Developmental Delay

A developmental delay occurs when a child does not meet expected developmental milestones in at least one of the following areas: physical, social, emotional, intellectual, speech and language, adaptive development of fine/gross motor skills, or daily living skills, such as feeding and toileting.  

Developmental delay is diagnosed when a child performs at approximately 30 percent below age norms in one or more of the aforementioned areas, excluding delays related to prematurity. The child’s progress trajectory also tends to occur more slowly than expected. Approximately eight percent of all children from birth to age six have delays in at least one area of development; these developmental delays are caused by a variety of medical and environmental factors.

Examples of developmental delays might include hearing deficiencies that have led to speech delay or undiagnosed behavioral or attention concerns that impede focus and, thus, typical development. Some conditions that commonly result in delayed development are genetic or congenital disorders, significant sensory impairments that could include hearing and vision, metabolic and neurological disorders, congenital infections, and disorders caused by exposure to toxic substances, such as fetal alcohol syndrome.  

It is important to note that developmental disabilities and developmental delays are not synonymous, though they both affect the rate of development and share similar treatment strategies. A developmental disability is an issue a child will not outgrow, while a developmental delay tends to be short-lived if addressed in a timely manner.  

Developmental delays do not stem from any one cause, but there are several known risk factors: 

  • Birth complications - Low birth weight, early birth (prematurity), and/or asphyxia, the lack of oxygen at birth
  • Toxicity - lead poisoning, lack of certain nutrients, and/or exposure to alcohol and drugs prior to birth
  • Trauma - physical or emotional 
  • Medical conditions - severe and/or long-term illnesses, injuries and/or infections 

To diagnose a developmental delay, an evaluation process must be completed. The evaluation process might include observational assessment leading to an informed clinical opinion, standardized testing, developmental inventory, a behavioral checklist, an adaptive behavior measure, and a parent interview.  Early intervention can help children with developmental delays to get back on track.

A developmental delay is when a child does not meet expected developmental milestones in at least one of the following areas: physical, social, emotional, intellectual, speech and language, adaptive development of fine/gross motor or daily living skills.

Conventional Treatment

Children with developmental delays can benefit from speech, occupational, and behavioral therapy, as well as exercises to improve fine and gross motor skills, within a program designed to address the child’s specific delay(s). 

They may also benefit from special education services and individualized attention at school and home, in conjunction with health care intervention to address health-related or physical impediments to developmental progression. Children with delays should have their hearing and vision evaluated so that untreated impairments do not exacerbate the delay. Some delays related to physical conditions, like hyper- or hypo-thyroidism, include medication therapy such as daily oral hormone treatment. 

In addition, if other disabilities are present, medical or surgical treatments may be required to manage those conditions. A physician or clinician may also refer the child to a developmental pediatrician, a neurologist, and/or a provider of Early Intervention Services for further evaluation and treatment options. Unfortunately, no single treatment works for every child with a developmental delay because so many variables need to be considered: causes, presentation, the child’s age and aptitude, and so on. 

Each state in the US provides a number of free and sliding-scale payment services for children with developmental delays. Up to age three, these are called Individualized Family Service Plans (IFSPs); these transition to Individualized Education Plans (IEPs after age three). Your healthcare provider can direct you to the community agencies that conduct evaluations for eligibility for these plans.

Support

At The Brain Possible, our goal is to empower you to take a holistic approach to your child’s treatment. Below are ways in which you can support several aspects of your child’s recovery; before embarking on any, be sure to discuss them with your trusted health care providers.

Physical

Treatment plans for developmental delay often include physical therapy for fine and gross motor skills (jumping, balance) and occupational therapy for daily tasks (eating, dressing, and using the bathroom). 

Therapies such as craniosacral, which regulates the flow of cerebrospinal fluid and myofascial release, which helps release tissue trauma, have helped children with developmental delays experience greater ease, coordination and relaxation. Chiropractic treatment, which uses spinal manipulation to increase joint mobility and the flow of cerebrospinal fluid (CSF) can facilitate nerve communication, thereby enhancing emotional and cognitive function. 

The Anat Baniel Method is a gentle movement therapy that creates new neural connections that allow children to improve their learning capabilities. MNRI, a movement therapy that improves reflexes, can help children improve coordination and motor skills.

Emotional/Social

Caregivers can provide emotional support to children with developmental delays by validating their strengths. To build resilience and motivation while undergoing therapies to catch up to their peers, remind them of what they’re already good at and how far they may have come. Older children struggling with shyness and anxiety as a result of developmental delays can benefit from cognitive behavioral therapy to learn coping strategies. Social skills therapy, in which children role play to practice interactions with family and peers, is also effective at treating developmental delays that impact interpersonal skills. Canine therapy and equine-assisted or hippotherapy can help children better regulate their emotions by forming bonds with animals and their therapeutic helpers.

Sensory

Speech and language therapy, auditory processing therapies, and olfactory and gustatory therapy are often primary components of developmental delay treatment plans. Learning programs that help encourage cognitive and sensory processing such as Auditory Processing Therapies, might be helpful in encouraging brain development. Olfactory and gustatory therapy strengthens children’s senses of taste and smell. These senses activate the brain’s hippocampus, which is where memory resides. These therapies, which can involve repeated timed sessions of experiencing a range of tastes and smells, are thought to help children strengthen memory and decrease impulsivity. 

Sensory integration therapies, such as the Wilbarger Protocol and Floortime, may include games, puzzles, and personal care or household tasks that help children regulate their states of sensory arousal. They also aid in building neuronal pathways for better integration of sensory input from multiple sources. Hydrotherapy, which uses water as a setting for occupational therapy and/or as a means of transferring heat or cold to the body, can also help with relaxation and neurological integration of sensory experiences.  In Napa suit therapy, (also called intensive suit therapy) children wear an orthotic suit fitted with adjustable straps and cords that can be manipulated to apply pressure on joints and muscle groups that need additional support. 

Intellectual

Once your child has been evaluated by experts in age-appropriate developmental milestones, they’ll create an Individualized Family Service Plans (IFSP) to assemble therapists and instruct you on how to support your child’s intellectual development. IFSPs transition to Individualized Education Plans after age three, and include recommendations for the child’s school setting. Children with developmental delays benefit from clear directions and understanding the structure of their day. You can support their growth by naming activities out loud and giving them a “heads-up” about the activities on the horizon. Children who struggle with language processing may also benefit from non-verbal instructions, such as pictures and movements. Most children with developmental delays will need extra time for tasks, and it’s important that caregivers be sensitive to their levels of fatigue during therapy or performing tasks outside their comfort zones. 

The Perceptual Enrichment Program is a short-term cognitive intervention that can help children with developmental delays learn time-management and problem-solving skills. Brain Gym is a series of exercises to help cognitive functioning. The exercises, which can be done at home, are thought to help children meet neurological milestones they may have skipped in their development.

Nutritional/Environmental

There are many adjustments caregivers can make to a child’s environment to help them overcome developmental delays. Infants and toddlers may benefit from colorful mobiles in their rooms to help stimulate sensory connections. Older children may benefit from posted pictures of processes such as dressing and grooming to help them learn the sequences of self-care tasks. 

Meals rich in protein and complex carbohydrates can provide sustained energy and help behavioral and cognitive function. Nutritionists also recommend minimizing sugar and simple carbohydrates to avoid spikes in blood sugar, which can trigger symptoms of developmental delay. The Ketogenic Diet is a high-fat diet that changes the brain metabolism. Children on Low Inflammatory High Fat Diets, which include the Mediterranean Diet, have reported fewer behavioral problems. Success has also been reported with the Nemechek Protocol. The Nemechek Protocol inhibits bacterial overgrowth in the gut, which may exacerbate developmental delays. 

Physiological

Antiseizure medication may be prescribed for children with epilepsy and developmental delays; carbamazepine and valproate are the current standards, though others may offer more targeted treatment depending on the child’s condition. Caregivers have reported benefits of the calming effects of homeopathy and cannabis therapy. However, caregivers are encouraged to research the efficacy of cannabis therapy for their child’s condition, as the neurological side effects of some forms of cannabis therapy can outweigh the benefits. Studies have shown that neurofeedback helps children regulate their brain-wave patterns, enabling them to better control their behavior and cognition. In laser reflex integration, cold lasers increase the amount of adenosine triphosphate (ATP) in cells, thereby stimulating the mitochondria and encouraging nervous system repair. Laser light therapy can improve muscle tone in children with movement delays, and promising studies have shown that stem cell therapy can improve muscle and cognitive function.