Developmental Delay in Children

What is a developmental delay?

A developmental delay is when your child is slow to reach one or more developmental milestones compared to their peers. Developmental milestones include skills such as:

• Smiling for the first time.
• Rolling over.
• Pulling up to stand.
• Waving “bye-bye.”
• Taking a first step.
• Speaking a first word such as “dada.”

Children reach milestones in playing, learning, speaking, behaving and moving. They develop and reach these milestones at different rates. There’s no strict timetable. So if your child is a little behind, that doesn’t mean they have a developmental delay. A developmental delay means your child is continually behind in developing skills expected by a certain age.

What is child development?

A child’s growth is more than just physical. Children grow, develop and learn throughout their lives, starting at birth. You can learn about your child’s development by watching how they interact with their environment, including how they play, learn, speak, move and behave.

Types of developmental delays

Developmental delays align with the areas of child development. These include:

• Cognitive (thinking) skills: Cognitive skills include thinking, learning and understanding information. A child with a cognitive delay may have trouble following directions or solving a problem.
• Social and emotional skills: These skills include getting along with others, expressing feelings and the ability to communicate needs. A child with social or emotional delays may struggle with understanding social cues, having a conversation or dealing with changes to a routine.
• Speech and language skills: Speech and language skills include using and understanding language. A child with speech and language delays may have difficulty speaking words or understanding what others say.
• Fine and gross motor skills: These skills include the ability to coordinate small (fine) and large (gross) muscles. A child with a fine motor delay may have trouble holding an object in their hands or have trouble with coloring and writing. A child with a gross motor delay may have difficulty rolling over, sitting up or walking.

What is global developmental delay?

Developmental delay can be isolated, meaning a delay affects only one area of development. If a significant delay occurs in two or more of these developmental areas, your child may have what providers refer to as global developmental delay.

Developmental delay vs. autism

Developmental delay is different from developmental disabilities such as autism spectrum disorder.

A developmental delay is when your child doesn’t reach their developmental milestones as expected. It usually means your child is developing certain skills slower than their peers. But with early intervention and support, they’ll typically catch up.

Developmental disabilities such as autism don’t go away on their own — they’re usually lifelong conditions. Autism is a neurodevelopmental disorder present from early childhood. Children with autism have trouble interacting with others, forming relationships and using language.

It can sometimes be difficult to determine if your child has a developmental delay or a developmental disability. Regardless, early intervention is the best way to help your child progress and thrive.

How common is this condition?

According to the U.S. Centers for Disease Control and Prevention, approximately 1 in 6 children in the United States, or 17%, has at least one developmental delay.

What are the symptoms of a developmental delay?

Symptoms of developmental delays vary depending on the type. Symptoms may include:

• Delays in rolling over, sitting up, crawling and walking.
• Trouble with fine motor skills.
• Problems understanding what others say.
• Trouble with problem-solving.
• Issues with social skills.
• Problems talking or talking late.
• Difficulty remembering things.
• Inability to connect actions with consequences.

What causes developmental delays?

Researchers don’t know the cause of many developmental delays. However, some developmental delays occur as a result of genetic factors, such as Down syndrome or fragile X syndrome.

In addition, some babies and children have an increased risk of developmental delays as a result of environmental factors, including:

• Exposure to toxins before birth, such as alcohol, opioids or weed (marijuana).
• Exposure to toxins after birth, such as lead poisoning.
• Premature birth.
• Low birth weight.
• Not enough oxygen at birth.
• Poor nutrition.
• Health conditions such as chronic ear infections and vision issues.
• Severe trauma, including child abuse.

What is developmental screening?

Healthcare providers use developmental screening to tell if children are learning basic skills when they should, or if they might have issues. Your child’s provider may ask you questions or talk and play with your child during an exam. This shows how your child learns, speaks, behaves and moves.

Your child’s provider may also ask you questions or give you a questionnaire to fill out. Developmental screening is a tool to find out if your child is on track or needs extra evaluations or treatments. There’s no lab or blood test to tell if your child may have a delay in their development. However, there are tests for other specific syndromes and disorders that cause developmental delays. Your child’s provider will tell you whether your child needs any of those.

Because there’s a wide range of growth and behavior for each age, it’s natural for children to reach a milestone earlier or later than a general trend. Your child’s provider will look at the big picture and let you know where your child fits in.

Why is developmental screening important?

When a developmental delay isn’t found early, children don’t get the help they need right away. This can make it hard for them to learn and it makes developmental delays worse. The sooner children get help, the better off they’ll be in the long run.

What happens if my child has a developmental delay?

Depending on what the concerns are, your child’s healthcare provider may refer your child to one or more specialists. These may include:

• A hearing specialist.
• A speech therapist.
• A developmental pediatrician.
• A neurologist.
• A provider of early intervention services.

What are early intervention services?

Early intervention services provide support for infants and toddlers with certain issues. These may include:

• Premature birth.
• A variety of health problems.
• Delays in talking, thinking, playing or moving.
• Difficulty with seeing or hearing.

If your child is eligible for early intervention services, their provider will write an Individualized Family Service Plan (IFSP). This plan is based on the particular needs of your child and your family. Your child’s provider will figure out what activities and services could best help your child. The types of services include:

• Assistive technology (devices your child may need).
• Audiology or hearing services.
• Speech or language services.
• Family counseling and training.
• Medical services.
• Nursing services.
• Nutrition services.
• Physical therapy.
• Occupational therapy.
• Psychological services.

Can this be prevented?

Scientists don’t always know why developmental delays happen, so you can’t always prevent them. It’s important to avoid toxins during your pregnancy and go to all of your prenatal appointments.

The best way to prevent long-term developmental delays is early intervention. Research has shown that early intervention services for babies and children up to 3 years of age can minimize and often prevent the long-term effects of developmental delays.

Will my child “outgrow” developmental delay?

Most developmental delays will resolve on their own over time. With early intervention services, your child should be able to catch up to their peers and reach their full potential. However, without early intervention support, there’s a chance a developmental delay may progress into a more serious problem. Therefore, it’s critical that you seek support as soon as possible if you suspect your child has a delay.

How do I take care of my child with a developmental delay?

If your child has a developmental delay, there are ways you can help them make progress. Along with making sure your child has the support of early intervention services, you can also:

• Play with your child: Playing can help your child develop a variety of skills. Activities such as using play-dough can help develop their fine motor skills. On the playground, your child can develop physical skills as well as social-emotional skills. Playing with adults and other children helps with language and social skills.
• Read with your child: Reading with your child helps them to learn language. The more words your child hears, the more words they learn.
• Limit time on screens: Children learn best from interactions with others, not from time spent watching TV or playing video games. Screen time for young children should be less than one hour per day.
• Make a schedule: Writing out and creating a schedule can help your child follow directions and better understand a routine. Printing out picture schedules for your family can help your child visualize what’s expected of them.
• Keep in contact: Regularly touch base with your child’s intervention services coordinator and other healthcare providers. These health professionals can let you know how your child is progressing and give you tips to help your child thrive.

A note from Cleveland Clinic

Development refers to how your child grows and changes over time. It includes physical, thinking and problem-solving (cognitive), language and social-emotional development. While there are developmental milestones that mark the stages of typical growth, every child is unique. If your child has a developmental delay, they’ve not yet gained the skills that experts expect children their age to have.

Learning that your child has a developmental delay can be concerning. But therapies can help your child with developmental delay function well or catch up with their peers. If you have any concerns about your child’s development, reach out to their healthcare provider. Getting a diagnosis and lining up the appropriate therapy can help your child thrive.