Developmental Disorders and Delays
Developmental delays can affect a child’s physical, cognitive, communication, social, emotional, or behavioral skills. Often, delays affect more than one area of development. When a child has delays in many or all of these areas, it is known as global developmental delay.
Delays in development may be present from birth, but may not be detectable and diagnosable right away. One reason clinicians encourage parents to pay close attention to charts outlining typical development of intellectual, social and cognitive abilities, as well as language and motor skills, is to enable families who see significant developmental delays in their children to get a diagnosis and begin treatment as soon as possible.
About 1 in 54 children will receive a diagnosis of autism. With treatment and support, many grow to lead full, meaningful lives, but early detection and diagnosis is considered essential so that parents can start to provide the attention and services children need. The developmental disorder affects information processing and can significantly affect social and communication skills. But the symptoms and their intensity vary widely from person to person, which is why the condition is generally referred to as Autism Spectrum Disorder.
Symptoms are usually detectable by age two, and are found in males four times more often than in females. While the number of children diagnosed with autism has risen sharply in recent years, there is some debate over whether the incidence is increasing, diagnosis is improving, or if the broader definition of the autism spectrum now simply covers a wider range of individuals
There is no cure for autism, and some in the community of autistic families believe it does not need one, but is instead an example of human neurodiversity. Still, for many on the lower-functioning end of the autism spectrum, therapies can be crucial for alleviating symptoms and stress.
For more, see Autism.
What symptoms of autism can a parent detect in a young child?
The severity of autism symptoms varies widely, but a child with impaired social and communication skills, such as highly delayed speech, restricted interests, repetitive behaviors, avoidance of eye contact, and difficulty forming emotional bonds, should be evaluated by a clinician. Children with autism may also be highly sensitive to certain sounds, textures, tastes, or smells, and may display deficits in motor coordination. Many children with autism also show a strong early preference for unvarying routines of everyday life.
For more, see Autism Symptoms and Diagnosis.
What causes autism?
The specific causes of autism are not fully understood, but researchers now know that the condition is influenced by multiple genetic factors: People with a sibling who has autism are more likely to have it themselves, for example. It has also been found to be more common in children with an older parent, and very low birthweight may be a risk factor as well. There is no connection between vaccines and autism, and no evidence that a mother or father’s parenting style leads to the development of autism.
For more, see What Causes Autism?
How can parents help a child with autism?
Early intervention for autism can be intensive and time-consuming but there is evidence that it can be highly beneficial for young children struggling to develop social, communication, and learning skills and navigate daily life, and that the best outcomes occur when therapies begin by around age three. Early treatment also benefits parents, provide them with support, alleviating their stress, and strengthening their relationship with their child. One widely-prescribed therapy is applied behavior analysis (ABA), which focuses on the components of a behavior—the trigger, the action, and the consequence—and rewarding and reinforcing the desired behavior at each step. Whatever approach is adopted for a child, parents are typically asked to be highly involved and to consistently practice routines at home. In some cases, doctors may suggest antidepressants, antipsychotics, and anticonvulsants, but the decision to medicate a child should always be carefully considered, especially the potential side effects.
For more, see How Is Autism Treated?
How can parents manage a child’s diagnosis of autism?
A diagnosis of autism can be extremely stressful for a parent; it is likely not the parenting path they envisioned or hoped for, and those feelings can be overwhelming. But a child’s early years represent a critical window for interventions that can benefit both parents and children. The right therapy for a child, and the right social support for parents, can make a significant difference and lead to warmer and more positive connections between them. Parents should also look past their natural concerns and recognize their child’s strengths and advantages. Every child struggles in some domains and excels in others; children with autism are no different.
For more, see Parenting a Child with Autism.
Can children with autism thrive at school?
With help, some definitely can. Parents of children with autism typically need to research available services, and advocate for them, but there are many resources available, including school-based programs. Children with autism are entitled to educational support services, for example, including an individualized education plan. No matter what type of services are obtained, parents are generally urged to be in close contact with teachers about their child’s progress.
For more, see Autism at School.
Attention-deficit/hyperactivity disorder (previously known as attention deficit disorder or ADD) is considered to be the most common childhood mental health disorder, affecting between 5 and 11 percent of children. This neurobehavioral disorder affects executive functioning and is typified by inattentiveness, distractibility, hyperactivity, and impulsivity. Some children present either hyperactive or inattentive symptoms, but in some cases, both sets of symptoms manifest, in what is known as combined-type ADHD.
Children with ADHD may find it difficult to concentrate on tasks at home or at school, may daydream frequently, and may become disruptive or defiant in some situations. Symptoms such as hyperactivity and impulsivity may also make it difficult to get along with parents, peers, or teachers. With help, many children with ADHD can learn coping skills, discover their talents, and thrive.
For more, see ADHD.
Is ADHD considered to be a learning disability?
Children with ADHD often face academic challenges, but it is not generally seen as a learning disability as dyslexia or dysgraphia are. But between a third and half of children with ADHD also have a learning disability; parents, teachers, and clinicians should be aware of this risk and evaluate a child’s school performance carefully.
How can parents support a child with ADHD?
Like all children, those with ADHD need a parent’s love and understanding; they may have particular need for structure and consistency at home. The symptoms of ADHD often lead to academic struggles and a lack of self-confidence; a parent’s support can help a child maintain their self-esteem and discover their strengths.
For more, see Parenting a Child with ADHD.
Is ADHD an actual condition?
Yes. The term ADHD is often casually, and wrongly, used by people to refer to themselves or others who may, for example, become distracted or inattentive in a certain moment, while some others dismiss it as a made-up diagnosis that pathologizes normal childhood behavior. But most researchers and clinicians agree that the condition is quite real for those who live with it. It appears to have genetic roots—it runs in some families—and to be associated with brain development. And the fact that people consistently respond to certain treatments is itself evidence that the diagnosis is clinically valid.
For more, see Causes and Risk Factors in ADHD.
Intellectual disability is marked by below average intellectual function and a lack of skills necessary for independent daily living. Symptoms often appear in early childhood and involve struggles with reasoning, problem solving, planning, abstract thinking, judgment, learning from instruction and experience, and practical understanding. Children with intellectual disability may struggle to communicate or engage socially as well. According to the DSM-5, intellectual disability affects about 1 percent of the population, and severe intellectual disability is present in about six per 1,000 people.
For more, see Intellectual Development Disorder.
What intellectual development delays might parents be able to detect in a child?
In the case of intellectual development disorders, delayed development may become apparent at a very early age, although mild intellectual disability may not be recognizable until early school age.
When these symptoms appear, a parent should seek a professional assessment of a child’s development:
Failure to meet intellectual developmental markers.
Difficulties learning academic skills.
Lack of curiosity.
Immaturity in social interactions compared with peers.
Difficulty regulating emotions and behavior.
Support needed in daily living tasks compared with peers.
Limited spoken language.
Other behavioral traits often associated with intellectual disability, although not necessarily part of a diagnosis, include aggression, dependency, impulsivity, gullibility, passivity, self-injury, stubbornness, low self-esteem, and low frustration tolerance.
What causes intellectual development delays?
The causes of intellectual disability can range widely; in many specific cases, they are likely to be unknown. Generally, the causes include prenatal and postnatal trauma, including oxygen deprivation before, during or after birth; infection; brain malformations; chromosomal abnormalities; genetic abnormalities; seizure disorders; malnutrition; environmental toxins; and severe, chronic social deprivation.
How are intellectual development delays treated?
There is no cure for intellectual disability, but the right services, and parental and social support, can significantly boost a child’s quality of life. Early assessment by a specialist of which typical developmental milestones have been missed is an important early step as it can lead to the right diagnosis and the start of therapeutic treatment and special education and training that can help a child reach their fullest potential and participate as fully as possible in family and community life.
Developmental Coordination Disorder
Children who struggle to acquire fine and gross motor skills may be affected by developmental coordination disorder, sometimes referred to as motor clumsiness. For such children, getting dressed, eating meals, and playing games may be difficult, and may become a source of extreme stress hindering their self-esteem and social development. About 5 percent of children will be diagnosed with developmental coordination disorder between the ages of 5 and 11, more of them boys than girls, according to the DSM-5. The root causes are unknown but appear to affect rhythmic coordination and timing, as well as executive functioning, working memory, inhibition, and attention. Some dysfunction in these areas mimics that of ADHD but they are distinct conditions.
For more, see Developmental Coordination Disorder.
What symptoms of developmental coordination disorder can parents detect?
Parents are often able to recognize delays in achieving motor milestones like sitting, crawling, or walking; consistent clumsiness (frequently dropping and bumping into objects); difficulty catching a ball, writing, using scissors, or riding a bike; or an unsteady walk. When these struggles interfere with routine daily living, parents should bring a child to a specialist for an evaluation so that therapies can begin as soon as possible. Children may also be tested to rule out the possibility of another medical condition or learning disorder. Since the normal pace of motor-skill acquisition can vary widely in children, developmental coordination disorder is not typically diagnosed before age five.
How is developmental coordination disorder usually treated?
Children can benefit greatly when intervention efforts begin early. Physical therapy often helps, but so do practical strategies such as encouraging children who have trouble writing to use a laptop to take notes in class. Perceptual motor training, which combines physical movement with tasks that require thinking, is a widely-adopted treatment for developmental coordination disorder. While many children see eventual improvement in symptoms, more than half children continue to struggle with coordinated movement through adolescence, with varying levels of severity. The condition does not typically worsen over time, but it can continue into adulthood.