Developmental Delay Assessments
What is a Development Delay?
A developmental delay is diagnosed when a child is assessed as being more than “a little behind” in performing everyday skills. The term defines a substantial lag in performance, and may be used to describe any type of delay in 1 or more of the following 5 skill areas:
- Fine and gross motor (movement)
- Cognitive (thinking)
- Social and emotional
- Speech and language
- Activities of daily living
These delays may or may not result from a specific medical condition. For example, a child with Down syndrome is identified at or before birth as having the syndrome, but also can have developmental delay. This fact holds true for any child with a disability, such as autism or cerebral palsy. Children without a specific medical condition, however, may still have a developmental delay. Early assessment is key. Parents should express any concerns, even the slightest ones, to their pediatrician or physical therapist.
The United States provides early intervention services for children with developmental delay, although each individual state has its own definition of what “developmental delay” is. As a result, offered services may vary from state to state. Parents can consult with their pediatrician or family physical therapist to determine what services are offered in their state.
Signs and Symptoms
Parents are often the first to notice a child isn’t hitting their milestones in 1 of the 5 areas of development mentioned above. However, lagging behind on a milestone attainment does not necessarily mean a child has developmental delay. Children need to demonstrate a significant delay in 1 or more areas of development.
For example, in infancy a child is first suspected to have developmental delay if common motor milestones are not being met, such as:
- Holding the head up by 4 months
- Sitting by about 6 months
- Walking by about 12 months
Children might be suspected of having a motor developmental delay if they are not exploring movement in a variety of ways. Sometimes children who have a motor developmental delay may also have an additional diagnosis, such as hypotonia (low muscle tone) that contributes to their difficulty with movement.
Motor development in children can often be the first area of delay that is noticed by caregivers. However, in infants and young children, all areas of development are closely connected; a delay in one area can impact progress in another. For example, learning about objects or babbling and talking can be affected if a child does not learn to sit or change positions. Sensory problems, such as hypersensitivity to touch or an inability to plan and problem-solve how to move, may also add to movement difficulties.
Children who have some or all of these problems that inhibit their movement development also may develop a fear of trying new motor skills, which can then lead to social or emotional problems.
How Can a Physical Therapist Help?
Your physical therapist will first evaluate your child, conducting an appropriate and detailed test to determine the child’s specific strengths and weaknesses. Your physical therapist will discuss your observations and concerns with you. If the child is diagnosed as having developmental delay, your physical therapist will problem-solve with you about your family’s routines and environment to find ways to enhance and build your child’s developmental skills.
In addition to evaluating your child and the environment in which the child moves, the physical therapist can give detailed guidance on building motor skills 1 step at a time to reach established goals. The therapist may guide the child’s movements or provide cues to help the child learn a new way to move. For example, if a child is having a hard time learning to pull herself up to a standing position, the physical therapist might show her how to lean forward and push off her feet. If a child cannot balance while standing, the physical therapist may experiment with various means of support, so he can safely learn new ways to stand.
The physical therapist will also teach the family what they can do to help the child practice skills during everyday activities. The most important influence on the child is the family, because they can provide the opportunities needed to achieve each new skill.
Your physical therapist will explain how much practice is needed to help achieve a particular milestone. A child learning how to walk, for example, covers a lot of ground during the day; your physical therapist can provide specific advice on the amount and type of activities appropriate for your child at each stage of development.
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