How Do You Diagnose a Global Developmental Delay?

How Do You Diagnose a Global Developmental Delay

Takeaway: Children with a global developmental delay are well behind in meeting many developmental milestones. These include milestones to do with (1) cognitive skills, (2) motor skills, (3) language & communication skills, (4) social and emotional skills, and (5) self-care skills. You can download milestone checklists to try and identify a global delay, but that’s just a first step. Eventually, you’ll need a team of specialists to make the diagnosis and create a care plan.    

It’s a joy to watch babies and toddlers grow up because we get to see them develop new skills.

In an earlier post, we explored the difference between babies ‘growing’ (i.e., getting bigger) and ‘developing’ (i.e., learning new, more complex skills). So, what are these skills they learn? Well, can categorise them as follows:

1. They begin to think, learn, and solve problems.

Babies are flooded with sensory stimulation and are drawn to the sights, sounds, and smells around them. Their brains begin to make sense of all this input, and the more a baby develops, the more complex this ‘making sense of things’ becomes. That is, her cognitive (i.e., thinking) skills evolve. She begins to learn the names of the objects and people in her life, and in time starts to understand what they can do for her. She knows ‘mummy’ will bring her food, ‘daddy’ will play with her, the ‘iPad’ shows her fun ‘videos’, and so on.

2. They get better at using their hands and legs.

Cognitive skills improve when children interact with the world around them. This means shoving fingers into food, climbing onto mummy’s lap, crawling up to toys, and more. And for this, children need to master the use of their hands and legs — i.e., they need to develop their motor skills. This includes both ‘fine’ motor skills (using small muscles in the hand, for example) and ‘gross’ motor skills (using larger muscles like those in the leg). Examples of fine motor skills would be picking things up, moving toys around, and drawing. And gross motor skills are things like sitting up, rolling over, crawling, and walking.

3. They start talking and using language.

Babies can only coo and babble. But as they develop, their mouths can start making more nuanced sounds, and their brains start rearranging these sounds to mimic the words their parents say to them. In time, they begin to join words together to form increasingly complex sentences, which improves their thinking and cognition.

4. They begin to understand people and emotions.

Exploring the physical world is exciting, but babies simultaneously discover the hidden world of emotions, feelings, and intentions. For example, this means knowing when they’re sad, understanding what that means, and learning what to do about it. But it also means recognising when mummy is sad and learning what to do about that, too.

5. They slowly master daily chores and activities.

A child’s cognitive and motor skills allow her to start handling everyday activities like eating, bathing, and dressing. These skills are a sign of her independence, and it’s why she’ll proudly say, “Look! I can tie my shoelaces myself!”

When children are significantly late to develop skills in one of these categories, we call it a developmental delay.

Sometimes, children lag in a single skill-category. For example, a child might have problems picking up her toys, drawing, and tying her laces. They might seem like separate problems but are likely all to do with a single delay — i.e., a delay in developing fine motor skills.

But when the difficulties spread to multiple categories, it’s termed a global developmental delay.

A global delay is far more complicated. Here, the same child might have motor issues, a limited vocabulary (a language delay), and handles frustration poorly (an emotion-control delay). Her delays now touch three of the five categories we covered earlier — making it harder to figure out the root cause.

As a parent, you can keep an eye out for delays and global delays by learning about common developmental milestones.

Psychologists can list the key skills children learn and when they’ll learn them by. These are called developmental milestones, and you can use them to track your child’s progress. Let’s take cognitive skills (thinking, learning and solving problems) for example. At 6 months, a baby will start looking around her and trying to get hold of whatever catches her attention. At 9 months, she’ll be able to grasp these things (between her thumb and index finger only) and pop them in her mouth as a way of exploring. By 1 year, she’s banging these things together and putting them inside containers, or will follow your instructions if you say something simple like, ‘Pick that up’.

The trouble is there are different versions of these milestones. And children progress at varying speeds. So, use any list of milestones only as a rough guide.

You’ll find milestone checklists for language/communication, social/emotional skills, physical development, etc. But remember they’re only rough guidelines and it’s perfectly normal for children to jump ahead or fall a bit behind. Funnily enough, these checklists often don’t have many milestones in common. Where they’re useful, though, is if your child falls significantly behind or is struggling with more than one category of skills.

For a truly objective assessment, you’ll need to take your child to a specialist.

Global developmental delays are stressful for both you and your child. And it’s quite a nuanced phenomenon, so blog posts and checklists are only a start. Eventually, you’ll need to consult a specialist for a thorough assessment. She’ll begin by having an in-depth conversation with you to understand your child’s history better. She’ll then examine your child for physical issues like poor hearing or vision. And she’ll also evaluate your child’s language and communication skills. If she needs to, she’ll then organise things like blood, genetic and chromosomal tests, and/or MRIs, EEGs, etc. This process will help her systematically rule out the various possible causes for your child’s global delay — for example, learning differences, autism spectrum disorder, genetic disorders, poor nutrition, chronic ear infections, and more.

Once we’ve found the cause, we can assemble a team of specialists to address all her delays.

The Ed Psych Practice offers consultation, advice, and problem solving for parents, nurseries, schools, and colleges, in London. We have paediatricians and psychologists who can help assess your child and offer guidance and support.

Want to see how else you can help your child? You might enjoy some of our other posts.

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