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Developmental Delays: How To Recognize and Address a Baby’s Developmental Delays

Parents worry about developmental delays because of confusion around the developmental delay definition and milestones.

The worry of developmental delay or cognitive delay can hang over the doting parent of a newborn. But much of the worry can be linked to a poor understanding of what the developmental delay or cognitive delay definition actually is. Developmental delay is when a child doesn’t reach certain milestones by the predicted time. They affect between 16 to 20 percent of all children and are linked to both emotional and social skills or gross and fine motor. But the understanding of developmental delays is also confounded by an understanding milestones, which are a bit more flexible than some parents might think. 

“There’s a range of normal when you’re looking at developmental milestones. Every baby does not roll over exactly at 4 months. Every baby is a little different,” says Dr. Susan Buttross, a fellow at the American Academy of Pediatrics and a professor of pediatrics at the University of Mississippi. “We don’t become concerned unless a child falls outside the range when 95 percent of children should be doing that particular skill, whether it’s saying first words or crawling or standing.”

How to Recognize Developmental Delays

  • Delays Can Affect All Developmental Areas: Developmental delays can be social and emotional (missing social cues, not returning smiles), related to motor skills or linked to speech and language development.
  • There are Different Types of Delays: Children who are slightly behind on certain milestones but catch up are considered typical but slow to develop. Children who are truly delayed are substantially behind on certain developmental milestones.
  • Causes of Developmental Delays: Delays can be caused by nervous system damage linked to environmental toxins, In-utero drug or alcohol exposure, medical conditions, autism spectrum disorders, genetic disorders, general poor health, and nutrition, or lack of opportunity to develop skills.
  • When to Worry About Delays: Short delays aren’t uncommon, but parents should be concerned when two or more unrelated developmental milestones have not been achieved beyond the projected time.

There are myriad factors that might contribute to a child’s delayed development, some more alarming than others. It could mean that a parent isn’t giving a child opportunities to develop on their own: for example, not giving the child tummy time to learn to crawl. And if a child is born early, it should be expected that they’ll be behind in developing — for example, if a child is one month premature, they might be a month late on most milestones.

There are more concerning causes for delays, too. Developmental delays can be the result of nervous system damage, exposure to controlled substance in-utero, hearing loss, autism spectrum disorders, genetic disorders, and general poor health and nutrition.

But, regardless of root cause, one delay isn’t necessarily a cause for alarm. If a child’s development is beyond the typical-but-slow category, there should be some concern. But true developmental delays only become truly alarming when there are multiple perceived delays.

“We don’t panic when we see a small delay, and if a child’s delayed in one area, sometimes it just needs to be monitored. But if they’re delayed in several different areas, we become a little more concerned and we’ll move to a real evaluation,” says Buttross, who is also medical director for the Center for Advancement of Youth. ”

When concerns do arise, parents can ask for a developmental screener. These are relatively common questionnaires which probe a child’s milestone progress. They are generally administered at 9, 18, and 30 months. Screeners serve as a “yes and no” checklist for milestones. And while they can’t diagnose a problem, the evaluations help doctors determine what types of treatment are necessary.

As an example: a child who is achieving all milestones except speech development might receive a hearing evaluation. But if other delayed development flags are raised — if there’s a delay in a speech in addition to delayed social development — screeners might point to autism spectrum disorder, in which case the child would be referred to a specialist.

While screeners are conducted at prescribed intervals, Buttross says parents can request a screening whenever concerns arise. “Typically, our advice is that if a parent believes a child has some sort of developmental delay in one or more areas, the first thing they should do is go to their primary care provider and request a developmental screener,” she says.

Given the broad range of time a child generally reaches milestones, parents are urged to not panic. It’s better to ere on the side of caution, raising flags to pediatricians as they come up. After all, nobody knows a child quite like the parents raising him or her, and being perceptive and open with a doctor when a delay becomes a concern — and snowballs into other delays — can help correct the course in many instances.

“About 80 percent of the time, if a parent has a concern, they’re right,” says Buttross. “We know that if there’s a mild delay or even a significant delay early intervention can make a huge difference, and by school age, that child might be right back to what we expect for every typically developing child.”