How to Recognize Developmental Delays in Children

Developmental delays in children can be noticed at different ages and can affect a particular area of development or a combination of the five areas of development (language and speech, vision, hearing, motor skills, and social and cognitive skills). Children with genetic disabilities like Down syndrome, fragile X syndrome, or fetal alcohol syndrome (due to alcohol consumption by mother during pregnancy), and prematurely born children may have a delay in more than one area of development; this is called global developmental delay.^{[1]XResearch source} Once identified, many development delays respond well to early and thorough treatment. Finding the right treatment for your child’s development delays can aid your child's progress so they can gain skills and live a happy life.

Method 1

Method 1 of 6:

Language and Speech Symptoms

If your child does not start to smile, known as social smiling, at you or other caregivers by three to five months of age, this may be a sign of a developmental delay.^{[2]XResearch sourceMartin, C., Fabes, R., 2008, January 25}
Meaningless words and sounds, such as babbling, usually begin at six months old and increase until the child reaches 9 to 12 months old.^{[3]XResearch sourceAshford, J., LeCroy, C., 2009, June 26} If your child does not make these noises or any noises at all, they may have a developmental delay.
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3
Pay attention to your child’s ability to form words or sentences. Your child’s first words will usually have single or reduplicated syllables, such as "mama", "dada", "baba", or "papa".^{[5]XResearch sourceHoof, E., 2013, January 1} By 12 months old, typically developing kids will react to words like “no” and “bye bye” with eye contact and gestures.
- Two-word combinations are usually formed by age two. Typically developing 2-year-olds can combine two words to communicate with you, such as "mama play", "papa milk", and "ball gone". Their vocabulary is usually at least 20 words.
- Three-word or larger sentences usually are created by the time they are four years old. Normally, a child at this age can form sentences to communicate with you and with other children, for example, “Mama play ball”, “Me go play doll” and “I want to eat apple.”^{[6]XResearch sourcePlotnik, R., Kouyoumdjian, H., 2012, March 23}
4
Become familiar with the possible developmental delays. Speech delays are the most common type of developmental delay in children. There are several possible developmental delays associated with this area, including:
- Learning disabilities.
- Autism, a disability that affects communication, socializing, thinking, and other areas.
- Deafness or hearing impairment.
- Problems with the muscles that control speech, such as a deformed frenulum, lips, or palate.
5
Understand the possible treatments. Support options depend on where your child struggles and what condition(s) they may have. Make sure you understand the options for treatment of this developmental delay, including:
- Speech therapy.
- Physical and occupational therapy for articulation difficulties.
- Make sure to check their hearing too.
Tip: You can encourage communication at home. Be patient and positive by reading together often,^{[6]XResearch source} chatting, and asking them questions in clear, simple words.
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Method 2

Method 2 of 6:

Vision Symptoms

Children's eyes are usually crossed at birth until two months old, when they typically stop crossing their eyes.^{[10]XResearch sourceEngel-Smothers, H., Heim, S., 2008}
By three months of age, typically developing children are able to follow moving objects and also the movement of your hands.^{[11]XResearch sourceRosdahl, C., Kowalski, M., 2008} They may also stare at moving objects. If your child is not acknowledging or focusing on moving objects, this might mean something is going on.
3
Pay attention if your child tilts their head or squints their eyes when looking at an object. Normally, children at four months of age and older will have less head movements when looking or gazing at moving objects.
- If your child moves their head with their eyes when looking at objects to the side of them, this may indicate a problem with the eye muscles that control the lateral (side) movement of the eyes.
4
Expect your child to be able to grab objects placed in front of them. At seven months of age, kids are usually able to grab objects near them. If they cannot do this, they may have problems judging distance, or be nearsighted or farsighted.^{[12]XResearch sourceLauwers, J., Swisher, A., 2010, October 25}
- By age three, if your child continues to complain about having to narrow their eyes to see distant or near objects, or if this issue is noted by a teacher or caregiver, they may have visual developmental issues.
5
Notice if your child rubs their eyes excessively or has watery eyes. Frequent rubbing of the eyes may be related to a blocked tear duct, causing the eyes to become irritated and watery.
- If your child complains of eye pains or discomfort, they may be experiencing visual developmental issues.
6
Be aware of the possible developmental delays. There are several possible causes of vision delays, including:
- Issues of refraction, such as nearsightedness and farsightedness.
- Amblyopia or lazy eye, which is poor vision in one eye that may appear to turn outward.
- Blocked tear ducts, meaning tears cannot pass through the tear ducts because it is obstructed, causing your child’s eyes to become irritated and watery.
- Strabismus or cross-eyed, which means your child’s eyes turn in or out and up or down.
- Infantile cataracts, which can be inherited and look like a cloudy appearance on the lens of your child’s eye(s).
7
Keep in mind that treatments are available. The best way to treat visual developmental delays is early detection of the exact problem and its causes, in order to immediately begin correct treatment.
- Depending on the cause, your child may need glasses, contacts, an eye patch, or eye surgery.^{[10]XResearch source}
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Method 3

Method 3 of 6:

Motor Skill Symptoms

1
Observe your child's control of their muscles and posture. If your child’s muscles appear floppy or rigid, their head flops when they sit, or if they only tend to use one side of their body when moving, this may indicate a motor skill developmental issue.
- It's perfectly normal for your child to have a head lag at one month old. By four months, typically developing kids gain increased head control and can hold up their head properly.^{[14]XResearch sourceKyle,T., 2008}
- Poor head control or a head lag can indicate a condition called cerebral palsy.
As early as six months, typical children can grab objects such as a toy or food and put them into their mouth using their hand. But if your child does not grab or grasp for objects and put them in their mouth, this indicates poor hand to mouth coordination.
3
Notice if your child cannot roll over, sit, or crawl after 12 months old. Normally, your child can roll over by six months old without any assistance.^{[15]XResearch sourceBachrach, S., n.d.} But if they cannot roll over in any direction, and they have difficulty sitting properly on their own, these may be signs of a condition.
- If your child has difficulty bearing weight on their legs when held up to stand or if they look clumsy and fall often, they may have developmental motor skill issues.
By two years old, typical children are able to walk on their own and push or pull objects or toys. If they are unable to walk by 14 months, this may indicate problems with their motor skills.
5
Look for problems with your child's fine motor skills. If your child shows delays in the development of small-muscle skills like holding crayons or utensils with their hands, this may indicate larger developmental issues.
- Any signs of regression of already learned motor skills, both small muscle and large muscle, such as holding objects, crawling, sitting, or walking, may indicate serious developmental issues, so always be cautious of this. There is a wide range of normal motor skills in children, but it is important to detect any delays early to intervene and improve your child’s motor skills.
6
Be aware of the possible developmental delays. Possible causes of motor skill delays include:
- Ataxia, a defect that impairs muscle coordination.
- Cerebral palsy, a condition caused by damage to the brain before birth.
- Myopathy, a disease involving a loss of muscle function.
- Vision issues.
- Spina bifida, a genetic condition that can cause partial or total paralysis of the lower body.
- Autism.
7
Understand the possible treatments. This may include occupational and physical therapy by specialists and at home with a caregiver or by you.
- Children with mild motor skill delays will improve well with the help of therapy. Children with more serious conditions may always need some degree of support. Regardless of severity, therapy can make a real difference.
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Method 4

Method 4 of 6:

Auditory Symptoms

1
Notice if your child does not react to loud or sudden noises. Typical kids startle or react to sounds like sirens outside, a loud bang in the kitchen, a dog barking. They might turn their head towards the sound or gesturing to the source of the sound. By three months old, typical babies react to musical toys, rattles, or instruments and move their body to the sound of music.
- Older children with hearing issues may constantly turn up the volume of the television, or want closed captions.
By eight months old, typical children attempt to make sounds or imitate the words or sounds made by others around them. When you tell your child “no” or “yes”, or change the tone of your voice, typical kids will visibly react to you.
3
Notice if your child cannot identify people or objects by name. By around 12 to 14 months old, typical children react to their name being called and are able to follow common vocal instructions like “come here” or “go inside” or “bye bye”. By around three years old, they can follow action words like run, walk, stop, and understand concepts like big, small, plural, opposite, etc.
- Typical kids are comfortable expressing their desires by speaking and recognize the names of family members, familiar people, pets, and objects.
- If your child does not enjoy reading or speaking, it may be because they are having difficulty comprehending words. They may not show curiosity about people or things or ask you questions about their environment if they are not aware of their surroundings.^{[13]XResearch source}
If your child has constant issues with earaches or noises in their ears, this may be an indication of auditory developmental issues.^{[14]XResearch source}
5
Be aware of the possible developmental delays. Several causes of auditory developmental delays include:
- Genetic hearing loss or defect from birth.
- Low birth weight.
- Birth defects in the ear canal or middle ear.
- Recurrent ear infections, resulting in fluid collection in the ear.
- Injuries to the eardrum.
6
Be aware of the possible treatments. Hearing is directly related to a baby’s ability to learn and understand, and a hearing defect or delay can result in a delay of other developmental milestones. So it is essential to screen your child for hearing issues and address them as soon as possible. An early diagnosis and early treatment will lead to a faster recovery and aid in developing better or normal hearing skills.
- Your child’s doctor will use an otoscope to look inside your child’s ear canal. Older children will be tested by an audiometry.
- Common tests are run on newborns to check for auditory issues, including auditory brain stem response and Otoacoustic emissions testing to detect hearing defects or loss.
- Ear infections may be treated with medication or ear tubes. Surgery may be needed to correct any structural problems in your child’s ears.
- Treatments to improve hearing skills include cochlear implants, speech therapy, and learning sign language.^{[15]XResearch source}
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Method 5

Method 5 of 6:

Social and Cognitive Symptoms

1
Notice whether your child can display facial expressions. Your child will normally start to smile at six to eight weeks old. If you do not notice they smiling at two months or older, they may have a form of cognitive development delay.
- Typical kids also react to the facial expressions of others and display facial expressions, even if it’s sadness or anger.
As early as three to four months old, typical children show affection towards others through physical gestures like gurgling, babbling, smiling, and moving their arms and legs.^{[19]XResearch sourceRicci, S., Kyle, T., Maternity and Pediatric Nursing, 2009)} By 12 months of age, they are able to interact with you through other physical gestures like waving their hands. ^{[20]XResearch sourceGardiner, M., Eisen, S., Murphy, C., 2009, September 10}
3
See if your child can display their emotions. Typical children are able to express their feelings and emotions in stressful or harmful situations.
- For example, if they fall and get hurt, they would cry or verbalize their injury, rather than stay quiet or appear emotionless. If they do not have these reactions, they may have brain damage or another condition
- Exaggerated fear responses in ordinary situations or diminished response to strong stimuli may indicate Sensory Integration Disorder.
4
Notice if your child is not interested in playing games with you or with other children. One of the most common games that parents and newborns play is Peek a Boo. At 8 to 12 months old, a typical child will want to play games with you like Peek a Boo, and respond to you with laughing or babbling sounds.^{[21]XResearch sourceGardiner, M., Eisen, S., Murphy, C., 2009, September 10}
- Typical children enjoy playing pretend with dolls or stuffed animals alone or with others, imitating father or mother roles and other familiar figures while playing.^{[19]XResearch source}
- The willingness to play with other children is also very important, as a child’s natural instinct will be to see another child and play or talk to them even though they are new or unfamiliar. If your child does not enjoy playing with others, this may indicate your child has problems with communication and interaction.
5
Notice when your child starts to play with other kids. Typically developing kids follow this schedule:^{[20]XResearch source}
- Age 2: The child plays alongside another child ("parallel play") and doesn't play with them.
- Age 3-4: The child starts interacting with other kids, but mostly plays independently.
- Ages 4+: The child plays with other kids, doing the same activity together and cooperating.
Did You Know? In addition to being slow to learn to play with others, many autistic kids line up their toys or make elaborate arrangements. This is their own way of having fun, and it's good for them in its own way.^{[21]XResearch source}
6
Look for problems with following simple instructions or imitating actions and words. If your child has difficulty following instructions, it may be because they cannot understand or comprehend the instruction, indicating possible cognitive developmental issues.
- As early as four months old, a typically developing child will repeat your words or imitate your actions, such as sticking your tongue out or blinking.^{[25]XResearch sourceAshford, J., LeCroy, C., 2009, June 26} If your child does not do this, it may be because they cannot recognize or understand your actions.
7
Notice if your child has learning and attention issues in school. As children with social and cognitive developmental delays grow older, they have difficulty with intellectual skills like limited reasoning skills, difficulty sitting still in class, difficulty memorizing problems or questions, and a slow rate of learning.
- They tend to perform poorly in academics compared to their peers and their learning abilities are usually two grades below others in their grade or age group.^{[23]XResearch source}
8
Be aware of the possible developmental delays. Social development delays include issues with interacting, sharing, and co-operating with others, as well as difficulties forming relationships.^{[24]XResearch source} Cognitive development issues include issues with learning and functioning.^{[25]XResearch source} These delays may be caused by:
- Genetic disabilities like Down syndrome.
- Significant medical problems before and during birth, or exposure to toxins or alcohol (fetal alcohol syndrome).
- Parental neglect or family disorder.
- Autism spectrum disorders.
9
Be aware of the possible treatments. If social and cognitive developmental delays are detected early in your child, proper treatment and assistance can improve their performance and help them become independent.
- Occupational, social, and cognitive skill-oriented therapies are all effective ways to treat social and cognitive issues.
- Behavioral therapy may be needed in severe cases. (Quality of behavioral therapies can vary, especially related to autism, so know the signs of bad behavior therapy.)
- Medication can help with out-of-control behavior or anxiety in more serious cases.
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Method 6

Method 6 of 6:

Risk Factors and Testing

1
Think about your family’s genetics. Children born with a chromosomal or genetic anomaly are at a greater risk for developmental delays. Conditions that are partially or completely genetic may run in families.
- For example, children with Down syndrome (an extra copy of chromosome 21) will have developmental delays.^{[26]XResearch source}
- Conditions like autism and ADHD tend to run in families.
2
Look for issues in your child’s environment. Factors such as exposure to toxic agents like lead and drugs before or after birth, as well as poor maternal nutrition, transmitted infections like measles or human immunodeficiency virus (HIV) from mother to child during pregnancy, premature birth and a lack of maternal care can all put a child at a higher risk for developmental delays.
- As the number of risk factors increase for a child, this will make them more susceptible to developmental delays. The risk factors have a cumulative effect on the child.
- Despite the popular hoax, vaccines don't cause autism. Vaccines drastically reduce the risk of serious diseases that could cause developmental delays and other complications.^{[27]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}^{[28]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source}^{[29]XResearch source}
3
Test your child for developmental delays. As these developmental issues can lead to serious health issues for your child, it’s a good idea to test them from an early age to prevent any smaller delays from becoming bigger, life-changing issues.
- Screening is a broad and fast measurement of a child’s skills, and is a good preliminary step to determine if your child requires a more in-depth evaluation. Developmental screening can be performed through a questionnaire given to the child’s parents or guardians, or as a test given to the child by a trained health professional.
- A developmental evaluation is a more extensive and thorough assessment of your child’s skills and is only performed by an experienced health professional, such as a psychologist. This test will outline your child’s strengths and weaknesses in all five developmental areas. The outcome of this evaluation will indicate if your child needs immediate medical assistance or treatment.
4
Remember that a developmental delay isn't the end of the world. Some kids catch up, especially with the right support. In some cases, kids don't fully catch up, but they can still gain skills and end up living happy lives.
- Don't despair if you get a diagnosis of autism, permanent hearing impairment, or another lifelong condition. Kids with disabilities can still lead full and happy lives.
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