Delay of a child in achieving the abilities expected at a particular age
- Usually apparent by the age of 5
- Lack of stimulation is a risk factor
- Gender and genetics as risk factors depend on the cause
There are significant stages in the first few years of life, known as developmental milestones, when a child is normally expected to have acquired certain basic physical, intellectual, and social skills. Children achieve these milestones at different ages but usually within an established typical age range. Failure to reach the milestones within this range is known as developmental delay.
What are the types?
Delays may be of varying severity and can affect one or more area of development. Children are usually mobile by about 9 months, and most are walking by 15 months. A delay in walking frequently runs in families and often has no obvious cause; most children catch up eventually and continue to develop normally. However, children who have a severe underlying disability, such as cerebral palsy, will have long-term difficulties with mobility.
Some children are slow to develop movements that involve good hand–eye coordination or fine control, such as catching a ball or using a pencil. These children should be monitored carefully because they are at risk of experiencing specific learning disabilities during their school years.
Delay in acquiring speech and language ranges from minor difficulties in increasing vocabulary (see Speech and language difficulties) to the severe communication problems often associated with autism spectrum disorders. Sometimes, delay is due to a lack of stimulation in the child’s environment. Hearing problems, which can be due to disorders such as chronic secretory otitis media, may also be a cause of delayed development in speech and language skills.
Certain basic accomplishments, such as learning to use the toilet unaided, are acquired only slowly in some children. Usually, these skills improve with time, but occasionally there may be underlying problems (see Bedwetting, and Encopresis).
Developmental delays that affect all areas of learning and general ability can be caused by underlying disorders, such as Down’s syndrome or inborn errors of metabolism, but often the underlying cause cannot be identified. Such delays in development can lead later to a diagnosis of generalized learning disabilities.
What might be done?
Developmental delays are usually first noticed by parents who are concerned when a child does not reach the normal milestones for his or her age group. A delay may also be detected at routine developmental checkups during the first 5 years of life. If a problem is suspected, your doctor may arrange for a full developmental assessment, which normally includes hearing tests (see Hearing tests in children) and vision tests (see Vision tests in children). Tests may be performed on a sample of the child’s blood to check for a genetic abnormality.
A child with delay in one area of development may only need encouragement to begin to catch up. Many children with mild delays develop normally over a period of time, especially if the cause is understimulation and the problem is given appropriate treatment. Other children benefit from help, such as speech therapy, in particular areas of development. A child with more severe delays will need specialized treatment.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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