Does my child have developmental delay?

Developmental delay means children are missing their developmental milestones — for instance not sitting, walking or talking by the time most children are. Remember, each child will develop at his/her own pace, but it may be best to act as soon as a pattern is noticed.

Developmental delay may be easy to spot or more subtle and hard to be certain of, but if it's detected early, it can sometimes be successfully treated or mitigated. Genetic testing can often pinpoint the cause and guide treatment.

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What is developmental delay? Rena Vanzo (Part 1) MS, LCGC Licensed & Certified Genetic Counselor,
Vice President, Clinical Services, Lineagen, Inc.

Read More: What is global developmental delay/autism spectrum disorder?

Developmental delay is a term that describes a child who is behind in his or her milestones. Those milestones can be physical in nature or they might be cognitive, or learning-based.

15 percent of all children have some kind of development delay

The Centers for Disease Control, or CDC, estimates that about 15%1. of children have some form of developmental delay. This means that 15 out of every 100 children have some form of physical or learning-based delays.

The cause of developmental delay may be hard to identify in a child and some families may never know why their child has these challenges. In general, causes of developmental delay can be either environmental or genetic.

Some examples of environmental causes of developmental delay include fetal alcohol syndrome or maternal infections during pregnancy. These are two examples of environmental factors that may change the way a child's brain develops and can lead to delays when the child begins to roll over, crawl, walk, and talk.

Genetic changes can affect children in many ways

Genetic changes can present very differently in a child. Some genetic conditions will affect both physical milestones and a child's learning-based milestones. Sometimes, a genetic condition may only impact one aspect of a child's development.

There are literally hundreds, even thousands of different genetic causes for developmental delay and it is very important for families to understand the root cause of their child's developmental delay. There are a variety of reasons why identifying the root cause may be important to families.

1. Boyle CA, Boulet S, Schieve L, Cohen RA, Blumberg SJ, Yeargin-Allsopp M, Visser S, Kogan MD. Trends in the Prevalence of Developmental Disabilities in US Children, 1997–2008. Pediatrics. 2011; 27: 1034-1042.

What is developmental delay? Julie Cohen (Part 2) ScM Certified Genetic Counselor Dept. of Neurology
and Developmental Medicine, Kennedy Krieger Institute

Read More: What is global developmental delay?

Global developmental delay refers to when a child is behind in his or her milestones in multiple areas of development. This could include:

  • Gross motor skills like walking and running
  • Fine motor skills such as using their hands or picking up items
  • Speaking and understanding language
  • Cognitive or learning abilities

Global developmental delay is relatively common and all children should receive therapies that are tailored to their delays.

Some children catch up

Some children with global developmental delay will catch up with therapies. Other children will remain delayed and eventually receive a diagnosis of intellectual disability, which refers to delays or deficits in cognitive skills as well as difficulties with activities of daily living.

Some children with global developmental delay may also have other developmental concerns like low muscle tone or sometimes symptoms like cerebral palsy.

Some children with developmental delays have autism spectrum disorder. Autism is also a developmental diagnosis that refers to difficulties or specific symptoms in language, social interaction, and behavior. Some children with autism also have cognitive or learning delays.

What is developmental delay? Adam Schwebach, Ph. D. (Part 3) Clinical Neuropsychologist
Neuropsychology Center of Utah

Read More: What is global developmental delay?

Developmental delays is a very broad term. There’s lots of different types of developmental delays and they can affect different areas of a child’s life. A child may have:

  • Struggles in school
  • Difficulties regulating their behavior and emotions
  • Problems with their social development

Typically, children who are experiencing developmental difficulties may have lots of different challenges. These types of developmental delays can be quite concerning to parents. Neuropsychologists are specialists who try to better understand what type of developmental delay a child is experiencing.

What is developmental delay? Gregory Barnes (Part 4) Dir. Of the University of Louisville
Autism Center

Read More: What is global developmental delay?

Developmental delay is a broadly defined category in which you have delays in one of four domains:

  • Social delay
  • Language delay
  • Cognitive delay
  • Motor delay

You can have any combination in those domains and fit the definition of developmental delay. Some of those combined domains can define particular diseases. For instance, autism is defined as delays in social skills, delays in communication, and restricted interests or repetitive behaviors.

All those delays described in those four domains are important to define because they may actually point to particular developmental disorder, for which autism is only one example.

Developmental delay causes? Julie Cohen (Part 1) ScM Certified Genetic Counselor Dept. of Neurology
and Developmental Medicine, Kennedy Krieger Institute

Read More: What are the causes of global developmental delay

There are many different causes for developmental delay. This is due to the many factors that contribute to a child’s development. These factors can be environmental or genetic. Often there can be a genetic cause or genetic factor that causes developmental delay in a child.

Genes are instructions

Our genes are the instructions for our bodies to grow, develop, and function. We inherit our genes from our parents. Every person has differences in their genetic information. That’s why we’re all unique. Genes play a role in many aspects in our body, such as eye color, height, health, and brain development. It’s why one person has blue eyes and another has brown eyes.

Sometimes those genetic changes or differences in our genes do impact the body. These genetic changes can affect the brain and since the brain controls our development, genetic disorders that affect the brain can cause development delay.

Many causes of developmental delay

There’s not one specific genetic cause for developmental delay, there are many. The medical community does not yet understand all of the genetic changes or the combination of factors that play a role in developmental delay.

These factors could be changes in the environment that the child experiences, such as an exposure to a certain infection during pregnancy. Because there are many factors that play a role in developmental delay, we can’t always pinpoint the specific cause. However, there are guidelines and certain tests and evaluations to look for certain causes, including genetic changes, when a child has developmental delay.

Developmental delay causes? Gregory Barnes (Part 2) Dir. Of the University of Louisville
Autism Center

Read More: What causes global developmental delay?

Developmental delay has a broad set of causes. There are some forms of developmental delay that are caused by physical changes to the brain, such as injuries. For example, during pregnancy or birth, a child can have oxygen deprivation, infections, or trauma that can impact how the brain develops. As a result, a child may have developmental delay.

Another cause for developmental delay can be inherited disorders. These inherited (or genetic) disorders are caused by changes in our genes. Genes are the inherited material, known as DNA, that provides instructions for particular proteins to be made that are important in brain development. If those proteins are not well-formed or don’t function properly, the brain functioning can be impacted and may result in motor delay or a language delay.

Signs of developmental delay? Rena Vanzo (Part 1) MS, LCGC Licensed & Certified Genetic Counselor,
Vice President, Clinical Services, Lineagen, Inc.

Read More: What are the signs of global developmental delay?

There can be several different signs of delayed development. Often, one of the most important signs is a mother or father's instinct that there is something that's not quite right with their child.

Know the milestones

Some of the first signs of developmental delay occur when a child is behind in physical or motor milestones. For example, rolling should be occurring at 3 to 4 months of age2. Sitting independently should be occurring around 6 months of age. When a child starts to pull to a stand and then begin walking, there can be a range of those ages when that's normal for your child. However, many parents have an instinct and may recognize that something is different compared to other children.

There may be a combination of delayed milestones that are behind. Parents should listen to their gut instinct and seek help if their child is experiencing any challenges in development.

Verbal milestones

Another sign of developmental delay may become apparent when a child begins to start talking. Children should be using about 50 different words and putting two words together by the time they're 2 years old. So if a parent does not see their child develop those verbal milestones, it could be a sign that their child has some form of developmental delay.

There are instances where speech is delayed for other reasons not related to developmental delay. For example, a child's hearing would commonly be checked if they are not meeting their verbal milestones. If a child is not able to hear words, we would not expect them to be able to verbally use those words.

It is important for families to know possible risk signs and seek help because there may be therapies or medical interventions that can help. Speech delay may not always mean that a child will have a long-term developmental delay, but it is important to rule out all possibilities so that the child receives the best care.

2. 2. Shelov F, Altmann T. Caring For Your Baby and Young Child: Birth To Age 5, Elk Grove Village IL: American Academy of Pediatrics, 1991. Print.

Signs of developmental delay? Julie Cohen (Part 2) ScM Certified Genetic Counselor Dept. of Neurology
and Developmental Medicine, Kennedy Krieger Institute

Read More: What are the signs of global developmental delay?

Parents might become concerned about their child’s development when he or she isn't meeting the expected developmental milestones.

There’s a range for when a child should meet milestones. This range is based on when the average child should sit up, walk, or start talking. The pediatrician can give guidance on what is an appropriate milestone and can raise concerns when a child is showing signs that they are behind.

If the pediatrician is concerned, they may recommend a more formal evaluation. That evaluation might be through a specialist such as a developmental pediatrician, pediatric neurologist, or sometimes through a state sponsored infants and toddlers program.

Delay can be treated Rena Vanzo MS, LCGC Licensed & Certified Genetic Counselor,
Vice President, Clinical Services, Lineagen, Inc.

Read More: A genetic diagnosis enables therapies and treatments

Years ago, when a child was diagnosed with developmental delay or autism spectrum disorder, little was offered to those families in terms of therapy, treatments, and support services.

Today, there are many opportunities available to these families. In particular, the advent of personalized medicine has opened the doors to more personalized treatment. Many drug companies and scientific researchers have clinical trials that are available where drugs are now being developed that actually address the biochemical deficiency in certain genetic conditions.

Drug treatments can help

Drug treatments for specific genetic conditions may have a significant impact on that child's ability to interact with his or her environment and behavior. With these advances, there's much hope for families. However, these opportunities can't be offered if we don't know the underlying genetic condition for these children.

Today it's easy for doctors take the initiative to provide a genetic diagnostic test so these doors can be opened for these families. With a genetic diagnosis, these children can have access to these personalized medical treatments that are now available.

Delay can be treated Adam Schwebach, Ph. D. (Part 1) Clinical Neuropsychologist
Neuropsychology Center of Utah

Read More: A common misconception is that developmental delay can’t be treated

There is definitely a common misconception that developmental delays can't be treated. About a hundred years ago, most children with developmental delays were not treated. They were either institutionalized or shunned in the community. Because of this, parents who had children with a developmental delay would often hide those kids and not seek out treatment.

In the last 30 to 40 years, we've been doing much better at identifying these developmental delays and really helping to educate parents and other professionals on the importance of getting the right interventions early so that these children are getting the help that they need both socially, emotionally, behaviorally, and academically.

Delay can be treated Adam Schwebach. Ph. D. (Part 2) Clinical Neuropsychologist
Neuropsychology Center of Utah

Read More: Almost every developmental delay can be treated

The treatment interventions for developmental delays vary and some of those delays might require very basic interventions like behavioral strategies. Other times, the specific delays might require speech and language therapy, medication interventions, or educational support.

Identifying developmental delays early is especially important so that we can put in place a very effective treatment plan. The earlier we can intervene with children who have developmental delays, the better the outcome.

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Developmental delay is a term that describes a child who is behind in his or her milestones. Those milestones can be physical in nature or they might be cognitive, or learning-based.
Rena Vanzo
MS, LCGC Licensed & Certified Genetic Counselor,
Vice President, Clinical Services, Lineagen, Inc.