by Donna Greco, Pediatric Physical Therapist

Identifying Developmental Delays in Children

OK, Show of hands.  How many moms out there have had concerns about their child’s development?  Perhaps your child never crawled, was a late walker, or was simply slower to reach milestones than other children.  How many took steps to do something about it?  You may have found that it took some serious work to find answers to your questions, and it can become a grueling process, following a twisting and spinning course before discovering what the problem may be, whether or not your concerns are valid, or if there is a problem at all.  But if you have some background information to help you along, it may make the path to discovery a little more direct and a little less stressful. 

Before we get started it is important to remember that physical development varies from one child to the next, and some children naturally take longer to reach milestones than others.  Often a child’s body type is a factor, as some babies are slightly heavier and have a little more trouble moving against gravity.  Some babies have long torsos and do not have the strength to lift up into crawling position.  Some are simply complacent and have little desire to get moving.  These babies are not necessarily delayed; they just need a little extra help that moms can easily provide through play.  The problem arises when the natural developmental process is not occurring on its own and becomes overdue, placing the child at risk for further difficulties down the line.  Often Moms are the first to notice when their child appears different, or is not doing the same things as other like-aged children.  Or perhaps a mother may notice that a younger child is doing more than her child and she may raise an eyebrow, wondering if she should be concerned.  When is it suitable to voice a concern?  And what should Moms do when concerns arise?  Getting your doctor to listen, to take your concerns seriously or to admit there is something amiss can be more of a challenge than you may be ready for. Often mothers voice concerns to their pediatricians, and are told that the child is “fine” and “not to worry”.  Mothers often report that their pediatricians disregard their concerns; attempting instead to reassure them, rather than take the Mom seriously.  When it is very obvious to you or your family that there is a problem do not allow your concerns to be ignored or discounted.  The sooner your child is identified and on the road to reaching milestones, the better the chance of full recovery.  Mothers with multiple children are much quicker to pick up on developmental delays, as their experience provides them with a scorecard for comparisons.  New moms are more likely to take the advice to “wait and see”, putting their child at risk for further delays by postponing a referral to a professional pediatric therapist for an evaluation.   Maybe the child needs a little more time, but it is often better to be safe than sorry.  Delaying services comes at a cost, and it is the child who pays the price, especially when the family is not willing to admit there is a problem that needs to be addressed.  When a child demonstrates a significant developmental delay, it is important to initiate therapies as soon as possible to prevent further setbacks and help the child get on track.  Is your child meeting developmental milestones?  Take a good hard look, get past the pain of reality and get your child the help he or she needs.  If the child qualifies for services, he will definitely get what he needs from a trained professional.  If not, there are things you can do to help him along, and you don’t have to be a therapist to perform simple play activities to help your child’s physical development.  But first, before deciding whether there is a developmental delay, let’s understand normal physical development by gaining a bit of background knowledge about a child’s developmental process so that moms are better equipped to make informed choices for their children. 

In the next series of articles I will describe, in simple terms, the process of normal development and give you some tips on what to look for in different ages and stages of a baby’s physical development.  I will include tips on simple activities you can do to encourage the sequence of physical development for your baby and I will provide red flags that may reveal a problem that may need further assessment by a pediatric therapist.  We will begin with an infant at age 0-3 months, and introduce important developmental milestones to look for in each 3 month increments in the first 12 months.  Understanding the normal sequence of development will help you determine if your concerns are valid and help you find the right path to addressing the issue promptly.  

Donna Greco is a physical therapist who has worked with the pediatric population for over 15 years.  She received her Master’s Degree in Physical Therapy from Chapman University of Southern California.  Her clinical experience includes a specialist position at the Shriner’s Hospital for Children in Los Angeles.  She has presented lectures on many therapy related topics to special education teachers, parents, doctors, therapists and other health professionals to teach therapeutic principles and to help improve awareness of children with special needs.  She is currently working with infants and toddlers through the Ulster County Early Intervention Program.