Effects of Therapy
A child who has not gained the developmental skills expected of him or her, compared to others of the same age.
Cognitive delays may affect a child’s intellectual functioning, interfering with awareness and causing learning difficulties that often become apparent after a child begins school. Children with cognitive delays may also have difficulty communicating and playing with others. They may also have a more difficult time in school since they tend to take longer to learn than other children. This type of delay may occur in children who have experienced a brain injury due to an infection, such as meningitis, which can cause swelling in the brain known as encephalitis. Shaken baby syndrome, seizure disorders, and chromosomal disorders that affect intellectual development, such as Down syndrome, may also increase the risk of a cognitive delay. In most cases, however, it is not possible to identify a clear reason for this type of delay.
Delays in motor skills interfere with a child’s ability to coordinate large muscle groups, such as those in the arms and legs, and smaller muscles, such as those in the hands. Infants with gross motor delays may have difficulty rolling over or crawling; older children with this type of delay may seem clumsy or have trouble walking up and downstairs. Those with fine motor delays may have difficulty holding onto small objects, such as toys, or doing tasks such as tying shoes or brushing teeth. Some motor delays result from genetic conditions, such as achondroplasia, which causes shortening of the limbs, and conditions that affect the muscles, such as cerebral palsy or muscular dystrophy. They may also be caused by structural problems, such as a discrepancy in limb length.
Social, Emotional, and Behavioral Delays: Children with developmental delays, including those with related neurobehavioral disorders such as autism spectrum disorder and attention deficit hyperactivity disorder, often also have social, emotional, or behavioral delays. Due to differences in brain development, they may process information or react to their environment differently than children of the same age. These delays can have an impact on a child’s ability to learn, communicate, and interact with others. It is common for children with developmental delays to have difficulty with social and emotional skills. For example, they may have trouble understanding social cues, initiating communication with others, or carrying on two-way conversations. They may also have difficulty dealing with frustration or coping with change. When the environment becomes too socially or emotionally demanding, children with developmental delays may have prolonged tantrums and take longer than other children to calm down. This behavior can be a signal that the child needs more support by modifying his or her environment or learning skills to cope with social and emotional challenges.
Some speech delays are receptive language disorders, in which a child has difficulty understanding words or concepts. Children with this type of speech delay may have trouble identifying colors, body parts, or shapes. Others are expressive language disorders, in which a child has a reduced vocabulary of words and complex sentences for his or her age. A child with this type of speech delay may be slow to babble, talk, and create sentences. Often, a child with a speech delay has a combination of receptive and expressive delays. Children with an oral motor problem—such as weakness in the muscles of the mouth or difficulty moving the tongue or jaw—that interferes with speech production have what is known as a speech production disorder. Children may have speech delays due to physiological causes, such as brain damage, genetic syndromes, or hearing loss. Other speech delays are caused by environmental factors, such as a lack of stimulation. In many instances, however, the cause of a child’s speech delay is unknown.
Attention-deficit/hyperactivity disorder (ADHD) is a disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.
Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
Combined Presentation: Symptoms of the above two types are equally present in the person.
Dyslexia is a Neurological Condition that is characterized by difficulties that mainly affect the ability of a child to read, write and spell. Categorized as a Learning Disability it usually manifests as a problem in listening, thinking, speaking, reading, writing, or spelling or in a person’s ability to do the math. Dyslexia is not an indicator of intelligence and many children who have Dyslexia are of above-average intelligence. But being limited by their ability to read fluently due to a difficulty in the area of language development and memory, makes a Dyslexic child learn differently.
In primary care settings, children with developmental delays are normally identified through three major channels: pediatric doctor regular screening, parental concern; and third party (preschool teachers and nursery care professionals) concerns. Child’s health booklets distributed by hospitals are a useful resource that should be wisely utilized by parents and clinicians to monitor a child’s development. Two such are the US CDC Milestone and UK NHS leaflets inked here. US CDC UK NHS
Cognitive development delays are the most common types of developmental disorders. This can range from mild and moderate to severe and profound. Here is a list typical developmental milestones from birth to five years. That being said, if you notice a delay, don’t panic, but don’t wait to get help. If you can get your child support early on, then they will likely catch up to near the levels of their peers.
Motor Skills are divided into two categories- gross motor skills and fine motor skills. Gross motor skills involve more motion and using larger muscles, while fine motor skills involve using the smaller muscles of the body. Fine motor skills involve use of smaller muscles, such as grasping, object manipulation, or drawing. Your child needs fine motor skills to do things like holding a pencil or scissors, writing, cutting, threading beads, playing with Legos, and buttoning up their coat.If you notice a delay at any time, get help as soon as possible. If you do that, there is a higher chance that your child will catch up with his or her peers.
Motor Skills are divided into two categories- gross motor skills and fine motor skills. Gross motor skills involve more motion and using larger muscles, while fine motor skills involve using the smaller muscles of the body. Gross motor skills pertain to skills involving large muscle movements, such as independent sitting, crawling, walking, or running. Gross motor skills include sitting, standing, walking, running, jumping, lifting (a spoon, a hairbrush, a barbell — they all count), and kicking. If you notice a delay at any time, get help as soon as possible. If you do that, there is a higher chance that your child will catch up with his or her peers.
Important social and emotional development takes place from birth to five years. Your child starts to develop socially and emotionally from birth and should reach social and emotional developmental milestones at certain ages. These milestones are the age at which most children develop abilities such as smiling, playing, and interacting. Although some children are a little faster or slower than others, delayed social and emotional milestones could be an early warning of future problems. That being said, do not panic if you notice delayed social and emotional milestones in children. Rather, get help as soon as you notice them. The first three years especially is the most crucial time for a child’s development since neural plasticity is at its peak. If you get help early, your child will be more likely to catch up.
While children develop speech and language at different rates, certain skills usually start to emerge by certain ages. These speech and language milestones can help you know whether your child’s skills are developing typically. When children have unusual difficulties with speaking and/or understanding, it might be language delay. If you think your child might have a language delay, see your GP, your child and family health nurse, your child’s teacher, or a speech pathologist. Support for children with a language delay might include special group programs, pictures, and books. Get help by the time your child is four years old. If you get help early, there is a higher chance that your child will be able to speak well. Don’t wait!
Brain/Neural circuits, which create the foundation for learning, behavior, and health, are most flexible or “plastic” during the first years of life. Over time, they become increasingly difficult to change (Center on the Developing Child at Harvard University ). There are undeniable benefits to getting children the support they need at a young age rather than waiting until the elementary school years. This is largely due to the rapid growth a child’s brain undergoes from birth to age three (Center for Disease Cotrol and Prevention, USA). That being said, not only is there always room for improvement, but if you get early help, your child might catch up with their peers by the time they reach adulthood.
Provide resources, support and information: Early intervention provides parents with resources, support and information to enhance their child’s communication skills. Working together with a provider trained in early child-hood enables parents to feel confident that they are facilitating their child’s communication development.
Improve relationships: When communication and language are delayed, understanding and interacting with other children will also be delayed. This makes it difficult to develop friendships, solve problems and learn to negotiate conflicts. Through early intervention, children learn how to use language to convey messages, to express feelings and to interact with their friends.
Improve behavior: Children with delayed communication development may get frustrated and exhibit challenging behaviors to compensate for their delays. It is difficult to express wants and needs when communication is delayed so often a physical response such as biting or hitting takes its place. Intervention will provide support and strategies to facilitate your child’s communication needs.
Promote future success in school: Communication development sets the stage for literacy and influences later success in school. There is evidence suggesting that having a good command of language goes hand-in-hand with the ability to imagine and to create new ideas and, eventually, to read and write.
Make learning fun: Early intervention will help families add support into everyday activities that they do with their child. This provides lots of opportunities for children to learn — not only when playing but also when getting dressed, brushing teeth, preparing meals, eating, bathing, helping with family chores, getting ready for bed, and lots of other activities. Intervention also brings the family a greater understanding of their child’s needs and how to break learning down into small steps for their child. When children know what they are expected to do and can be successful, they have fun learning in almost any activity, and want to learn more.
A speech-language pathologist teaches a child with language and speech delays or disorders how to improve communication. This may include helping the child learn to talk in sentences of increasing complexity and working on speech production. The pathologist also offers strategies for relearning language skills that may have been lost due to an accident or surgery. The specialist counsels parents about age-appropriate speech and language milestones and how to help their children improve their ability to communicate.
Doctors and specialists may refer your child to an occupational or physical therapist who treats school-aged children with motor delays. This type of therapy helps children attain the physical skills and dexterity to perform age-appropriate activities at home and at school, whether moving around the classroom, playing with friends, or participating in sports.
Occupational therapists focus on tasks that involve fine motor skills, such as tying shoes and writing with a pencil or pen. Physical therapists offer exercises to improve strength, balance, and coordination in children with gross motor problems, which can affect activities such as walking up stairs, running, and jumping. Occupational therapists also help children with sensory processing disorders swap the soft, non textured, or “white” foods of infancy for more highly textured, colorful, age-appropriate foods.
Social skills therapy is a research-based approach to teaching children as young as three how to behave in a social setting, control their behavior, and communicate more effectively. This type of therapy is usually provided in a group setting with a social worker or psychologist who is experienced in working with children who have a social or emotional delay, such as shyness or tantrums, attention difficulties, or autism spectrum disorder.
Therapists choose structured, age-appropriate activities that build and reinforce important social skills, such as coping with shyness; interpreting nonverbal cues; sharing; initiating and maintaining play; and following directions.
They also teach parents and caregivers how to support a child struggling with a social or emotional delay. They may offer strategies for helping your child counteract negative emotions and building his or her self-esteem. Our specialists also help your child learn how to recognize social cues to encourage social and emotional development.
Therapists also offer cognitive behavioral therapy, in which children are given strategies for reducing worries or fears and improving social and behavioral skills. This helps reinforce improvements in children with social and emotional delays. The therapist can help your child focus on a specific challenge, such as a refusal to talk due to extreme shyness, anxiety about interacting with peers, or difficulty regulating behavior.
Parents are included in this treatment so you can apply the skills attained during therapy to your child’s home and social environment. Your child’s therapist can also suggest rewards to reinforce your child’s progress.
In some of the progressive countries, developmental delay support is mandated by law.
In USA the Individuals with Disabilities Education Act (IDEA) of makes sure that children with disabilities get the same free, quality public education as other kids and these kids must learn side by side with peers as much as possible — something called the least restrictive environment.
As a result, the schools do the following:
a.Uses a program to assess and find children with developmental disabilities in the school system.
b.In consultation with the parents, draft a Individualized Educational Plan (IEP) which identifies the kind of in school support the child will get – speech and languages services and counselling.
c.For each kind of service multiple goals are set and monitored through parent/teacher meetings periodically – at least once in 6 months.
However such support in schools are unavailable in most developing countries. Some specialized schools provide these support in school settings and can be sought out.
Accordingly, a more structured support is needed outside school settings for developmental delay children in these countries. This entails strong, long-term, and dedicated engagement of immediate families and care givers.
The following purport to provide support to developmental delay children in major cities (A1). We have not reviewed their service offerings:
Kolkata
UDBHASS (www.udbhaas.com/about-page#team-main)
MONOVIKAS KENDRA (manovikaskendra.org/unit/centre-for-assessment-and-therapy/)
Delhi
INSTITUE FOR CHILD DEVELOPMENT (www.icddelhi.org/contactus.html)
CHILD DEVELOPMENT CENTER in Maulana Azad Medical College (www.mamc.ac.in/layoutpage-child-development-centre-cdc)
Chennai
MADHURAM CENTER FOR EXCEPTIONAL CHILDREN (www.mncindia.org)
KANCHI KAMAKOTI CHILDS TRUST HOSPITAL (www.kkcth.org/facilities/department/growth-development/)
Mumbai
UNMEED (www.ummeed.org)
ANSHU CENTER (www.anshucentre.com/child-development-centre-vile-parle/)
Pune
KEM HOSPITAL CHILD DEVELOPMENT CENTER (www.kemhospitalpune.org/specialities/child-development-centre-tdh/)
ZEP REHABILITATION CENTER (www.zeprehabcentre.org)
Hyderabad
ANANYA CHILD DEVELOPMENT & EARLY INTERVNETION CLINIC (www.asap.org.in/diagnosis-assessment)
“The discussion is for information purpose only and should never be used for diagnosis. Please consult a certified medical processional for diagnosis.”