Generally speaking, something is labeled as a “delay” if the timing is late or taking longer than usual. A doctor will diagnose a child as having “developmental delay” if he or she is developing in the correct pattern and sequence as other children, but the development is slower than expected for that age or level of development.
A delay can be specific (i.e. speech delay), or unclear (i.e. there is something different in the development of the child but further tests need to be conducted to pinpoint it).
On the other hand, there are specific criteria before a child can be diagnosed with global developmental delay.
1. The child is below five years of age.
2. The child has delays in at least two of the following domains of development:
- Gross motor (how arms and legs move and function)
- Fine motor (how skilled the fingers are)
- Language (understanding and comprehension, expression and use)
- Social (how an individual interacts with other people and the environment)
- Cognition (learning and thinking processes)
- Adaptive (skills in activities of daily living)
3. The degree of delay is significant.
To meet the criteria for global developmental delay, the delay should be at least two standard deviations from the average for that age based on a standardized test. However, kids who are too young to undergo testing but have obvious delays compared to peers may still be diagnosed with GDD.
Causes of GDD
There are many possible reasons for GDD:
1. Events that occurred while mom was pregnant with the child
This can include the following:
- Abnormalities in the formation of the child’s central nervous system
- Metabolic causes
- Exposure to dangerous chemicals and medications
2. Complications during birth or soon after birth
- Oxygen deprivation
3. Events during the course of a child’s life
- exposure to toxins
- parental neglect
What will happen to my child if he or she has GDD?
There are three different possible outcomes:
- The delays resolve and the child eventually catches up with peers.
- The delays are found to be non-progressive. This means that the child is consistently behind the development expected for his or her age, but constantly at the same rate (e.g. skills always seem to be a year behind what is expected for age).
- Lastly, there is a third group of children with GDD whose delays are progressive. This means that the gap between them and their peers seem to widen with time.
Children who fall into the two latter categories often become diagnosed with Intellectual Disability after the age of 5 years. (Discussed in the next article)
While there is no sure way to determine which of the three outcomes a child will fall under, there are signs that doctors can watch out for to get an idea of how a child will progress. For example, children with gross motor delays will not necessarily have intellectual delays, but the chances are higher for those with fine motor and language delays. In addition, a child’s social development is a key indicator if he or she can live independently later on.
For children whose developmental delays seem to resolve with time and catch up with their peers, we still advise parents to continue to see their doctor to monitor their child’s development. This is because studies show that these children are at risk for acquiring specific learning disorders when they reach the school-age years. It is always preferable to catch difficulties and intervene early on to provide support for the child.
Once a child has been diagnosed with GDD, he or she must be frequently monitored by a pediatrician or a developmental pediatrician. In some cases, depending on the signs and symptoms a child may be experiencing, additional work-ups such as blood and/or urine tests, imaging procedures, or even genetic testing may be required. All these will help a family know if the delays are caused by treatable medical conditions, the course it will likely take, and treatment options. In addition, doctors can help parents find resources and support (i.e. support groups for a particular condition), and in planning for the future.
The information we provide on our website is meant to help parents understand certain terms and conditions better. These posts should not take the place of a comprehensive medical consult. Should you have questions or clarifications, we encourage you to reach out to your primary care physician.