Children's Hospital Colorado

Developmental Delay

What is developmental delay?

Developmental delay refers to a child who has not gained the developmental skills expected of him or her, compared to others of the same age. Delays may occur in the areas of motor, speech and language, cognitive, play and social skills. Global developmental delay means a young child has significant delays in two or more of these areas of development. 

The terms developmental delay or global development delay are used to describe younger children before school age. Importantly, a diagnosis of developmental delay generally does not predict later intelligence. 

What causes developmental delay?

There is not one cause for delays in development. Factors that may contribute can occur before a child is born, during the birth process,and after birth. For example:

  • Genetic or hereditary conditions like Down syndrome
  • Metabolic disorders like phenylketonuria (PKU)
  • Trauma to the brain like shaken baby syndrome or severe head injury
  • Severe psychosocial trauma like post-traumatic stress disorder
  • Exposure to certain toxic substances like prenatal alcohol exposure or lead poisoning
  • Some very serious infections
  • Deprivation of food or environment

In some cases, it may not be possible to find the cause of the developmental delay.

What are the signs and symptoms of developmental delay?

Children with developmental delays meet developmental milestones at a slower rate than expected based on their age. Delays in the different areas may occur when a child develops skills slower than other children the same age in the following areas:

  • Speech-language milestones (babbling, first words, combining words)
  • Fine motor milestones (grasp and thumb-fingertip skills)
  • Gross motor milestones (rolling over, sitting up, walking, jumping)
  • Social milestones (social smile, eye contact, interest in others, play skills)
  • Problem-solving skills (curiosity, interest, early reasoning skills)
  • Daily skills (dressing, eating, progress with toilet training)  

Each child is an individual who will develop these skills on his or her own time. However, there is a range, usually several months, which is considered "normal" for different developmental milestones.

If you have questions about your child's developmental progress, you should first discuss them with your child's primary care physician. He or she will help you decide if your child might benefit from seeing a specialist like those at Children's Hospital Colorado.

What tests are used to diagnose developmental delay?

Most children are screened for developmental skills by their primary care provider during well-child visits at 9, 18, 24 and 30 months. Primary care providers are also a great first resource for any questions or concerns parents might have about development. If those initial screenings indicate a child may need more testing, primary care physicians often refer to a specialist for more intensive diagnostic testing.

Seeing a specialist for developmental delay

During a full diagnostic test of development at Children's Colorado, a specialist will test your child's cognitive, fine motor, gross motor, expressive and receptive language, social and daily living skills using standardized tests. These tests are non-invasive and won't cause any pain to a child. In fact, many of these tests seem like games to children.

In addition to this developmental screening process, a child's hearing and vision should be tested to make sure that these are not contributing to a child's slower skill development.

In some cases, doctors at Children's Colorado may recommend additional medical tests based on your child's history, physical examination and results of developmental testing. These tests may include a blood test or imaging test. During these tests, doctors will try to determine if there are ongoing medical issues that could be contributing to the delays.

How is developmental delay treated in kids?

If there is an underlying medical reason causing developmental delay, identification and treatment of that condition may improve your child's developmental skills.

Although there is no cure for developmental delay, therapies directed to the specific area of delay are very effective in helping children catch up to their peers. These types of therapies include:

  • Physical therapy is helpful for children with delays in gross motor skills, often addressing issues related to muscle tone, strength and coordination.
  • Occupational therapy addresses fine motor skills, sensory processing and self-help issues. The occupational therapist, along with the speech therapist, may also address feeding issues related to delays in oral motor skills or sensory processing issues.
  • Speech and language therapy addresses problems in the areas of understanding and producing language and speech sounds. The speech therapist may also be involved in development of feeding skills. 
  • Early Childhood Special Education provides stimulation for early developmental skills, including play skills.
  • Behavioral therapy may be needed in some children to address behavioral difficulties that affect socially appropriate behaviors.

Why choose Children's Colorado for your child's developmental delay?

Our Developmental Pediatrics Program includes developmental pediatricians, psychologists, speech-language therapists, occupational therapists and social workers who all have extensive experience working with children and their families with developmental delays.

Our clinicians work closely together in multidisciplinary teams, and may refer children to other medical providers at Children's Colorado to help with additional assessments or therapies when needed.

  • Early Intervention Colorado matches families with counselors and therapists.
  • ARC of Colorado is an advocacy group for children and adults with intellectual disability. They can be reached at 303-864-9334.
  • The Centers for Disease Control's First Signs program offers help in identifying symptoms of developmental delay in kids and other medical information about other intellectual conditions.

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