Global Developmental Delay (GDD)

A child may be described as having global developmental delay if they have not reached two or more milestones in all areas of development.

In this article

What is Global Developmental Delay?

Babies and children usually learn important skills as they group up. This includes sitting up, rolling over, crawling, walking, babbling (making basic speech sounds), talking and becoming toilet trained. These skills are known as developmental milestones.

Developmental milestones occur across different areas of development (known as developmental domains). These areas are:

• Motor skills. This includes gross motor skills, like sitting up or rolling over, and fine motor skills, for example picking up small objects.
• Speech and language. This includes babbling, imitating speech and identifying sounds, as well as understanding what other people are trying to communicate to them.
• Cognitive skills. This is the ability to learn new things, process information, organise their thoughts and remember things
• Social and emotional skills. Includes interacting with others and development of personal traits and feelings, as well as starting to understanding and respond to the needs and feelings of others.

While all children reach developmental milestones at different times, they usually happen in a predictable order and at a fairly predictable age. A child with Developmental Delay may not reach one or more of these milestones until much later than expected. A child has Global Developmental Delay (GDD) if they haven’t reached two or more milestones in all areas of development.

You may also find it helpful to read our guide Developmental Delay

What are the causes of GDD?

The most common causes are problems with the child’s genes or chromosomes, for example Down syndrome or fragile X syndrome.

Sometimes, a child can have GDD due to problems with the structure or development of the brain or spinal cord. Other causes can include:

• Prematurity (being born too early).
• Childhood infection (for example meningitis).
• Metabolic diseases, such as having an underactive thyroid gland (hypothyroidism).
• Other problems affecting babies before they are born.

Toxic (poisonous substances), such as alcohol in the case of fetal alcohol syndrome, can also contribute.

For some children, the cause of the GDD is never identified.

How do practitioners diagnose GDD?

As they grow, medical practitioners regularly assess a child’s development. If the child isn’t meeting the expected development milestones and levels of abilities, practitioners may refer them for more specialist assessment.

It is likely that a paediatrician (children’s doctor) will see your child. If they suspect GDD, they may ask questions regarding your child’s progress. They may look at their development (checking out what exactly they’re able to do and when they became able to) and carry out medical tests to try to identify a cause for the developmental difficulties.

Some families may go to a genetics service to see if there is a genetic cause for the difficulty.  Others may see specialists such as psychologists, speech and language therapists or occupational therapists for further evaluations.

How do practitioners treat GDD?

Some children may catch up on developmental milestones later. This can happen without any additional support, and these children have no permanent problems and go on to develop as expected.

Some children require additional support to allow them to catch up with other children. Support may be with speech and language therapy, physical therapy, occupational therapy or other methods of support. Special educational input is a common and useful support.

As a parent, it is natural to want to find ways to help your child develop as much as you can. You may want to speak to your GP, paediatrician, nurse or health visitor about strategies. They’ll be able to discuss the type of support that’s right for your child and how to get it.  

Children and young people with generalised developmental delay experience higher rates of emotional and behavioural difficulties than other children. For this reason, some benefit from seeing a clinical child psychologist or a child and adolescent psychiatrist.

Some children may never catch up with the expected development milestones. This could be because there is an underlying condition that has not been diagnosed yet. For some families, it can take many years to get a firm diagnosis or reason why their child is behind.

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Inheritance patterns and prenatal diagnosis

Inheritance patterns
This will depend on the underlying cause of the GDD. Infections are never inherited, although an infected mother can pass on an infection to her unborn child or during the birth.

Down syndrome, the most common identifiable cause of significant developmental delay, is a condition caused by a change in the chromosomes so that there is one too many. However, it is usually not inherited – the main risk factor being increasing maternal age.  Conversely fragile X syndrome, the most common identifiable cause of inherited developmental delay is always passed on from one or other parent who may be unaware that they are at risk of doing so.

Prenatal diagnosis
This is dependent on the underlying cause of the condition. If there is a strong family history of GDD, your doctor should refer you to a genetics specialist to discuss testing.

Is there support?

If your child is affected by a medical condition or disability, we can help. Call our freephone helpline on 0808 808 3555 to get information, support and advice. We also offer emotional support for parents via our Listening Ear service.

We have a range of parent guides on aspects of caring for a disabled child in our resource library. You may also find our Early Years Support useful, which includes help for families going through the diagnosis process.

We’ve listed some support groups below and you can also meet other parents online in our closed Facebook group.

Brainwave

Tel: 01278 429089
Email: enquiries@brainwave.org.uk
Website: brainwave.org.uk

Brainwave is a registered Charity in England and Wales No. 1073238, established in 1982. It works with children under 12 with a range of conditions including Autism, brain injuries including Cerebral Palsy and genetic conditions such as Down’s Syndrome. Parents are shown how to carry out a daily exercise programme with their child.

Group details last confirmed October 2015.

If the underlying cause is known, then support can be offered by the relevant condition group. Information and support in the UK for general developmental delay is provided by Mencap and Enable (see entry Learning Disability). Information and support in the UK for developmental delay, brain injury and other conditions affecting development is provided by bibic (see entry Brain Injuries).

Credits

Last updated July 2012 by Professor J Turk, Professor of Developmental Psychiatry, St George’s and the Institute of Psychiatry, University of London and Consultant Child and Adolescent Psychiatrist, Child and Adolescent Mental Health Neurodevelopmental Services, South London and Maudsley Foundation NHS Trust, London, UK.