Developmental problems

What are developmental problems?

Developmental problems, often called developmental delays, happen when a child doesn't reach the skills and milestones expected for their age, whether in moving, talking, thinking, or getting along with others. Some children have a delay in just one area, while others have delays across several areas at once, known as global developmental delay.

There's no strict timetable for development, and children reach milestones at their own pace, so being a little behind doesn't necessarily mean there's a delay. A developmental delay describes a child who is continually behind in developing the skills expected for their age.

Symptoms of developmental problems

Which signs you notice depends on which area of development is affected, and often more than one area is involved at once.

• Being slow to roll over, sit up, crawl or walk
• Trouble with fine motor skills, such as holding small objects, tying shoelaces or brushing teeth
• Difficulty understanding what others say, or being slow to talk or build sentences
• Trouble with problem-solving, learning, or remembering things
• Difficulty with social skills, such as understanding social cues, having a two-way conversation, or coping with changes to a routine
• Difficulty managing emotions or behaviour, such as becoming easily overwhelmed, struggling to cope with changes in routine, or taking longer than expected to calm down when upset.

Causes of developmental problems and who's at risk

For many children, no clear cause is ever identified. Where a cause can be found, it's often one of the following:

• Genetic conditions, such as Down syndrome or fragile X syndrome
• Being born prematurely, or with a low birth weight
• Lack of oxygen around the time of birth
• Exposure to alcohol, drugs, or other toxins before birth, or exposure to toxins such as during childhood
• Brain injury, for example following a serious infection such as meningitis or a significant head injury
• Hearing or vision problems, which can affect communication, learning and development
• Neurodevelopmental conditions, such as autism spectrum disorder
• Severe or prolonged nutritional deficiencies
• Significant trauma, neglect or abuse.

Developmental delays are common in childhood and can affect areas such as movement, speech and language, learning, behaviour, and social skills. Many children with developmental delays improve significantly with appropriate support and early intervention.

Are there different types of developmental problems?

Developmental delays are generally grouped by the area of development they affect:

• Cognitive delays: affect thinking, learning and understanding, and often become more noticeable once a child starts school
• Speech and language delays: affect understanding words and concepts (receptive language), using words and sentences (expressive language), or physically producing speech sounds
• Motor delays: affect coordination of either large muscle groups, such as the arms and legs (gross motor skills), or smaller muscles, such as those in the hands (fine motor skills)
• Social, emotional and behavioural delays: affect a child's ability to interact with others, communicate, and manage their emotions.

In a child under 5 years of age, significant delays in two or more of these areas at once are described as global developmental delay.

How are developmental problems diagnosed?

There's no blood test or scan that diagnoses a developmental delay on its own. Instead, your child's doctor will use developmental screening, watching how your child plays, talks, moves and behaves, and asking you questions or having you complete a questionnaire about the skills your child has reached.

A detailed history helps build the full picture, including details about your child's birth and any medical conditions, medications or surgery. Because there's a wide range of normal development, your child's doctor will look at the overall picture rather than a single missed milestone. If a delay is suspected, your child may be referred for a fuller evaluation, and further tests may be arranged to look for a specific underlying cause where one is suspected.

How are developmental problems treated?

Treatment depends on which areas of development are affected, and starting support as early as possible gives your child the best chance of catching up with their peers.

• Speech and language therapy, for children with communication or speech production difficulties
• Occupational therapy, to help with fine motor skills and processing sensory information such as light, sound or touch
• Physical therapy, to build strength, coordination and balance for gross motor skills
• Referral to a relevant specialist where a specific cause is identified or suspected, such as a geneticist, hearing specialist, developmental paediatrician, neurologist, or psychologist.

Alongside formal therapy, there's a lot you can do at home to support your child's development: playing together helps build a range of skills, reading together supports language development, and creating a predictable routine, including visual schedules, can help your child understand what's expected of them. Staying in regular contact with your child's therapy team also helps you track progress and adjust support as needed.

When should I see a doctor?

If you have any concerns about your child's development, don't wait to see if they catch up on their own. Speak to your GP or health visitor, since identifying a delay early gives your child the best chance of getting the right support and reaching their full potential. Without early support, a delay occasionally progresses into a more significant, longer-term difficulty.