Children develop at different speeds. This is evidenced by one child walking at 12 months while another child walks at 18 months or one child saying a word at 14 months while another can say a word at 12 months. However, a child's normal developmental process is defined with developmental milestones and these milestones are what pediatricians use to assess development. Developmental milestones are age specific skills and behaviors that a child exhibits within a predictable timeframe. When these skills are not achieved within the predictable time frame, it is called a developmental delay. For example: normal development shows that a child should be able to control their head by age five months. If a child is six or seven months old and still does not have steady head control, that is considered a developmental delay. You can review typical ages, and milestones here.
The specific skills that children develop can be categorized into five main categories:
Gross motor skills- skills that use large muscles ( example- walking.)
Fine motor skills-coordination of small muscle movements (example- clapping hands.)
Language skills- communication skills (example- gesturing or talking.)
Cognitive skills- use of thought (example- reasoning.)
Social skills- interaction and relationships with others (example- cooperation.)
If you recognize a delay, or your child seems grossly behind other children of the same age, you should discuss it with your pediatrician. Sometimes a delay can be temporary from an illness, but often the delay needs intervention. The pediatrician may recommend you see a behavior specialist, neurologist, developmental specialist, etc.. depending on what area(s) the delay is in. The sooner a diagnosis can be made as to why the child is delayed, the sooner a specialized therapy disciple can begin working with the child. When it is decided there is a developmental delay and it warrants intervention, there are many types of therapies available.
Three common therapy disciplines for developmental delays:
Physical therapy or Physiotherapy (PT)
This therapy will focus on movement dysfunctions and gross motor skills. A PT has specialized training in gross motor development, functional mobility skills, posture alignment, and gait training (walking.)However, they are also trained in fine motor development, oral motor, adaptive skills, etc… The PT understands how bones, muscles, joints, and nerves make a child move and function. It will be their jobto develop a specific program for each individual child, that best provides a foundation for the sensory motor development. This plan may include exercise routines, flexibility and stretching routines, and play oriented techniques. Whatever plan is made will be taught to the parent or caretaker for use on the days the child does not see the PT. The PT will also be the one to assess the need for and use of braces, crutches, walkers, wheelchairs, and other assistive devices.
Occupational therapy (OT)
This therapy will focus more on activities of daily living, sensory awareness, psychosocial needs, and fine motor skills. The OT will work on a child's coordination, self help (feeding, dressing and grooming, safety) focus and attention, play/social interaction, eye-hand coordination, and specific social behaviors . The OT will make a plan and teach to the parent for the days the child does not see the OT. OT can also assist in ordering equipment and devices.
Speech/Language Pathology
A speech pathologist specializes in communication skills, speech, language, hearing, and voice disorders. They assist in bridging the path from listening and speaking to reading and writing. They also address feeding & swallowing difficulties. Through repetitive drilling, muscle strengthening, audio visual aids, sign language, etc.. they develop a plan to optimize communication and feeding skills. They also evaluate and order alternative communication devices such as, switches and speech generating devices. They too will teach the parent or caregiver how to be involved and reinforce what is taught.
Through my experience, I have found that the most beneficial therapy took place in the home. It is where my child is most comfortable, the items she uses everyday are located, and has the least amount of distractions. Some therapy services provide home visits and some only offer services in clinic or hospital settings. The most important tip is to always make sure the therapist is licensed and has specialized in pediatrics .
