Children with developmental delay are not achieving certain skills as quickly as expected. This means that the child is not reaching developmental milestones at the usual age. This may affect the child’s speech and language, fine and gross motor skills, and/or personal and social skills.
There are numerous causes of developmental delay. One of the goals of the pediatric neurologist is to identify the cause of a child’s neurologic or developmental problem.
Some signs that infants are not meeting their normal motor milestones include not being able to bring their hands together by 4 months, not rolling over by 6 months, having head lag when pulled to a sitting position after 6 months, not sitting by themselves without support by 8 months, not crawling by 12 months, and not walking by 15 months. It is important to remember that mild delays in motor development can be normal, and there is a range during which these milestones are usually met, so the child may not meet each one at the same time as other children. Delayed motor development, with normal language skills, can be caused by a neuromuscular disorder or mild cerebral palsy.
A delay in fine motor skills in older children may be manifested by not being able to use a spoon or fork, tie his shoes, button his clothes, write his name, draw shapes, color inside the lines, or hold a pencil correctly by the age-appropriate time, or by having poor handwriting. A delay in gross motor skills in older children may include not being able to ride a tricycle or bicycle, being clumsy, or not walking correctly.
A global delay, which involves delays in all areas of development, is usually caused by a static (does not worsen with time) encephalopathy (brain disease) caused by a disorder before or near the time of birth. Causes of global delays include prematurity, cerebral malformations, chromosomal disorders, infections, and progressive (may worsen with time) encephalopathies (metabolic diseases, hypothyroidism, hydrocephalus). Testing to look for the cause of a global developmental delay may include a magnetic resonance imaging (MRI) scan of the head.
Delayed speech and language development can be caused by a developmental language disorder, hearing loss, mental retardation or autism. Among the screening tests used for diagnosis are the Early Language Milestone (ELM) Scale-2 and the Clinical Linguistic and Auditory Milestone Scale (CLAMS).
Other evaluation tools include:
Early intervention is designed to identify and treat a problem or delay in an infant, toddler or preschooler as early as possible. Even young babies may benefit from early intervention. Today, there are many treatment approaches that didn’t exist just a few years ago to help babies and toddlers.
At the CHOC Neuroscience Institute, we offer highly individualized, tailored care to manage the full range of developmental disabilities. This individualized treatment may include self-care training, fine motor training, sensory processing regulation, social/play development and speech therapy and communication skills.
Infants and children who are hospitalized at CHOC with developmental concerns or disabilities receive quality, compassionate care from pediatric neurologists, registered physical and occupational therapists, child life specialists and licensed speech pathologists.
At the CHOC Neuroscience Institute, our experts have extensive experience in the diagnosis and treatment of developmental delays. They work closely with families to help maximize abilities while preventing new problems wherever possible.
A Special Program at CHOC: Early Developmental Assessment Center
The Early Developmental Assessment Center (EDAC) at CHOC is designed to detect a broad spectrum of developmental problems early--including those resulting from premature birth or illness during the first month of life--to prevent or minimize developmental delays in the future. At the Center, a comprehensive, multidisciplinary assessment is done during one office visit to screen for medical, developmental, nutritional and behavioral concerns. Our team of experts assesses your child’s progress and makes referrals to community resources. EDAC provides comprehensive assessment to infants and toddlers up to 36 months old.
It is important to remember the health information found on this website is for reference only not intended to replace the advice and guidance of your healthcare provider. Always seek the advice of your physician with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician or 911 immediately.
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