Developmental delay explained



What is development?

Development is the long process by which each child develops from a helpless infant to an independent adult by acquiring sets of skills also known as milestones. This process comes from the growth and maturation of its brain . This is often termed psychomotor development . It is divided into four domains:

  1. Gross motor skills – ability to sit , walk, run

  2. Fine motor skills – ability to grasp objects , clap hands , use a spoon , draw

  3. Speech and language

  4. Social and personal and activities of daily living – ability to interact with others , imitate parents , play with toys , learn to use the potty



What is developmental delay?

Many children have mild delay in some skills which is absolutely normal . A significant delay is a performance which lags behind the average by a great degree . For example the average child walks is 12 months but a few normal children do not walk until 15 months - that is still fine . However if a child has not walked by 18 months that can be considered a significant delay . The term “global developmental delay” means a significant delay in two or more of the four main developmental domains listed above . In children over the age of 5 years the term developmental delay is no longer appropriate and is substituted by the term ‘’learning difficulties ‘’.



What causes developmental delay ?

Brain development is a complex process which is affected by a child’s genes and the environment in which a child grows. The genes may determine a child’s developmental potential ( that is what would be the maximum performance that can be achieved ) but environmental factors have crucial influences on the end- result either in a positive or negative manner.


Below are some examples of environmental factors that can influence development in a negative way and thus cause developmental delay .

  1. During pregnancy : maternal infections ( rubella, toxoplasma, cytomegalovirus) and exposure to alcohol, radiation, smoking and certain Drugs

  2. Infections like meningitis

  3. Metabolic disorders, such as hypoglycaemia

  4. Toxins—for example, lead, mercury, arsenic

  5. Severe brain trauma

  6. Severe understimulation and maltreatment

  7. Malnutrition and lack of nutrients



Milestones are just milestones

A child should not be labelled as abnormal just because has not achieved a certain milestone at a certain age. Many normal children are late to walk or speak and catch up with their peers in due course. This often runs in families. One should be looking at the overall picture before rushing into conclusions about abnormality .