Developmental delay

What is development delay?

Babies and children usually learn important skills as they develop. In fact, during the first five years of their lives, most children develop more skills than at any other time.

These skills are known as 'developmental milestones' and usually happen at fairly predictable ages. A child with developmental delay is much slower in reaching one or more of these milestones than expected.


Important milestones

The key areas of development are:

  • communication - such as smiling, listening, responding to words
  • physical - such as holding and handling objects, sitting up, crawling, walking
  • thinking - learning about the world, developing understanding
  • personal, social and emotional - such as copying facial expressions, responding to what parents say, forming close attachments.

The tables in our development delay poster [PDF] list the ages by which most children will have gained certain skills in the four key areas of development.

If your child has not reached these milestones by these ages it is advisable to talk about it with your health visitor or GP. More detailed information on this can be found in the 'Birth to Five' section of the NHS Choices website.


Why might a child be slow in development?

A child's development can be slower than others for various reasons. For example:

  • if they are born prematurely
  • if they become ill; if a child becomes severely ill they may even appear to regress and no longer be able to do things they could before the onset of the illness, though most children will catch up once they recover
  • any accident or illness that affects the brain
  • family events, such as the arrival of a new baby
  • some children are slower in their progress because of a medical condition that restricts their development; this condition might be diagnosed shortly after birth, or their slow progress might be the first sign that the child has an underlying medical condition.

If a child's progress slows for a while and there seems to be a reason, this is not necessarily a cause for concern. But if the delay is persistent, or happens for no obvious reason, it is important that you seek advice so that any necessary help can be given as soon as possible.


Types of delay

Delay might be specific to one particular area of development. For example, children with muscular dystrophy will have specific delays in their physical skills. Children on the autistic spectrum will be slow in developing personal, social and communication skills.

A child may be described as having global developmental delay (GDD) if they are slow in reaching two or more milestones in all areas of development - see our milestones poster [PDF].

What to do if you are concerned?

It is well known that parents are often the first to realise that their child is not developing in an expected way.

If you are worried about your child's progress you should talk to your health visitor or GP.

It can be helpful to have your Personal Child Health Record with you. Your health visitor or GP might suggest activities you can do with your child to support their development. This might be all that is needed.

However, if after four to six weeks, or after having tried the activities, you are still worried, go back and tell your health visitor or GP.

It is important that different types of delay are identified as early as possible so that support can begin, tailored to your child's specific needs.


Who can help?

If your child is referred for further assessment, they could be seen by a paediatrician, who is a doctor specialising in children's health and wellbeing. The paediatrician might order tests for specific conditions that could be causing the delay in their development. You might also see a:

  • physiotherapist if your child requires help to sit up, crawl or walk
  • speech and language therapist if your child requires help to develop speech, language and communication or has difficulty chewing food or swallowing
  • occupational therapist if your child needs help with developing their physical skills or finds it difficult to manage everyday tasks by themselves, for example in feeding, dressing or playing
  • educational psychologist if your child needs help with learning and with benefiting from a learning setting
  • clinical psychologist if your child might have emotional or behavioural difficulties.

The professionals are likely to ask questions about how your child has developed since birth and may want to spend time observing and possibly giving them one or more developmental assessments.

If you have been recording your child's progress in their Personal Child Health record, they will find this information useful.

If the specialist says there is nothing to worry about but you are still concerned, do go back to them or talk to your GP.


Contact with other families

Parents often report feeling lonely and isolated and that other people do not understand what they are going through.

Families often find it helpful to get in contact with others who are going through, or have been through, similar experiences. Parents frequently say that other parents have been their best source of information and support. Find out more about parent support groups.

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