As children grow and develop, they hit certain “milestones,” such as picking up food and feeding themselves, walking, and talking. Guidelines set forth time periods when children should hit these milestones. While every child is different, if your son or daughter is missing developmental milestones, it may be a sign of a developmental disorder.
Developmental disabilities – including autism spectrum disorder, cerebral palsy (CP), intellectual disability, and attention deficit hyperactivity disorder (ADHD) – can have many potential causes, including genetics, exposure to toxins, and birth injuries. Signs and symptoms of a developmental delay can often be spotted by your own observations, or through screening and testing during regular well-child visits. Diagnosis is often the key to helping your child achieve the best possible outcome, as early intervention services can be incredibly helpful.
Screening and Testing for Developmental Delays
According to the Centers for Disease Control and Prevention (CDC), children should hit certain “developmental milestones” within a specified age range. If they aren’t hitting these milestones, it might be a sign of a developmental delay or a developmental disability. Catching delays early through screening is critical to getting your child the services that they need to achieve their full potential.
There are three ways that you – alongside your child’s providers – can check for developmental delays. A combination of developmental monitoring, developmental screening, and developmental evaluation is crucial to making sure that your child is on track, and getting them a diagnosis and/or the help that they need if they are missing these milestones.
Developmental monitoring is often a less formal way of seeing how your child grows and changes over time. Parents, family members, daycare staff, and other people in your child’s life can observe how a child is developing over time. If anyone notices that a particular child seems to be behind their peers in meeting certain milestones, it may be a sign that they have a developmental delay.
Parents may already be generally familiar with developmental milestones from baby books, parenting classes, or another source, such as the CDC’s milestone checklist. Parents and other adults may also simply note that a child seems to be hitting milestones well after their siblings or peers. These concerns may prompt further testing or evaluation.
At regular well-child checkups, a doctor or nurse will also do basic developmental monitoring. They will typically ask you questions about your child’s development, such as whether they are talking yet and how many words or phrases they are using. A missed milestone could be a sign of a developmental disability, which may prompt more testing.
It is important to remember that children can and do grow out of developmental delays, particularly when they receive services. While they may be a sign of a disability, such as autism spectrum disorder, it could simply be a matter of that child developing at a different rate than is typical. Monitoring your child’s progress is important so that you can catch any potential delays and/or disabilities as soon as possible.
Developmental screening is a more formal step that is usually undertaken if a parent or physician has a specific concern about a child’s growth and development. However, some doctors incorporate developmental screening as part of all well-child visits. The purpose of these screenings is to find out if your child needs more help with their development and to determine if a more extensive developmental evaluation is needed.
This screening uses either a brief test for your child or a questionnaire that you will complete about your child. These tools are based on research on early childhood development. It involves taking a closer look at a child’s language, movement, thinking, behavior, and emotions. It is often performed at a doctor’s office, but may also be performed by other professionals in different settings, such as a school.
Typically, children undergo developmental and behavioral screening during well-child visits at 9 months, 18 months, and 30 months. They will also be screened for signs of autism spectrum disorder at the 18-month and 24-month visits.
If your child is at higher risk of a developmental disorder due to factors such as oxygen deprivation at birth, preterm birth, or lead exposure, their doctor may perform screenings more frequently or may recommend additional screening. If your child’s doctor does not perform developmental monitoring and screening during appointments, you can ask them to do so.
Developmental monitoring and screening can be a sign that a child is not developing typically, but it does not provide a diagnosis. If a screening tool indicates that there is an area – or more than one area – of concern, then your pediatrician may recommend a formal developmental evaluation. This type of testing is usually performed by a specialist, such as a developmental pediatrician, speech-language pathologist, child psychologist, occupational therapist, or other professional.
The exact nature of the developmental evaluation will depend on what the potential concern is. If you or your child’s doctor are concerned that your child has an intellectual disability, for example, then the examination will be different from an evaluation of a potential hearing disability. Generally, a specialist will observe a child, give them a structured test, ask parents or caregivers questions, and/or ask parents or caregivers to fill out questionnaires. This testing may result in a formal diagnosis and a referral for treatment or early intervention services.
Developmental evaluations may include:
- Medical history and parent interview, to gain insight into factors that may affect a child’s development (such as a family history of mental health conditions, a mother’s medical history while pregnant, and a child’s birth and medical history)
- A physical examination to check for atypical growth patterns or any issues that may cause gross and fine motor delays or problems with eating or speech. A doctor will also check a child’s reflexes, muscle tone, and balance.
- A developmental assessment, where a neuropsychologist or developmental-behavioral pediatrician observes a child’s behavior and social skills over the course of several visits. They will also evaluate a child’s ability to remain focused on tasks, their language skills, motor skills, and ability to pay attention and follow directions.
- A hearing test performed by an audiologist, which may show hearing loss that affects a child’s speech and language skills. These tests may measure otoacoustic emissions, auditory brainstem response, or a child’s response to sounds (visual response audiometry).
- Psychoeducational evaluations, where a psychologist assesses an individual’s learning style to determine if they may have a learning disability. This type of evaluation is performed on school-aged children.
- Laboratory testing for developmental delays, intellectual disability, autism spectrum disorder, and genetic conditions. This often includes a chromosomal microarray (CMA) to test for these disorders. Genetic testing, including whole genome sequencing (WGS) and whole exome sequencing (WES), may also be ordered in combination with CMA.
These evaluations and diagnostic tests may lead to a formal diagnosis of a developmental disorder, such as intellectual disability, autism, cerebral palsy, or ADHD. A comprehensive evaluation is the best tool that can be used to ensure that your child gets the diagnosis and treatment that they need.
What Happens After Your Child Is Diagnosed with a Developmental Delay?
There are many different examples of developmental delays, from fine and gross motor delays to speech and language delays to autism spectrum disorder. Within each category, there are also degrees of severity that will affect the next steps. For example, a child with some degree of hearing loss will likely receive different treatment than a child who is deaf.
Generally, your child’s treating doctor or specialist will refer you for services that are appropriate based on their diagnosis. These services may include medical treatment, behavioral therapy, speech and language therapy, occupational therapy, or a combination of several different services.
Developmental disorders are not curable. However, with treatment, many children are able to improve their development. Early intervention is particularly important, but services at any age can still make a huge difference in a child’s development and quality of life.
Examples of treatments for developmental delays include:
- Individual behavioral therapy
- Family-based therapy
- Applied behavioral analysis (ABA)
- Occupational therapy
- Speech therapy
- Special education services
- Treatment of any underlying medical issues
Your child’s specialist will discuss options for treatment and services with you and may refer you to your province’s early intervention program. The services that they receive will be specifically tailored to address their developmental delay or disorder, with the goal of helping them achieve the best possible outcome.
How BILA Can Help
Developmental delays can have many possible causes, from genetics to prenatal exposures to birth injuries. If your child has been diagnosed with a developmental disability that you believe was caused by a birth injury or substandard prenatal care, then you may be able to file a lawsuit against the at-fault medical provider. Through this type of claim, you can recover financial compensation to support your child.
The Birth Injury Lawyers Alliance (BILA) advocates for parents and families throughout Canada whose lives have been affected by medical negligence. We will help you understand your rights and your options for pursuing a lawsuit. 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.
How Can I Know If My Child Has a Developmental Delay or Disability?
The best way to find out if your child has a developmental delay or disorder is by monitoring, screening, and if necessary, a comprehensive evaluation. These tools were specifically designed to detect developmental delays and to diagnose developmental disabilities. It is important to familiarize yourself with developmental milestones so you can raise any potential concerns with your child’s doctor, and to cooperate with screening assessments.
Developmental delays may not always be a sign that your child has a disability. It could just be that your child is developing at a slower rate than their peers. A medical professional can help you determine whether your child needs a clinical evaluation or other testing.
If My Child Suffered a Birth Injury, Should We Do Extra Screening for Developmental Delays?
Suffering a birth injury can put a child at higher risk of developmental delays. In many cases, these issues are apparent almost immediately during newborn screening. Many delays or disabilities do not appear until a child is slightly older.
If your child suffered a birth injury, then you should make sure that their doctor is aware of this fact so that they can be monitored more closely for developmental delays. If you believe that their birth injury was caused by medical negligence, you may be able to file a lawsuit against the responsible physician, nurse, or other medical professional. Reach out to BILA to schedule a free initial consultation with a birth injury lawyer in your province.