Developmental Delay

As a child grows and develops, he learns different skills, such as taking a first step, smiling for the first time, or waving goodbye. These skills are known as developmental milestones. There is normal variation around what age children will achieve a specific developmental milestone.  Developmental delay refers to a child who is not achieving milestones within the age range of that normal variability. Most often, at least initially, it is difficult or impossible to determine whether the delay is a marker of a long-term issue with development or learning (i.e. known as a disability) or whether the child will ‘catch-up’ and be ‘typical’ in their development and learning.  ’There are five main groups of skills that make up the developmental milestones. A child may have a developmental delay in one or more of these areas:

  • Gross motor: using large groups of muscles to sit, stand, walk, run, etc., keeping balance and changing positions.
  • Fine motor: using hands and fingers to be able to eat, draw, dress, play, write and do many other things.
  • Language: speaking, using body language and gestures, communicating and understanding what others say.
  • Cognitive: Thinking skills including learning, understanding, problem-solving, reasoning and remembering.
  • Social: Interacting with others, having relationships with family, friends, and teachers, cooperating and responding to the feelings of others.

Usually, there is an age range of several months where a child is expected to learn these new skills. If the normal age range for walking is 9 to 15 months, and a child still isn’t walking by 20 months, this would be considered a developmental delay (2 standard deviations below the mean). A delay in one area of development may be accompanied by a delay in another area. For example, if there is a difficulty in speech and language, a delay in other areas such as social or cognitive development may coexist.

It is important to identify developmental delays early so that treatment can minimize the effects of the problem. Parents who have concerns about their child’s development should consult the child’s physician, who, in turn, might make a referral to a developmental pediatrician, developmental psychologist or pediatric neurologist. The consultant can evaluate the child and recommend treatments and therapies that might benefit the child.

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American Academy of Pediatrics

Developmental Delay Resources (DDR)

First Signs

National Center on Birth Defects and Developmental Disabilities
Learn the Signs. Act Early (with checklists for Developmental Milestones)

National Center of Medical Home Initiatives for Children with Special Needs

Zero to Three