considered “early” or “late.” But you might also pick up on your child’s finer motor skills, like his ability (or inability) to draw a circle or brush his teeth.
In the language arena, you might notice that your child has difficulty with receptive language (understanding the meanings of words and sentences) or with expressive language (expressing ideas in words and sentences).
It’s a good idea to familiarize yourself with the normal timeline for developing cognitive and physical skills, so you can use it as a general guideline. That way you’ll know that by 30 months most preschoolers can wash and dry their own hands, for example, and by 36 months most can use three to four words in a sentence. You’ll also learn that by 24 months most children can stack six blocks and by 36 months most can name one color.
Keep in mind that if your child was born prematurely, he might need a bit more time than other kids his age to reach some developmental stages. Most doctors assess a preterm child’s development against the time he should have been born (his due date rather than his actual birth date) and evaluate his skills accordingly until his second or third birthday.
If my child does have a delay, what could be causing it?
Sometimes delayed development has a medical cause, such as complications of a premature birth or a genetic condition, like Down syndrome. Or it could be the result of a serious illness or accident.
Speech and language delay might stem from a hearing impairment or a problem with the larynx, throat, or nasal or oral cavity. Difficulties with communicative intent might be related to a problem with the central nervous system.
Most often, though, no specific medical cause can be found to explain developmental delays, says Henry Shapiro, developmental pediatrician at All Children’s Hospital in St. Petersburg, Florida.
When should I get in touch with the doctor?
Follow your instincts. You know your child best, so you’re likely to spot problems – or potential problems – early. If you have a question or concern, check it out, even if it’s just for reassurance, says Lerner.
It might be helpful to jot down your impressions before the doctor’s appointment. Is something in particular bothering you about the way your child is walking or talking? Does she seem to have lost a milestone that she previously reached? Have you noticed any specific signs of a physical delay or signs of a language or communication delay?
Will my preschooler’s doctor check for developmental delays?
Yes, she should. The American Academy of Pediatrics recommends that babies and children be informally screened at every well-child visit for any potential delays and that parents complete a formal, structured developmental screening questionnaire at the 9-, 18-, and 30-month well-child checkup. (If you don’t plan to schedule a 30-month checkup, the 24-month checkup can replace it; some health care plans don’t cover 30-month checkups.)
The doctor should ask you about any concerns you may have. Using standard developmental assessment tests, the doctor will look for specific motor skills, communication and language skills, and cognitive ability.
If she finds anything of concern, she may refer you to a doctor who specializes in developmental issues. Your preschooler will then have a developmental evaluation, which is a more in-depth assessment of his skills.
Or, if your child seems to have a language or communication delay, the doctor may send him to a speech pathologist for an evaluation directed specifically at language development.
Of course, vision and hearing problems – which may affect development in other areas – can be hard to spot unless you’re a professional. Eye and ear checkups should also be part of every checkup for your child. If your child’s doctor suspects a problem, she may want to conduct more thorough hearing or vision tests.
If you’re worried about your preschooler’s development between regular well-child visits, don’t wait until the next one. Call the doctor and explain your concern. She may be able to calm your fears quickly, or she may want to schedule an appointment for a developmental screening right away.
3 ways to help a child with developmental delay in school.
If your child has been evaluated by his doctor and you’re still concerned, don’t hesitate to get another opinion. Look for a pediatrician who specializes in developmental issues, or consult a speech pathologist if you’re concerned about your child’s language delay.
In addition, most communities have early intervention programs that provide free developmental evaluations and screenings to those who qualify.
Whatever you decide to do, it’s a good idea to keep your child’s primary care provider informed about visits to other doctors and their findings.