Understanding Developmental Delays in Children and What to do About Them

There are many different types of developmental delays in infants and young children. They include problems with:

• language or speech
• vision
• movement — motor skills
• social and emotional skills
• thinking — cognitive skills

Sometimes, a delay occurs in many or all of these areas. When that happens, it is called “global developmental delay.” Global developmental delay may occur for any of the following reasons:

• a genetic defect, such as Down syndrome
• fetal alcohol syndrome, caused by a mother drinking alcohol during pregnancy
• fragile X syndrome, an inherited type of cognitive impairment
• severe medical problems developing soon after birth, often associated with prematurity
• often no cause can be found

What follows are warning signs for different types of delays that may show up from infancy to age 2. You will also learn about some of the causes of developmental delays and potential treatments.

Speech delays in toddlers are common. In fact, language and speech problems are the most common type of developmental delay. Speech refers to verbal expression, including the way words are formed. Language is a broader system of expressing and receiving information, such as being able to understand gestures.

Possible causes. A variety of problems may cause language and speech delays, including:

• exposure to more than one language — which can cause mild delays in toddlers but not delays by the time they reach school age
• a learning disability
• child abuse or neglect
• a problem with the muscles controlling speech — a disorder called dysarthria
• hearing loss, which may occur in children who have severe middle ear infections or occur as a result of certain medications, trauma, or genetic disorders
• autism spectrum disorders — a group of neurological disorders that may involve impaired communication as well as impaired social interaction and cognitive skills
• no cause can be found

Types of treatment. If you or your child’s doctor suspects a speech delay problem, seek an evaluation by a speech-language pathologist. This specialist may test your child’s hearing and use speech therapy with your child. The specialist or doctor may also suggest that you:

• communicate more with your child — talk, sing, and encourage repetition
• read daily to your child
• reinforce speech and language throughout the day
• get treatment for middle ear infections

Until 6 months, a newborn’s vision is normally blurry. Then it improves as the child begins to coordinate sight in both eyes. However, sometimes this does not happen or other vision problems show up.

Possible causes of vision delays. Refractive errors, such as nearsightedness and farsightedness, are common in children. Other eye problems include:

• amblyopia (lazy eye), poor vision in one eye that may also appear to turn outward
• infantile cataracts — a clouding of the eye’s lens — or another inherited problem (these problems are rare)
• retinopathy of prematurity, an eye disease that sometimes affects premature infants
• strabismus — also called cross eyes — eyes that turn in, out, up, or down

Types of treatment for vision delays. Early treatment can help correct many vision problems. Depending on the eye problem your child has, he or she may need:

• glasses or contact lenses
• special glasses
• surgery
• an eye patch

Developmental delays may be related to problems with gross motor skills, such as crawling or walking, or fine motor skills, such as using fingers to grasp a spoon.

Possible causes of motor skill delays. Children who are born prematurely may not develop muscles at the same rate as other children.

Other possible causes of motor delays include:

• ataxia, a defect that impairs muscle coordination
• cerebral palsy, a condition caused by brain damage before birth
• cognitive delays
• myopathy, a disease of the muscles
• problems with vision
• spina bifida, a genetic condition causing partial or total paralysis of the lower part of the body

Types of treatment for motor skill delays. Your child’s doctor may suggest taking certain steps at home to encourage more physical activity. Your child may also need physical therapy for gross motor delays. Certain types of physical or occupational therapy may help with fine motor problems or sensory integration dysfunction.

Children may experience problems interacting with adults or other children, called social and/or emotional developmental delays. Usually these problems show up before a child begins school.

Possible causes. Some causes of social and emotional delays include:

• neglect from early institutionalization or parental neglect
• ineffective parenting or attachment problems
• cognitive delays
• an unknown cause

Another common cause of social and emotional developmental delays fall under the umbrella diagnosis autism spectrum disorder (ASD). This was previously referred to as pervasive developmental disorder (PDD), autism, aspergers and other names. ASD includes disorders that can cause a child have difficulty communicating, have repetitive behaviors and have language problems.

Types of treatment. There is no known cure for these conditions. However, treatment may include:

• special types of behavioral and skill-oriented therapy
• medication may help some problematic behaviors

As with most types of delays, early treatment can make a big difference in the progress your child makes. Depending upon the diagnosis, treatment may also include play therapy or steps to aid attachment between parent and child.

Problems with thinking, or cognitive delays, may be due to one or more of these reasons:

• genetic defects
• significant medical problems before birth
• exposure to something harmful in the environment, such as a toxin

Possible causes. Causes of cognitive delays include:

• a wide range of different learning disabilities
• exposure to alcohol or toxins before birth or afterward, including lead poisoning
• institutionalization or neglect during infancy or early childhood
• Down syndrome and other genetic disorders
• autism spectrum disorder
• severe newborn medical problems
• no known cause

Types of treatment for cognitive delays. As with most types of developmental delays, early treatment can make a big difference in the progress your child makes. Educational intervention can help your child develop specific cognitive skills. Educators and therapists may also recommend specific steps you can take at home to help your child.

Remember: There is a wide range of normal development in children. Most developmental delays in children are not serious and children eventually catch up. Even children who do have serious delays can make big improvements when treatment begins as early as possible. If you have any doubts, talk to your child’s health care provider.

Sunset at Brant Rock