Developmental delay in childhood

• What is developmental delay?
• Who is at risk for developmental delay?
• Developmental disorders
• Where do I go if I think my child is delayed?
  • Paediatrician
  • Speech pathologist or therapist
  • Occupational therapist
  • Physiotherapist
  • Clinical psychologist

What is developmental delay?

Development that is slower than would be expected for a child’s age is termed developmental delay. Developmental delay affects between 5% and 17% of children, with a smaller percentage of these children affected by severe delay or developmental disorders.

Who is at risk for developmental delay?

Children with hearing or vision impairment are at risk for delayed development due to their differing experience of some aspects of the world. For example, visually impaired children will usually move around their environment later than sighted children, and they will develop fewer ‘attention attracting’ gestures (e.g. looking, waving, pointing, facial expressions).

Other factors such as poor nutrition, poor caretaking or a lack of social and emotional stimulation can lead to developmental delays. For example, infants raised in institutions where they have little contact with adults are less likely to babble, vocalise and cry.

Very low birth weights and some chromosomal or genetic disorders (e.g. Down’s syndrome) can also lead to developmental delays.

If there is a family history of language or learning difficulties, then these children may also be at a greater than average risk for developmental difficulties.

Developmental disorders

If a child is severely delayed or if their development is quite unusual or different to a typical child, then a doctor may investigate the possibility that a child has a developmental disorder. The diagnosis of a developmental disorder will typically occur after several assessments and tests have been performed by doctors and specialists.

Where do I go if I think my child is delayed?

Your GP should be able to answer any questions and address any concerns you have about your child’s development. GPs will often ask you about their developmental history, will observe the child themselves, and will sometimes use screening tools such as the Parents’ Evaluation of Developmental Status or the Denver II Developmental Screening Test to assess whether there are areas of development that might warrant further investigation. If your GP is also concerned about your child’s development, they will usually refer you to a specialist for further evaluation. Types of specialists are described below.

Paediatrician

A paediatrician is a doctor who specialises in the development of babies, infants and children. Paediatricians routinely use tests to measure or investigate specific problems your child may be experiencing.

Speech pathologist or therapist

A speech pathologist or therapist is a health professional who can be consulted when there are problems with a child’s communication.

Difficulties with eating and drinking due to swallowing problems can also be addressed by a speech pathologist.

Aspects of communication that may be addressed by a speech pathologist can range from the physical production of words, to understanding the meaning of words, to non-verbal communication such as gestures and sign language.

Occupational therapist

An occupational therapist can help children with specific needs to be involved with all aspects of their home and school life. Occupational therapists will work with parents and teachers to include toys, furniture and equipment to help children develop.

The role of an occupational therapist is varied and can include helping with dressing, eating and toileting, or school skills such as writing. Occupational therapists aim to maximise the wellbeing and independence of a child.

Physiotherapist

A physiotherapist can help a child who is struggling with their physical development or coordination. They can recommend exercises or games to improve physical skills, posture, balance and coordination.

In the case of physical disabilities, physiotherapists can work with parents and schools to aid physical development and care.

Clinical psychologist

A clinical psychologist may be recommended particularly if your child has behavioural or emotional problems. A clinical psychologist can help to develop a child’s ability to understand and communicate their thoughts, feelings and ideas.

A clinical psychologist can be consulted for a range of developmental problems including adjustment problems (e.g. dealing with a new school or parent’s divorce), mood problems such as anger, depression or anxiety, or behavioural problems such as hyperactivity.

Clinical psychologists can work with parents and families to develop strategies to help children with emotional and behavioural problems, to improve their wellbeing and personal development.

More information

For more information on developmental milestones in childhood, including recommended health check-ups and childhood immunisation, see Developmental Milestones.

References

1. Oberklaid F, Efron D. Developmental delay: Identification and management. Aust Fam Physician. 2005; 34(9): 739-42.
2. Centre for Community Child Health, Royal Children’s Hospital. Child health screening and surveillance: A critical review of the evidence. Melbourne: NHMRC; 2002.
3. Adelson E, Fraiberg S. Gross motor development in infants blind from birth. Child Dev. 1974; 45(1): 114-26.
4. Slater A, Hocking I, Loose J. Theories and issues in child development. In: Slater A, Bremner G (eds). An Introduction to Developmental Psychology. Oxford: Blackwell Publishing; 2003, 34-63.
5. Bowlby J. Maternal care and mental health. Geneva: World Health Organisation; 1952.
6. Children, Youth and Women’s Health Service: Parenting and Child Health. Physical disability [online]. Adelaide: Government of South Australia. 1 September 2008 [cited 21 November 2008]. Available from URL: http://www.cyh.com/ HealthTopics/ HealthTopicDetails.aspx? p=114&np=306&id=1874