About developmental delay

When young children are slower to develop physical, emotional, social and communication skills than expected, it’s called developmental delay.

Developmental delay can show up in the way children move, communicate, think and learn, or behave with others. When more than one of these areas is affected, it might be called global developmental delay.

Developmental delay might be short term, or it might be the first sign of a long-term problem.

Long-term developmental delays are also called developmental disabilities. Examples include learning disabilities, cerebral palsy, intellectual disability and autism spectrum disorder.

Signs of developmental delay

Every child develops differently, and there’s a big range of ‘normal’ in children’s development.

But as a general guide, you might be concerned about developmental delay if you notice that, over several months, your child isn’t developing motor, social or language skills at the same rate as other children the same age.

People who can help children with developmental delay

Your GP, child and family health nurse or paediatrician can help if you think your child might have developmental delay, or your child has a developmental delay diagnosis. The following professionals can also help:

• audiologist
• occupational therapist
• physiotherapist
• psychologist
• social worker
• special education teacher
• speech pathologist

Living with developmental delay

Like other children, children with developmental delay keep learning. But they take longer to develop new skills, and they might learn in slightly different ways from other children.

For example, most children can learn skills quickly and by example. But children with developmental delay might need to be shown skills in smaller, simpler steps. They might also need more time and opportunities to practise skills.

At preschool or school, your child might need extra support to do well. It’s always a good idea to talk with preschools and schools about your child’s needs. And if your child has a disability diagnosis, you might be able to get funding and other school support.

Causes of developmental delay

Lots of different things can cause children to develop more slowly than others.

Developmental delay might happen because of genetic conditions like Down syndrome or because of complications during pregnancy and birth, like premature birth.

Other causes for short-term delays include physical illness, long periods in hospital, and family stress.

In many cases, the cause of developmental delay isn’t known.

What Challenges does your child experience?

Does your child have difficulties with day-to-day activities at home, school, or in the community? Do they experience challenges that do not affect most typically developing children? If so, an occupational therapist may be able to help your child.

Occupational therapy is a treatment that supports a child and their family when they experience difficulties in the areas outlined below.

DEVELOPMENTAL DELAY

Developmental delay means that a child is behind in developing skills that are common during a particular age or during a particular time period. A developmental delay, however is more than being a little behind other children in a skill; it is being behind in a combination of skills or not meeting development milestones. These are examples of developmental delays:

• Not reaching developmental milestones of sitting, crawling, and walking
• Not learning at an age appropriate level
• Not developing age appropriate play and social skills

FINE MOTOR SKILLS

Fine motor skills are small movements made with fingers, toes, wrists, lips, and tongue, like holding a small object or picking up a spoon. If your child is struggling with fine motor skills, they may have difficulty with one of these actions:

• Manipulating toys and puzzles
• Holding a pencil
• Using silverware or straws at an age-appropriate time
• Using scissors
• Using zippers, buttons, shoelaces
• Coloring, drawing, tracing, prewriting shapes
• Poor handwriting, letter/number formation
• Not developing a hand dominance at an age-appropriate time
• Avoiding tasks and games that require fine motor skills

MOVEMENT, STRENGTH, & BALANCE DEVELOPMENT (GROSS MOTOR SKILLS)

Gross motor skills help us move and coordinate our arms, legs, and other body parts. They involve larger muscles that help us control our body. A child who is behind in movement, strength, and/or balance may appear clumsy or uncoordinated. They may also have difficulty with these things:

• Going up and down stairs at an age appropriate time
• Coordinating both sides of the body
• Understanding the concept of right and left
• Poor ball skills
• Poor balance

Their muscle tone, or muscle tension and resistance, could be higher or lower than the appropriate developmental milestone. They might also:

• be fearful of feet leaving the ground
• doesn't cross midline of his or her body during play and school tasks
• avoids tasks and games that require gross motor skills

VISUAL PROCESSING

Visual processing is the process we use to make sense of what we see. It is a process in our brain that interprets visual information. If your child has difficulty with one of these things, they may have difficult with visual processing:

• Difficulty with the spacing and sizes of letters
• DDifficulty with recognizing letters
• DDifficulty with copying shapes or letters
• DDifficulty with visual tracking and crossing midline
• DDifficulty finding objects among other objects
• DDifficulty with copying from the board or another paper
• DDifficulty with the concept of right and left
• DYour child may lose his or her place when reading or copying from the board or may have poor eye contact.

ORAL MOTOR/ORAL SENSORY

Oral motor or oral sensory skills are control of muscle movements in the face and oral area, such as the lips, jaw, tongue, and soft palate. Delayed oral motor and sensory skills can show in one or more of these ways:

• Excessive drool
• Çhews food in the front of the mouth, rather than on the molars
• Difficulty using a cup at an age-appropriate time
• Difficulty with drinking from a straw at an age-appropriate time
• Lengthy bottle or breast feedings
• Tiredness after eating
• Baby loses excessive liquid from his or her lips when bottle or breast feeding
• Child loses excessive liquid or food from his or her mouth when drinking or chewing
• Child appears to be excessively picky when eating, only eating certain types or textures of food
• Child excessively mouths toys or objects beyond an age-appropriate time

SENSORY PROCESSING

Sensory processing is making sense of information that we receive through our senses, like sound and smell. Your child may be oversensitive to things around them and show the following symptoms:

• Overly sensitive or heightened reactivity to sound, touch, or movement
• Under-responsive to certain sensations (e.g., high pain tolerance, doesn't notice cuts/bruises)
• Constantly moving, jumping, crashing, bumping
• Easily distracted by visual or auditory stimuli
• Emotionally reactive
• Difficulty coping with change
• Inability to calm self when upset

SOCIAL INTERACTION SKILLS

Social interaction skills are skills that help us have relationships and understand those around us. They help us bond with other people in our life. Your child may have delayed social skills if they show some of the following things:

• Difficulty interacting socially and engaging with family and peers
• Difficulty adapting to new environments
• Delayed language skills
• Overly focused on one subject (e.g., space, universe, dinosaurs, trains)
• Can't cope in the school environment

LEARNING CHALLENGES

Learning challenges, sometimes called learning disabilities, are another type of developmental delay. If your child is challenged by one of the following, you may want to consult an occupational therapist:

• Unable to concentrate and focus at school
• Easily distracted
• Difficulty following instructions and completing work
• Tires easily with school work
• Poor impulse control
• Hyperactivity or low energy
• Not keeping up with workload at school
• Difficulty learning new material
• Makes letter or number reversals after age seven

PLAY SKILLS

Play skills are skills that can help a child make sense of the world around them. A child can gain self-confidence, learn problem solving, and develop social skills through play. Your child may be developmentally delayed if they show one of the following symptoms:

• Needs adult guidance to initiate play
• Difficulty with imitative play
• Wanders aimlessly without purposeful play
• Moves quickly from one activity to the next
• Does not explore toys appropriately
• Participates in repetitive play for hours (e.g., lining up toys)
• Does not join in with peers/siblings when playing
• Does not understand concepts of sharing and turn taking

Remember that all children are different and develop these skill sets at their own pace. However, if you think your child may be struggling with adopting some of the skill areas above, you can contact an occupational therapist.