When doing a developmental assessment of a child it is important to appreciate that children develop at different rates, and there is flexibility in the milestones. However, a child who is very slow to achieve all milestones or lags behind on a specific developmental domain may have underlying pathology.
Global Developmental Delay
Global developmental delay refers to a child displaying slow development in all developmental domains. This could indicate an underlying diagnosis such as:
- Down’s syndrome
- Fragile X syndrome
- Fetal alcohol syndrome
- Rett syndrome
- Metabolic disorders
Gross Motor Delay
A delay that is specific to the gross motor domain may indicate underlying:
- Cerebral palsy
- Ataxia
- Myopathy
- Spina bifida
- Visual impairment
Fine Motor Delay
A delay that is specific to the fine motor domain may indicate underlying:
- Dyspraxia
- Cerebral palsy
- Muscular dystrophy
- Visual impairment
- Congenital ataxia (rare)
Language Delay
A delay that is specific to the speech and language domain may indicate underlying:
- Specific social circumstances, for example exposure to multiple languages or siblings that do all the talking
- Hearing impairment
- Learning disability
- Neglect
- Autism
- Cerebral palsy
Management of language delay involves a referral to speech and language, audiology and the health visitor. Referral to safeguarding is required if neglect is a concern.
Personal and Social Delay
A delay that is specific to the personal and social domain may indicate underlying:
- Emotional and social neglect
- Parenting issues
- Autism
Last updated January 2020