As parents, we want the best for our children. It can be hard to watch your child grow and develop and then realize that they are falling behind their peers or not hitting developmental milestones.
Missing milestones can be a sign of a developmental delay, or in more severe cases, a developmental disability. These delays can be caused by any number of factors, from chronic childhood infections to hereditary conditions to birth injuries. Routine evaluations can help you spot developmental delays and get your child the services that they need to thrive.
At BILA, we advocate for parents and families whose children have suffered preventable birth injuries. Reach out to learn more about how we can help if your baby was diagnosed with a developmental disorder caused by medical negligence.
What Is a Developmental Delay?
A developmental delay happens when a child does not achieve developmental milestones in the same period of time as their peers. Healthcare professionals have established guidelines for when children should be able to do certain things – such as rolling over, waving hello or goodbye, or talking – based on when a majority of children achieve these milestones.
Generally, your child should be hitting these developmental milestones within roughly the same time period as listed in the guidelines. For example, by the age of 8 months, they should be able to hold and shake a toy in their hands. However, there can be some variation that is within the normal range, with some babies achieving milestones slightly ahead of schedule and others hitting them slightly behind schedule. Babies who are born prematurely have a corrected age (their actual age minus the weeks or months that they were born early). Their developmental milestones should be evaluated based on their corrected age.
There are many possible causes of developmental delays, such as:
- Genetic conditions like Down Syndrome
- Metabolic disorders
- Oxygen deprivation in utero or at birth (such as hypoxic ischemic encephalopathy or HIE)
- Exposure to toxic substances, including drugs and alcohol
- Birth injuries or trauma
In some cases, the cause of a developmental delay is unknown.
A developmental delay is not necessarily a sign that your child has or will have a disability. It is possible for kids to outgrow their developmental delay or catch up with their peers of the same age. This is particularly true when a child receives services, such as physical therapy, occupational therapy, behavioral therapy, and/or speech therapy.
By comparison, a developmental disability is a lifelong condition. Developmental delays can be a sign of a developmental disability (such as autism spectrum disorder) but are not the same thing. Importantly, children who have developmental disabilities can still make progress and thrive through early intervention services.
Types of Developmental Delays
As they grow, children develop skills in different areas:
- Gross motor skills, which involve the large muscles of the body. Gross motor skills help us stand, walk, run, maintain our balance, sit, and change position.
- Fine motor skills, which involve the small muscles in our hands and fingers. We use our fine motor skills for a number of different tasks, such as eating, writing, drawing, dressing themselves, and playing. These skills develop over time and involve hand-eye coordination as well.
- Language skills, including speaking, understanding what others say, and using body language and gestures.
- Social skills, which involve responding to others’ feelings, connecting with and having relationships with other people, and cooperating.
- Cognitive skills, including learning, understanding, reasoning, solving problems, and remembering.
A child can have a developmental delay in one or more areas. When you take your baby to the pediatrician, they should perform a developmental screening at most visits through approximately 5 years of age. These screenings are designed to look for developmental delays that may be an indication of a developmental disorder or disability.
There are many potential warning signs of developmental delays. This includes:
- Motor delay: rolling over, sitting up, crawling, or walking later than their peers
- Language delay: difficulty talking, or not babbling or attempting to say words until much later than children of the same age
- Cognitive delay: having difficulty remembering things, following simple instructions, or problem-solving
- Social delay: inability to mirror or respond to facial expressions or difficulty communicating with others
If your child is not hitting these milestones within the age range in the guidelines, it may be a sign that they have a developmental delay. For example, if they are unable to walk without holding onto anyone or anything by 18 months of age, it might be a sign of a motor delay.
When Should You Be Concerned If Your Child Has Missed Developmental Milestones?
Developmental delays are not uncommon. Studies show that between 10 to 15% of preschool-aged children have one or more developmental delays. Global developmental delays – a term used to describe a significant delay in two or more areas of development – are less common, occurring in just 1 to 3% of children of preschool age.
If a doctor or other healthcare provider tells you that your child has a global developmental delay, then it may be a warning sign that they have a developmental disability. These include conditions such as:
- Autism Spectrum Disorders (ASD)
- Cerebral Palsy (CP)
- Fetal Alcohol Spectrum Disorders
- Fragile X Syndrome
- Intellectual Disability
- Muscular Dystrophy
- Spina Bifida
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Hearing loss
- Learning disabilities, such as dyslexia or dyscalculia
- Vision impairment
While there is no cure for these and other developmental disorders, there are treatments that can help. Depending on your child’s condition, they may benefit from services such as physical therapy, occupational therapy, speech and language therapy, counseling, or special education. If you notice warning signs of a developmental disability, you should talk to your healthcare provider about a developmental evaluation and a potential referral for intervention services.
There is a wide range of normal human development. Some children simply hit certain milestones ahead of or behind other kids. When there are significant delays or delays in more than one area of development (such as speech delays and cognitive delays), it may be a sign of a larger issue. You should note these missed milestones and be sure to ask your child’s doctors about them.
For example, by the age of 4 months, your child should be looking at you and trying to get your attention. If they aren’t making eye contact or are avoiding social interaction, these could be signs of autism. It is a good idea to reference a list of milestones to get a better idea if your child is falling within the range of normal development.
It can be hard to know when a child’s delay is a sign of a larger issue, such as cerebral palsy or a cognitive delay. Some developmental disorders – such as learning disabilities – do not appear until a child is in school. The most important thing that you can do is continue to watch to see if your child is hitting physical milestones, social milestones, language milestones, and cognitive milestones within the wide range of normal development. If they are not, consult with your childhood providers to discuss a developmental screening.
Concerned about Developmental Delays? We’re Here for You.
Developmental delays are not always a sign that a child has a disability. However, if your child has something more than a mild delay, particularly if they are missing milestones in more than one area, it could be a sign of a developmental disorder. In some cases, these disabilities are caused by preventable medical negligence.
At BILA, we work with parents to help them understand their legal rights. If you believe that your baby suffered a birth injury, we can help you evaluate your options. To learn more or to schedule a free initial consultation with a birth injury lawyer in your province, call BILA today at 1-800-300-BILA or fill out our online contact form.
Are Developmental Delays Always a Sign of a Birth Injury?
No. While developmental delays and disabilities can be caused by a birth injury or another type of medical negligence, there are many other possible causes. This may include inherited conditions, abuse and neglect, and exposure to toxic substances (such as lead poisoning).
It can be difficult to know whether your child’s developmental delay is linked to a birth injury. If you had any complications during pregnancy, labour and delivery, or after your child’s birth, it may be an indication that their delays or disability was caused by a birth injury. Contact BILA to schedule a free consultation with a birth injury lawyer in your province.
What Happens During a Developmental Assessment?
Doctors and other healthcare providers use screening tools during regular visits to monitor a child’s progress and determine if they are hitting developmental milestones. Other early childhood providers, such as preschool teachers, may also use these tools to determine if your child may have one or more developmental delays. If there is a concern that your child has a developmental delay or disability, they may be referred for a developmental evaluation or assessment.
A developmental evaluation is typically performed by a trained specialist, such as a developmental pediatrician or a child psychologist. They may observe your child, give them a structured test, or ask you to fill out questionnaires. The results of this evaluation may determine whether your child qualifies for formal treatment for a developmental delay or disorder.
Do Children with Developmental Delays Have Behavior Problems?
Children with developmental delays are at increased risk of behavior problems, although not all children with developmental delays or disabilities have behavioral issues. Developmental delays often mean that certain social skills – such as sharing, waiting their turn, or controlling their impulse – develop later than in children of a similar age. At the same time, there may be a mismatch between a child’s abilities and an adult’s expectations, which can cause frustration.
If your child has developed behavioral problems as a result of a developmental delay or disability, intervention services – such as behavioral therapy or counseling – can help. Similarly, addressing any underlying delays (such as a lack of fine motor skills) can often improve behavior. These and other therapies can be incredibly beneficial as you work with your child to help them achieve their full potential.