Recognizing Developmental Delays in Children

As you watch your child grow, remember that each child develops at his or her own pace and the range of normal is quite wide. However, it is helpful to be aware of red flags for potential developmental delays in children. These delays are significant lags in one or more areas of emotional, mental, or physical growth. If your child experiences a delay, early treatment is the best way to help him or her make progress or even to catch up.

What Are Developmental Delays in Young Children?

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:

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.

Language and Speech Developmental Delays in Children

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

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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

Warning signs of speech or language delays. Contact your child's doctor if your child has any of the following signs at the age that's indicated. In addition, watch for any loss of skills that have already been learned.

By 3 to 4 months, contact the doctor if your child:

  • does not respond to loud noises
  • does not babble
  • begins babbling but does not try to imitate sounds (by 4 months)

By 7 months, contact the doctor if your child:

  • does not respond to sounds

By 1 year, contact the doctor if your child:

  • does not use any single words (like "mama")

By 2 years, contact the doctor if your child:

  • cannot speak at least 15 words
  • does not use two-word phrases without repetition; can only imitate speech
  • does not use speech to communicate more than immediate needs

 

Vision Developmental Delays in Children

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:

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Warning signs of vision problems. Contact your child's doctor if your child has any of the following signs at the age that’s indicated. In addition, watch for any loss of skills that have already been learned.

By 3 months, contact the doctor if your child:

  • does not follow moving objects with his or her eyes
  • does not notice hands (by 2 months)
  • has trouble moving one or both eyes in all directions
  • crosses eyes most of the time

By 6 months, contact the doctor if your child:

  • has one or both eyes turning in or out all the time
  • experiences constant tearing or eye drainage
  • does not follow near objects (1 foot away) or far objects (6 feet away) with both eyes

If your child's doctor notes any problems, the doctor may refer your child to an ophthalmologist for further evaluation.

Motor Skill Developmental Delays in Children

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.

Warning signs of motor skill delays. Contact your child's doctor if your child has any of the following signs at the age that's indicated. In addition, watch for any loss of skills that have already been learned.

By 3 to 4 months, contact the doctor if your child:

  • does not reach for, grasp, or hold objects
  • does not support his or her head well
  • does not bring objects to his or her mouth (by 4 months)
  • does not push down with legs when his or her feet are placed on a firm surface (by 4 months)

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By 7 months, contact the doctor if your child:

  • has stiff and tight or very floppy muscles
  • flops his or her head when pulled into a sitting position
  • reaches with one hand only or does not actively reach for objects
  • has trouble getting objects to his or her mouth
  • doesn't roll over in either direction (by 5 months)
  • cannot sit up without help (by 6 months)
  • does not bear weight on his or her legs when you pull him or her up to a standing position

By 1 year, contact the doctor if your child:

  • does not crawl
  • drags one side of his or her body while crawling
  • cannot stand when supported

By 2 years, contact the doctor if your child:

  • cannot walk (by 18 months)
  • does not develop a heel-to-toe walking pattern or walks only on toes
  • cannot push a wheeled toy

 

Social and Emotional Developmental Delays in Children

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.

Warning signs of social or emotional delays. Contact your child's doctor if your child has any of the following signs at the age that’s indicated. In addition, watch for any loss of skills that have already been learned.

Continued

By 3 months, contact the doctor if your child:

  • does not smile at people
  • does not pay attention to new faces, or seems frightened by them

By 7 months, contact the doctor if your child:

  • refuses to cuddle
  • shows no affection for parents or caregivers
  • shows no enjoyment around people
  • cannot be comforted at night (after 5 months)
  • does not smile without prompting (by 5 months)
  • does not laugh or squeal (by 6 months)
  • shows no interest in games of peek-a-boo (by 8 months)

By 1 year, contact the doctor if your child:

  • shows no back-and-forth sharing of sounds, smiles, or facial expressions (at 9 months)
  • shows no back-and-forth gestures, such as waving, reaching, or pointing

 

Cognitive Developmental Delays in Children

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.

Warning signs of cognitive delays. Contact your child's doctor if your child has any of the following signs at the age that's indicated. In addition, watch for any loss of skills that have already been learned.

By 1 year, contact the doctor if your child:

  • does not search for objects that are hidden while he or she watches
  • does not use gestures, such as waving
  • does not point to objects or pictures

By 2 years, contact the doctor if your child:

  • does not know the function of common objects, such as a hairbrush, telephone, or spoon
  • does not follow simple instructions
  • does not imitate actions or words

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.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on January 08, 2017

Sources

SOURCES:

CDC: "Developmental Screening" and "Important Milestones."

Shevell, M. et al. Neurology, March 16, 2007; vol 60: pp 367–380.

Gillette Children's Specialty Healthcare: "Identifying Patterns of Developmental Delays Can Help Diagnose Neurodevelopmental Disorders."

WebMD Feature: "Is Your Baby on Track?"

Nemours Foundation: "Delayed Speech or Language Development" and "Your Child’s Vision."

First Signs: "Red Flags."

National Institute of Neurological Disorders and Stroke (NINDS): "NINDS Pervasive Developmental Disorders Information Page."

American Academy of Pediatrics: "Sensory Integration Therapies for Children With Developmental and Behavioral Disorders."

© 2017 WebMD, LLC. All rights reserved.

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