Developmental Delays

Understanding child development

Child development is the individual skills that are built up during childhood that allow more sophisticated skills to be learnt in the future, such as walking, talking, thinking and communicating. Regardless of the rate of development, every child will develop according to their own patterns. There may be some variability in development rate between children, but there is a general pattern to how individual skills develop.

Simple skills allow more sophisticated ones to be learned. The achievements of young children tend to cause great excitement in those closest to the child, with the most notable developmental achievements such as sitting, walking and talking called milestones, reached around certain ages. Milestones are used to track whether a child’s rate of development is faster, slower or the same as other children of the same age.

What’s normal?

1st Year

  • Sitting without support
  • Making a certain sound to get attention
  • Being able to clearly distinguish strangers from family members
  • Looking for dropped toys
  • Enjoying simple games – peek-a-boo
  • Babbling a wide range of sounds

2nd Year

  • Scribble with a pencil
  • Build a small tower out of blocks
  • Recognise pictures of common objects
  • Use some single words
  • Walk well on their own
  • Imitate simple activities
  • Understand when they’re told not to do something

3rd Year

  • Jump and get both feet off the ground
  • Draw a circle
  • Form simple sentences
  • Assert self by opposing the will of their parents
  • Feel comfortable in a familiar place without parents
  • Put on and take off some clothing articles
  • Join in play with others

5th Year

  • Able to share while playing
  • Dress without help
  • Copy some shapes
  • Grip a pencil properly
  • Speak clearly
  • Begin to count
  • Hop
  • Know common shapes and colours
  • Understand simple game rules such as taking turns

What does developmental delay really mean?

‘Developmental delay’ is a term used when a child’s development is delayed in one or more areas compared to children of the same age.

These areas of development can include:

  • Fine motor development – manipulating objects, use of hands
  • Cognitive/intellectual development – understanding, thinking, learning
  • Motor development – movement
  • Speech and language development – communication, understanding and use of language
  • Emotional and social development – relating with others and increasing independence

Parents often become aware of the delay when a child does not achieve one or all of the expected milestones at the expected time, and some children may show behavioural problems that can be associated with delayed development. The term developmental delay is only used until the cause of the delay is known.

What is an intellectual disability?

An intellectual disability is a delay in a child’s understanding of the world whereby it takes longer to think and learn new skills. The age at which a skill is acquired depends on the rate of learning. Children who have a slower rate of learning acquire skills at different ages and delays become more obvious as the child grows.

There is a wide range of severity when it comes to intellectual disability. Children who have a moderate to severe intellectual disability have a very slow learning rate, and cause concern in the first two years of life. These concerns may be about a lack of sustained interest in toys and people, slow feeding or a delay in speaking the first words.

A child with a mild intellectual disability may have a delay in their talking in their third or fourth year, while others may have a delay in their play, self-help and learning skills. A very mild intellectual disability may not become apparent until a child’s early school years.

Other problems that can affect children with an intellectual disability include vision and hearing impairments. Some children may have epilepsy from birth, or develop it during childhood. A child with an intellectual disability will need more time and practice to learn than other children.

What causes intellectual disability?

The cause of an intellectual disability is not always known, however over half are caused before birth. Some prenatal conditions that can cause an intellectual disability include:

  • Down syndrome
  • Metabolic disorders
  • Fragile X syndrome
  • Williams syndrome

Some factors that can cause an intellectual disability around the time of birth include:

  • A lack of oxygen
  • Infections
  • Trauma

Factors that can cause an intellectual disability after birth include:

  • Car accidents
  • Near-miss drowning accidents
  • Infections – meningitis, encephalitis

How common are disabilities in childhood?

It is unknown howcommon disabilities are in childhood, but there are figures available for some conditions that cause a major developmental delay.

  • Autism spectrum disorder affects 1.6 /100 children
  • Intellectual disability (mild) affects approximately 1/100 children
  • Intellectual disability (moderate/severe) affects approximately 3–5/1,000 children
  • Cerebral palsy affects 2/1,000 children
  • Hearing impairment requiring a hearing aid affects 1–2 /1,000 children
  • Blindness/severe visual impairment affects 3/10,000 children

What is an autism spectrum disorder (ASD)?

Autism spectrum disorders (ASD) describe children who behave in a certain way, with a diagnosis made when a child displays the following:

  • A major delay in language development
  • Difficulties relating to other people
  • Limited play and unusual repetitive behaviour

The majority of children with ASD have intellectual disabilities that present developmental delays in their second year of life. ASD and intellectual disability share most of the same possible causes.

How are developmental delays assessed?

Assessments are used to discover a child strengths and weaknesses, allowing parents to plan for the future of their child. Parents should discuss what an assessment involves with medical and support staff. Parents are often asked to contribute to the assessment, as they are usually the best observers of their child.

The first stage of the assessment is often with a paediatrician who will look at medical history, observe the child, conduct a physical examination, or order some relevant medical tests.

The second stage gathers information about a child’s skill across all areas of development, how a child relates to those around them and learns. This process involves the child and family being seen by one or more of the following:

  • Speech pathologist
  • Physiotherapist
  • Occupational therapist
  • Psychologist
  • Teacher
  • Social worker

A child will be observed interacting and playing with others and may be given tasks to complete, such as puzzles, climbing steps and naming pictures.

The assessment is helpful in understanding a child’s development, however it is important to remember that as a child grows and changes, so will their needs. Assessment may take place at:

  • A local community setting – day care centre, community health centre
  • A hospital with paediatric and therapy departments
  • In the home
  • A specialised centre

An assessment may take one or more sessions over several days depending on the nature of the child’s developmental delay.

What do children with developmental delays need?

Children with developmental delays have the same needs as other children: a warm, secure and nurturing environment, and a need to feel accepted. It is important to develop self-esteem and build confidence.

Children with developmental delays need extra help in one or more areas of development.

They may require:

  • Hearing language in a way they can understand
  • More time to learn and practice new skills
  • Have tasks simplified or broken down into smaller tasks
  • Know their efforts and contributions are valued
  • A variety of ways to learn – touching, listening, looking

Teachers and therapists may be able to give suggestions and advice about the best ways a child can learn at home in the early years of life.

Are developmental delays related to behavioural problems?

Children with developmentaldelays have an increased risk of behaviour problems. Parents begin to adjust the individual needs of their child when they display signs of delayed development. There will be a lot of trial and error during this process that can cause frustration in both the child and parent.

Parents may not understand a child’s intention or capability. Some children with developmental delays have trouble remembering simple instructions, while others who cannot talk may not be able to understand.

Developmental delays often mean that behavioural skills are created gradually, but this is not an indication of a behavioural problem.

The difference between ability and expectation can cause frustration for children and those around them. When frustration or uncertainty is persistent it can be helpful for the family to talk to one of the workers familiar with the child. It may also be helpful to discuss any progress to help distinguish whether behaviours are a feature of the delays or indicate an emotional problem.

What do families need?

Family members may feel intense, recurring emotions like anger, grief, disbelief and isolation, and should seek help and support.

Children with severe delays may need lot of assistance with activities of daily living such as eating, dressing and talking, which can put excessive stress on the family. Hidden costs such as doctor’s’ visits, special equipment and extra child care can also put huge amounts of financial stress on a family.

Each family will have different requirements, however, most families will need:

  • Answers to any questions they have
  • Support in understanding their child’s delay – family members, professionals, friends
  • Information about services they need and are available to them
  • Information about how they can help their child
  • To be able to have a break

How to prepare a child for school

It can take a lot of time and planning to choose the most appropriate school for a child with a developmental delay or disability. Parents often wonder if their child will be able to go to a normal school.

All children are entitled to an education at their local primary school, and any special resources will be made available to the school. Some schools offer specialised programs for children with intellectual or other forms of developmental disability.

Workers who know your child well will be able to provide information to help you to choose a school and equip your child with appropriate support.

Schools may request assessment reports to figure out what your child will need, and your doctor or therapist may also assist.

Regional offices of the Department of Education can provide information and resources about schooling for children with developmental problems.