Delays & Disorders

Developmental Delays & Disorders

Parents, pediatricians, or others sometimes notice that a child is not developing in the expected manner. Sensory-motor, language, or emotional development may be developing slowly, or developing in unusual ways. Their behavior may be hard to understand. For example, children who have problems in expressive language frequently show more aggressive behavior than the average child, because of the frustration of being unable to speak and understand as well as others.

Some developmental delays and associated symptoms are regularly grouped into diagnosed "developmental disorders." Other delays are irregular and hard to classify. In any case, the label or diagnosis is not as important as a thorough understanding of the child's development. A number and a label from a diagnostic manual mean relatively little. A thorough understanding of the child's current strengths, weaknesses, developmental history, and family are the true guides for helping.

Developmental problems can strongly influence a child’s self-esteem and social skills. Some developmental problems involve one area of development; others may involve multiple areas. Children can also show difficult "temperaments" which can interfere with sleeping, calming down, relationships, and learning. When difficult temperament causes cycles of negative behavior, professional help can be necessary to put family relationships on a more positive course.

It is important to do thorough developmental assessment as early as possible when problems are detected. Parents are sometimes urged to wait until the child is older, but this can cause the child to lose invaluable time to get help during critical years. Understanding development requires far more than collecting the traditional developmental milestones, such as when the child sat up, walked, said the first words, etc. A careful and detailed developmental history is essential, since the child’s parents know him or her better than anyone. We must understand how the child responded to a variety of situations and experiences in each developmental phase. We must also understand what stresses the child had to face. Another important part of development concerns what has given the child happiness, joy, and a sense of accomplishment. How the child has calmed down and recovered from upsets is another important chapter of the developmental history. The child's growth in relationships is essential to understand. Some standardized tests are available for evaluating development. Child and parent-child interviews are also essential. When a child shows unusual patterns of development there is no substitute for getting to know the child in detail. It can be important to involve and work with other professionals, such as language specialists, pediatric occupational therapists, pediatric neurologists, child psychiatrists, and others.

When children have developmental problems, their parents can have a harder job in aiding their development, advocating for their education, and managing their behavior at home. I can help parents set up an intervention plan for enhancing a child’s development. The plan would typically include activities parents can do at home, as well as coordination with educational, therapeutic, and medical services as needed.