There’s a reason parents track developmental milestones, and it’s not to get competitive with other parents on the playground. Developmental milestones are important tools for letting parents know if their children are developing on a typical timeline, or if they might need a little extra help in certain areas.
There’s a huge range for when children meet developmental milestones, though, and being a little late to catch up on one or two milestones doesn’t make a developmental delay. For one thing, developmental delays are diagnosed by pediatricians and specialists in child development. A diagnosis can be important for children as a way of qualifying for early intervention or programs and services that can help children with delays get the help they need to develop to their highest potential.
Early intervention can make a huge difference in the lives of children with developmental delays. Unfortunately, many children with developmental delays aren’t identified until after they start school.
How are developmental delays diagnosed?
While developmental delays need to be diagnosed by a healthcare provider, in many cases, it’s a parent who first notices a potential delay, and brings it up with a healthcare provider. In other cases, a doctor or other healthcare provider will notice a potential delay during a well-child visit. Developmental milestones aren’t a perfect way of looking for a delay, since children can meet milestones at many different times, but they’re the best benchmarks doctors have for identifying delays.
Pediatricians perform developmental screening tests to test for developmental delays at certain well-child visits – usually the visits around 9 months, 18 months, and 24 to 30 months. From there, if a pediatrician suspects there might be a delay, he or she may refer the child to a specialist for confirmation. In the U.S., pediatricians are required to refer children with either suspected or confirmed delays to the appropriate early intervention system. This means that if a pediatrician is worried about a potential developmental delay, or if the results of a screening are positive, they will probably recommend a formal developmental intervention.
In the U.S., this might mean referring the child to Early Intervention, an agency that evaluates children for delays and then provides treatment by speech and language pathologists, occupational therapists, and physical therapists. In other cases, children might need direct referrals to specialists like speech-language therapists, physical therapists, occupational therapists, developmental behavioral pediatricians, or genetic, neurological, or mental health providers.
Children who are confirmed to have developmental delays or disabilities after evaluation may then need further medical evaluation to see if there is a medical reason for the disability.
Different types of developmental delays
Not all delays stick around. There are a few different kinds of delays, and some, called “transient delays” can be worked through either at home or with help from a specialist. Once children move past transient delays, they may continue to develop at the same rate as most of their peers. Transient delays can be caused by certain health complications, like children who were born prematurely, or who have had long-running illnesses, like iron-deficiency anemia, or have been hospitalized for a significant amount of time. Transient delays can also be caused by lack of opportunity to work on certain skills.
It’s hard to predict which delays will last, and which will disappear over time. In longitudinal studies, speech delays that start to disappear in the preschool years are associated with factors like isolated speech-language problems (that is, children who tended to meet other milestones at more usual times), no problems with receptive language, normal nonverbal skills and communication in gestures and body language, and symbolic thinking (like playing with dolls, or playing pretend).
Persistent developmental delays, on the other hand, may be a challenge for children throughout childhood and into adulthood. These delays can be caused by disorders that can be diagnosed, but are also often not known. In either case, delays generally fall into four categories, although children can experience delays in any one or any combination of those categories.
- Motor development: Motor development is divided into fine and gross motor skills. Fine motor skills, like holding a crayon or pencil, or putting small objects into a bowl, require using the muscles or the hand, fingers, and wrist to complete refined tasks. Gross motor skills, like crawling, standing, walking, or climbing stairs, use large muscle groups in the neck, arms, legs, and trunk to move around effectively. Delays in motor development are often related to muscle control, and can be caused by any of several conditions or disorders.
- Cognitive development: Delays in cognitive development can cause problems with thinking and learning, or with forming short- and long-term memories, mastering new skills, and problem-solving.
- Language development: Delays in communication can show up in both receptive language (understanding what’s said to them) and expressive language (speaking to or communicating with others) and can have roots in physical challenges, like muscle control or hearing loss, or in cognitive delays.
- Socio-emotional development: Social skills are a big part of emotional development as children grow, and are tied up in the way children relate to other children, caregivers, and their own feelings.
The fifth type of developmental delay that’s sometimes talked about is adaptive behavior delay, which can be caused by any combination of other delays, but manifests as delays in developing skills they need to start taking care of themselves, like feeding themselves or dressing themselves at an age-appropriate level, personal hygiene, and, eventually, household maintenance, and skills like cooking and cleaning.
Developmental delays can be scary for parents, so it’s a good idea to have clear lines of communication with your child’s primary care provider, and let them know about any concern you might have regarding your child’s development.
Kyla Boyse. “Developmental delays.” University of Michigan Health Center. Regents of the University of Michigan, February 2010. Web.
Dinah Reddihough, Cathy Marraffa, Marg Rowell, Rod Carne, Libby Ferguson. “Developmental delay: An information guide for parents. The Royal Children’s Hospital Melbourne, 2009. Web.
“Eligibility Criteria.” New York State Department of Health. New York State, August 2005. Web.
“How is Developmental Delay Diagnosed?” My Child Without Limits. United Cerebral Palsy, 2016. Web.
- “States’ and territories’ definition of/criteria for IDEA Part C eligibility.” EctaCenter. Early Childhood Technical Assistance Center, March 4 2015. Web.