Developmental delays or disorders are a common term given to a group of chronic conditions that arise due to mental or physical impairments. A child with developmental delays has trouble learning and functioning as well as his or her peers. Developmental disabilities can begin at any point of time, right from birth to maturity and usually last throughout a person’s lifetime.

Causes of Developmental Delays

There are a variety of factors that can cause developmental delays including:

• Genetic factors like PKU and Down’s syndrome

 

• Exposure to toxic substances, such as alcohol, tobacco, or other drugs during pregnancy

 

• Infection during pregnancy

 

• Stress on the baby during labor, such as not getting enough oxygen

 

• Serious head injury after birth

In many cases, it is difficult to identify the exact cause of developmental delay.

Types of Developmental Delays

Developmental disabilities arise due to birth defects and can be placed in different categories:

• Nervous system-related disabilities are birth defects that affect the functioning of the brain and spinal cord and have an impact on a child’s intelligence and learning ability. These include intellectual and developmental disabilities such as Down’s syndrome and fragile X syndrome, genetic conditions that causes mental impairment. Autism spectrum disorders also come under nervous system disabilities, where a child’s communication and social skills are negatively affected.

• Sensory-related disabilities arise as a result of complex birth defect patterns. Most common sensory disabilities include congenital rubella and fragile X syndrome. Congenital rubella, which is caused by a combination of problems from a mother having rubella while pregnant, causes the child to be deaf or develop cataracts of the eyes. Children with fragile X syndrome will be over sensitive to loud noises.

• Metabolic disorders, which occur when abnormal chemical reactions disrupt the metabolic process, include phenylketonuria (PKU) and hypothyroidism. PKU occurs when the baby is born without the ability to break down an important amino acid called phenylalanine. Babies born with hypothyroidism are unable to make enough thyroid hormone, which controls metabolism.

• Degenerative disorders usually manifest as the child grows older and can cause physical, mental, and sensory problems that can result in loss of function. Rett’s syndrome is a degenerative birth defect of the nervous system affecting language and hand usage.

A child is considered to have a developmental delay when there is a significantly low intelligence quotient (IQ) of 70 to 75 or lower and problems with everyday activities such as getting dressed or using the bathroom.

Diagnosis

During routine child exams, pediatricians and family medicine physicians perform screening tests to assess children’s development of physical, social, language, and mental skills. If there is a delay or deficiency suspected, the physician will refer the child to a certified psychologist or psychiatrist (physician who specializes in mental disorders) who specializes in diagnosing developmental disorders by administering standardized tests and exams.

The child’s adaptive behavior will also be observed. Adaptive behavior includes how well the child interacts and meets the demands of other people, motor skills, ability to self-help, and day-to-day independent living skills, such as eating.

Ideally, pediatric screening for developmental delays should help identify the signs early; however, many children are not detected until early school years.

The earlier the diagnosis, the easier it is to provide an appropriate school setting. Information gathered from parents, teachers, and family members regarding behavior and family history can be used as a basis for diagnosis.

Helping the Child

The majority of developmental disabilities have no cure, but the symptoms can be treated. Help from a speech pathologist, occupational therapist, and trained child development specialist will assist the child in developing fine and gross motor skills, speech, and language skills. The child can attend classes in a special educational setting with a trained educator for more individual attention and support.

When the child has mild symptoms, engaging in non-academic activities like sports, physical education, singing, and art with peers is encouraged, especially in inclusive schools where students with special needs are not segregated in “special” classes. Preparing the child to be as independent as possible and pursue vocational training will be a major goal of education.

A developmentally delayed child will need extra help at school, and educators will need to be proactive in observing the child’s behavior and response to the environment. All schools are required by the federal government to create an Individualized Education Program (IEP) that will identify the child’s strengths and weaknesses and define the strategy and measures that will be done to maximize the child’s ability to learn and develop. It is imperative that the progress of the child be routinely monitored so that the IEP’s effectiveness can be evaluated; the IEP should be revised as necessary. Being taught ‘life skills’ is also important so the child can learn to be self-sufficient and do certain chores alone. Any episodes of teasing or bullying by other children should be brought to the notice of the teachers and caregivers.

A small percentage of children, who have severe developmental issues, may benefit from placement in residential settings with special education.

Caregiver Needs

At times, looking after a child with developmental delays can be stressful for the family members.

Caregivers can become so focused on looking after a child with developmental delays that they lose interest in all other activities. Caregivers should be encouraged to seek help from community support organizations, and avoid becoming a ‘hidden patient,’ as some doctors have termed the isolation that can arise.

The child with developmental delays may not always show affection or actively respond to a caregiver, but continuous attention and care will create a lasting bond with the child.