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Developmental Delay

What is Developmental Delay?

Developmental delay is when a child does not reach his/her developmental milestones by a time or age that expected. Developmental milestones are tasks most children learn or develop that commonly appear in certain age ranges. Developmental milestones from the age of 1 month to 1 year are described as below.

Table 1: Developmental Milestones


Look out for Warning Signs


Some of the parents may think that babies should develop at their own paces, and they should not be challenged to do things that they are not yet ready for. There are warning signs of development that parents have to concern and take it seriously.



1. Persistence of primitive reflexes > 6 months of age


2. No response to environment or parent by 12 months


3. Not walking by 18 months


4. No clear spoken words by 18 months


5. No two word sentences by 2 years


6. Problems with social interaction at 3 years


7. Any delay or failure to reach normal milestones


Developmental Red Flags


You know your child better than anyone. If your child is unable to perform tasks within the expected time frame and you may note for the red flags according to the Table 2 shown above, speak to your doctor.



Table 2: Developmental Red Flags




Cause of Developmental Delay



The specific cause is unknown, but there are some risk factors to consider. Risk factors for developmental delay fall into two categories:

1. Genetic factors – Children are at risk of acquiring developmental delay if they are born

​with a genetic or chromosomal abnormality such as Down Syndrome and Autism.

2. Environment factors – Developmental delay may also occur due to premature birth, poor nutrition, exposure to certain toxic substances or infections either before or after birth and lack of play and stimulation throughout the development process.




How to define as Global Developmental Delay(GDD)?

A child may be described as having Global Developmental Delay (GDD) if they are not reached two or more areas of development. These areas are:

1. Motor skills – either gross motor skills like sitting up or rolling over and fine motor skills, for example picking up small object.


2. Speech and language – which also includes babbling, imitating speech and identifyingsound, as well as understanding what other people are trying to communicate to them.


3. Cognitive skills – the ability to learn new things, process information, organize their thoughts and remember things.

4. Social and emotional skills – interacting with others and development of personal traits and feelings, as well as starting to understanding and respond to need and feelings of others.

Role of Parents in Child’s Development

1. Keep an eye on your child’s development according to the milestones, speak to doctor as soon as you feel something is not right.


2. Introduce the child to a variety of different environments will provide an opportunity to develop in a variety of different ways. 


3. Spend more time to play with the child.


Piaget believed that play is the child’s way of assimilating new information into his/her view of the world and adapting to new situations. It has an important implication for physical, psychological and psychosocial development of children.



Role of Physiotherapist in Helping Kids with Developmental Delay

Early detection and intervention are important to help children learn and develop essential skills. Physiotherapy treatment should be started as early as possible as a child’s brain can adapt easily therefore they respond well to treatment. Physiotherapist will focus on:

1. Carry out comprehensive assessments of the areas concerned with your child development.


2. Develop a personalized and effective long-term rehabilitation plan which meets the goals of both therapist and parents.


3. Assist your child to learn basic physical activities like crawling, sitting and standing.


4. Assist your child to gain independence in mobility and daily activities.


5. Help your child to improve posture, body balance, motor control and coordination.


6. Help your child to develop confidence.


7. Provide a safe, fun and stimulating environment.


8. Encourage active participation from parents throughout the child’s rehabilitation.


9. Educate and guide parents or caregivers in transferring exercise programs at home.


References:  

1. Rebecca J. Scharf, Graham J. Scharf and Annemarie Stroustrup. 2016. Developmental Milestones. Pediatrics in Review 37 (1): 25-38.

2. Paediatrics Protocols for Malaysian Hospitals 3rd Edition.


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