Watching children grow, pick up skills and learn in and from their environment is an enriching, interesting, and at times a daunting experience for parents and carers. This is particularly the case for new parents and it is normal for parents to experience anxiety about their child’s growth and development. Parents will often ask themselves “should he be doing this?”, “why is she doing it like that?” or “why isn’t he doing that like the others at childcare, is that normal?”.
Childhood development refers to the acquisition of skills in key developmental areas over time. Some skills in key areas can be picked up by the child relatively quickly and others are acquired more slowly. For this reason childhood development is a complex and gradual process that is not linear. Children grow in spurts and at different rates and therefore there is wide variation in what is considered ‘age-appropriate’ or ‘normal’ development. The key period of childhood development is thought to be between 0 and 6 years, especially the years between 0 and 2.
The primary areas in child development over the period of 0 to 6 years of age are:
- Gross motor skills: Head/postural control, sitting, rolling, crawling, walking, jumping, hopping, skipping, bike riding and ball skills.
- Fine motor skills: holding items and grasp, gripping and handling objects, hand dominance, stacking blocks, pencil and scissor skills, threading beads and manipulating puzzle pieces.
- Speech and Language skills: Responding to sounds, cooing and vocalising, babbling and babbled phrases, single words, 2-3 word utterances and using full sentences. Understanding single and more complex instructions/routines.
- Personal/social skills: Feeding, dressing, toileting, grooming/hygiene, assisting others with tasks, parallel and cooperative play (eg. sharing/turn-taking/waiting), relationships with strangers/family/peers. Knowing personal information (eg. name, gender, age, address).
- Non-verbal problem solving skills: Exploring objects, looking for and finding items, packing away blocks, inset and interlocking puzzles, copying block/puzzle designs.
- Practical reasoning skills: Concept formation including size, location, number, speed, cost, right/wrong, days of week and sequencing.
What is Developmental Delay?
Developmental Delay is a term used for children under the age of 5 years who have reached their usual milestones at an age that is sufficiently later than expected. Children can have developmental delay in one or two areas, for example speech and language, and fine motor skills can be considered some of the more ‘common’ areas of delays. Delays can also be seen more broadly across all areas of development and this is referred to as Global Developmental Delay.
Although there is variation in when certain skills in key areas can be obtained, when children have not obtained particular skills by an expected time, developmental follow-up, assessment and intervention is important. Some areas which have a wider range of ‘normal’ include walking, attainment of single words and talking in sentences. Other skills which have a narrow age range of expected acquisition and that cause concerns if they haven’t been met within that age range include head control, sitting independently, grasping and pulling, vocalising/babbling and turning to name calling. It is important to look out for developmental ‘red flags’ and to consult your GP or a specialist such as Paediatrician and/or a Clinical Psychologist specialising in development.
Assessment of Developmental Delay
If developmental delay is isolated to one or two areas a full developmental assessment is not necessary however a developmental screen can be helpful (eg. The Ages and Stages Questionnaire, ASQ, and The Australian Developmental Screening Tool (ADST)). Seeking assessment for the particular area of delay via a Speech Pathologist, Occupational Therapist or Physiotherapist is beneficial. It is very important to have a child’s hearing and vision assessed as part of assessment of developmental delays.
When a child is presenting with delays in three or more areas, a developmental assessment via a trained doctor or Clinical Psychologist is an important step to examine strengths and weaknesses, examine and make possible diagnoses, tailor early intervention to a child’s needs and make appropriate referrals to specialists and services.
The tools most commonly used to assess child development include The Griffiths Mental Development Scales-Extended Revised (GMDS-ER) and The Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). These tools which can only be administered by trained specialists examine a child’s skills in the primary developmental areas listed above, noting strengths and weakness and developmental ages.
Importantly, assessments carried out via a trained Clinical Psychologist or Paediatrician will also help obtain other information regarding a child’s social interest and engagement, non-verbal communication, attention, cooperation and behaviour. This additional information is extremely important when considering the context and presence of developmental delay as well other possible queries and diagnoses.
Early Intervention for Developmental Delay
There is a strong evidence base for early intervention and tailored therapies to assist children in developing skills which are delayed. Due to ‘brain plasticity’ in childhood and ‘sensitive’ developmental periods in early development, early intervention is considered very important and generally beneficial. This has been well-researched and supported. Early intervention not only allows a child to receive additional and tailored therapy but also allows families to seek appropriate support for themselves. This support can include counselling and behaviour management support, financial assistance in some cases, access to resources and specialist services as well as social support via connections with other parents and families. This aids parents’ coping, competence, relationships and quality of life.
Early intervention including individual therapies as well as multidisciplinary programmes can include:
- Speech Pathology: to assist with speech, language, communication, pragmatics and play.
- Occupational Therapy: to assist with fine motor, gross motor, eating/toileting, pre-writing and writing, sensory sensitivities and sensory seeking.
- Physiotherapy: to assist with large motor movement, balance, coordination, spatial and body awareness, and limb and muscle strength.
- Clinical Psychology: to assist with comprehensive diagnosis, formal assessment and referrals as well as behaviour management and parenting support, family counselling and the development of everyday living skills (ie. adaptive functioning), social skills and coping skills.
- Early Intervention/Therapy groups such as those offered by government and non-government organisations including Lifestart, Pathways, and Learning Links.
- Childcare and Preschool: to assist with all areas of development especially language, communication and social skill development with other children.
If you would like to find out more about our assessment or treatment for developmental delay, or to book an appointment with one of our child clinical psychologists who is experienced in this area, please email or call the clinic on 02 9438 2511.