5 Types Of Developmental Delays In Children & Ways To Manage

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Developmental delay in children should be evaluated by a pediatrician. Delays are diagnosed when they take longer to reach developmental milestones (age-specific skills) than expected of their age. According to the Centers for Disease Control and Prevention, developmental delays and disabilities are prevalent among one in six US children. That said, each child is unique, and a little delay in attaining milestones is not a reason to worry (1).

However, if children are continuously lagging in their movement, communication, behavior, and thinking and learning abilities, it might indicate an underlying problem. If the developmental delay is long-term, it might be called a developmental disability, such as intellectual disability or cerebral palsy (2).

In this post, we discuss the types, causes, symptoms, diagnoses, and ways to help a child with developmental delay.

What Are The Types Of Developmental Delay In Children?

Developmental delays occur in five areas. When a child shows delay in more than one development area, it is known as global developmental delay. The types of developmental delays are:

1. Cognitive delay: Cognitive delay may affect intellectual function, causing intellectual disability in children and declining their ability to think, learn, and solve problems. A learning disability may result from cognitive delays, leading to difficulties in comprehension and understanding, which become evident when children start going to school or even earlier. (3) (4) (5) (6).

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Causes of cognitive delay

• Genetic disorders in children may cause the inheritance of mutated genes. For example, Down syndrome and fragile X syndrome.
• Injury during pregnancy or the child’s inability to develop properly in the womb
• Problems during birth, such as inadequate oxygen (birth hypoxia) or intracranial bleedsⁱAny bleeding in the brain’s functional tissue and adjacent three layers of membrane , or hemorrhage.
• Health conditions such as malnutrition, untreated meningitis, whooping cough, seizure disorders, shaken baby syndromeⁱLife-threatening brain and neck injuries in babies caused when they are violently shaken , and exposure to lead or mercury

Signs of cognitive delay

• Delay in sitting, crawling, or walking
• Speech delays
• Inability to pay attention for long
• Inability to solve simple problems
• Absence of logical thinking or completing simple tasks
• Memory problems
• Inability to think logically and understand social rules
• Infantile behavior

Treatment for cognitive delay

• Play therapy (teaching skills through play)
• Occupational therapyⁱTreatment that helps people with sensory, physical, or cognitive issues to improve their ability to perform their daily tasks
• Speech therapy
• Special attention in school, which may also include an individualized education plan

Research finds

Studies indicate that children with cognitive delay may begin to exhibit behavioral problems by the time they are nine months old. These problems become more pronounced by 24 months and increase as they reach the school-going age (17).

Causes of motor delay

• Conditions affecting muscles, such as cerebral palsy and muscular dystrophy in children
• Problems with body structure
• Birth hypoxia and intracranial hemorrhage
• Prolonged labor

Signs of motor delay

• Infants have problems with crawling and rolling over
• Inability to control head and neck
• Stiffness in muscles, difficulty in walking, and scissor gaitⁱA condition where knees and thighs cross each other while walking, creating a scissor-like pattern
• Speech problems
• Difficulty in swallowing
• Improper body posture
• Muscle spasms
• Difficulty in running
• Problems climbing up and down the stairs
• Difficulty in holding something, picking small objects, and tying shoes

Treatment for motor delay

• Physical therapy (develops gross and fine motor skills)
• Occupational therapy (develops fine motor skills and sensory integration problemsⁱA condition where the brain struggles to process information coming from several senses )
• In mild cases, physical activity and play also help

3. Socioemotional delay: Socioemotional delay affects the social and emotional skills of children, making it difficult for them to interact with others and communicate their thoughts and feelings (4) (6) (8).

Causes of socioemotional delay

• Neurobehavioral disorders, such as autism spectrum disorder and attention deficit hyperactivity disorder (ADHD)
• Anxiety disorders

Signs of socioemotional delay

• Infants do not respond to waves or smiles
• No eye contact
• No social interaction
• Repetitive movements
• Scared of new people
• Difficulty in starting a conversation with others
• Inability to calm down and adapt to change
• Prolonged tantrums

Treatment of socioemotional delay

• Attachment therapy (counseling children, parents, and caregivers to build attachment)
• Play therapy
• Behavioral therapy
• Skill-oriented therapy (focusing on developing skills)

4. Speech and language delay: Children with delayed speech and language skills find it difficult to communicate with others and understand words and concepts (4) (6) (8) (9).

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Causes of speech and language delay

• Oral motor problems, such as weak muscles of the mouth
• Problems with tongue and jaw movement, leading to speech production disorder
• Brain damage (cerebral palsy)
• Hearing loss
• Genetic disorders
• Environmental factors such as lack of stimulation
• Being a twin
• Living in a bilingual home (children find it difficult to interpret two languages simultaneously)

Signs of speech and language delay

• Reduced vocabulary
• Delay in initial speech, such as saying simple words “papa” and “mama.”
• Inability to form age-appropriate sentences
• Doesn’t talk
• Delay in expressing thoughts

Treatment of speech and language delay

• Increased communication with the child
• Reading to the child
• Hearing test
• Getting ear infections treated
• Speech therapy for kids
• Special attention in school

Besides the conventional measures to help children with speech delay, certain assistive technologies may have an important role to play.
Dana, a mother, talks about one such gadget that helped her daughter communicate. She says, “My daughter, Maya, is almost five. She can clearly speak approximately 15-20 words. With her talker (an iPad with a communication app), she can speak approximately 700 words, with thousands more available at the touch of a button if needed. She can say “Mommy” and “Daddy” with her voice. With her talker, she can tell me that today is Friday, and she’s going to the therapy gym in the afternoon, and she wants to ride on the big swing and the tire swing and do an art project… With her talker, she tells jokes and is sassy and is proud, so proud, to tell us things and to connect with us. If she only had her speaking voice, I would barely know her (i).”

Point to consider

Consult a doctor if parents and caregivers cannot understand 50% of a child’s speech by two years and 75% by three years, as it may indicate speech and language delay in babies (18).

Causes of adaptive delay

• Premature birth, leading to slow muscle development
• A genetic condition such as Down syndrome
• Nerve and muscle disorders, such as cerebral palsy and muscular dystrophy
• Autism spectrum disorder
• Problems with gross and fine motor skills
• Delay in acquiring cognitive skills

Signs of adaptive delay

• Inability to manage daily activities, such as feeding, dressing, or brushing teeth
• Speech and language difficulties
• Problems with reasoning and problem solving
• Lacking organizational skills, such as following a routine or completing assignments

Treatment for adaptive delay

• Physical therapy
• Behavioral therapy
• Occupational therapy (focuses on self-help skills)
• Sensory practice to allow children adapt to the surroundings

How Is Developmental Delay Diagnosed In Children?

As per the data acquired from the National Health Interview Survey, from 2015-2018, approximately 17.8% of children between 3-17 years in the United States have been clinically diagnosed with some form of developmental disability. The diagnoses that surfaced as the most pervasive were ADHD and learning disabilities, trailed by autism spectrum disorder in children and other developmental delays.

Proportion of US children diagnosed with developmental disabilities (2015-2018)

Healthcare providers use developmental screening to diagnose the challenges children are experiencing. The process followed is (1) (11):

• Knowing the medical history: Parents may be interviewed to gain information about the medical details, medical issues, birth defects, medications, and surgeries their children might have had.
  The health professional may also want to know the details about the parents’ medical history or health condition. They may also want details about the mother’s pregnancy, maternal infections, or other related problems.

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• Physical examination: Doctors may examine children to check their physical health and general appearance. They may check their head, eyes, skin, muscle movement, speech, and other characteristics to rule out the possibility of any disorder.

• Developmental assessment: A developmental-behavioral pediatrician may assess children’s behavior, social skills, focusing abilities, language skills, and learning abilities to check the presence or absence of disorders, such as ADHD, autism spectrum disorder, or learning disorders. Some of these developmental tests include ADOS (for autistic children), Denver developmental test, and the Batelle developmental test.

• Hearing test: The healthcare provider may also refer children to an audiologist to check hearing abilities that affect language and speech. In young infants, brain stemⁱThe stalk-like structure that links your brain to the spinal and helps in maintaining the vital functions of the body -evoked potential tests are performed. The audiologist may perform different tests based on the child’s age. If a problem is diagnosed, children are referred to a specialist for further treatment.

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There are no specific laboratory tests to determine developmental delay in children. However, based on the developmental screening, pediatricians advise further testing and steps for treatment.

How To Deal With Developmental Delay In Children?

Apart from the therapies, some other strategies used to address developmental delay are (12):

• Breaking down essential skills into small steps and giving clear instructions to children
• Repeating instructions and giving adequate time to complete the task
• Rewarding for accomplishments
• Teaching interpersonal skills and imparting social skills training
• Using visual instructions, such as pictures, posters, and videos

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• Using gestures
• Integrating learning with fun
• Providing supportive environment
• Taking the help of parents to understand children
• Observing children understand unexpressed signs and signals

The team of professionals that may help children attain their full potential includes pediatricians, physiotherapists, psychologists, social workers, audiologists, speech pathologists, special education teachers, and occupational therapists (2).

Can Children Overcome Developmental Delay?

Although there is no cure for developmental delay, early intervention may help children overcome the challenges more effectively. The progress depends on the degree of delay and effectiveness of the interventions. In addition, management and treatment are slow and require parents’ persistence to continue therapy for months and years.

Children with mild developmental delay and without any sign of physical problems may improve with the help of close monitoring and appropriate stimulation activities.

However, children with high-risk developmental disorders and signs of chronic illness may need support from specialists and therapists (13) (14).

Infographic: Therapies For Developmental Delays

When children are diagnosed with developmental delays with or without behavioral issues, doctors often refer them to therapists. The therapies depend on the type and severity of the child’s health condition. Read this infographic to learn about the different kinds of therapies available.

Illustration: Momjunction Design Team

Illustration: Types Of Developmental Delays In Children & Ways To Manage

Image: Dall·E/MomJunction Design Team

Discover the various developmental delays that might be seen in children, ways to manage them and promote their growth and development, in this video.

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Dr. Mubina AgboatwallaMBBS, DCH, MCPS

Dr. Mubina Agboatwalla is a well-known pediatrician, practicing paediatrics since the last 20 years in Karachi Pakistan. She is the head of the department of Pediatrics in Karachi Liaquat Hospital, as well as her private practice in three specialist clinics in Pediatrics.

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Pragya BhargaviMSc, BEd

Pragya Bhargavi has been in the field of content research, writing and editing for over six years. Her passion for academics and science has enabled her to write creative as well as research-based articles. She has completed her Masters in Microbiology from Bangalore University and obtained a Bachelor’s degree in Education (BEd) from Acharya Nagarjuna University, Guntur.

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Dr. Ritika ShahBDS, CLC

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

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Apoorva KMSc (Counseling Psychology)

Apoorva is a certified psychological counselor and NLP practitioner. The assistant professor-turned-writer believes that her experience as a teacher, psychologist, and researcher enables her to guide MomJunction readers on child development and mental health.

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