Healthy Kids: Assessing developmental delays
Childhood is a time of significant developmental milestones, and it can be worrisome to parents if their child falls behind. Regular well-checkups allow your pediatrician to track your child’s development, from birth through adolescence, to identify and assess possible issues or delays, and help correct them.
Physical delays can affect children emotionally
Five-year-old Andrew Bell was born with severe vision problems, which has led to developmental delays in his fine and gross motor skills.
“What was most alarming to me, as a mom, was that because of those struggles, he had a hard time emotionally. It affected his self-esteem and his confidence level,” says Andrew’s mom, Alison Bell.
“Parents are often terrified when they compare their child to other kids and realize their child is behind, or they perceive their son or daughter might not be doing well in a specific area,” says Dr. Pilar Bradshaw with Eugene Pediatric Associates. “If that’s the case, parents need to know that there’s help available.”
A child's development is divided into five main categories:
• Big body movement (gross motor) skills
• Hand movement (fine motor) skills
• Communication skills
• Personal/social skills
• Problem-solving skills
Regular screenings are designed to help identify kids who may need extra support in one or more of these categories. All well-child checkups should include specific questions about your child's development and behavior.
“It’s one of the reasons we use a standardized tool called the Ages & Stages Questionnaire, the ASQ, because it asks parents specific questions about their child’s development that they can complete prior to their child’s appointment,” Dr. Bradshaw says.
“Once we have that information, we can grade it, and then we know which kids we should be concerned about. We can ask more detailed questions at the checkup and then put an appropriate referral in place, if needed.”
If a screening or a parent’s concern shows that a child is at risk for a developmental disorder, he or she should be referred to an early intervention program. Dr. Bradshaw referred Andrew to Connect the Dots Pediatric Therapy (CTD), which specializes in occupational, physical and speech therapy services for children birth-18.
“Using scissors was hard for Andrew. Climbing hand-over-hand on a rope, putting on pants, using zippers and fastening snaps – all of that was hard for him,” says Stephanie Wagers, an occupational therapist who owns and operates CTD with her husband, Lee. “So, we started right where Andrew was at, we built on that, and we do it all through play.”
Once a week, through a series of activities and games, Stephanie and the Connect the Dots staff work with Andrew on building up the intrinsic muscles of his hands, improving his flexibility and strengthening his core.
“We work a lot on core stability, because we know as occupational therapists that when we strengthen the core, it promotes fine motor development out to their fingers.”
An integral part of CTD’s holistic approach focuses on developing treatment and skill building plans with realistic goals, involving the parents throughout the process and giving them exercises to do with their children at home.
“Our family motto is ‘Bells don’t quit, and we can do hard things,’” says Alison. “But those words are meaningless if Andrew doesn’t have the skills to do hard things. Connect the Dots is giving him the skills and confidence to do hard things, to achieve those difficult goals. I’m blown away by how much he’s progressed in just a few months.”
When Andrew first started his therapy play sessions at CTD, he couldn’t cut a straight line with scissors. Now, he’s doing that and so much more with ease.
“I always tell parents, there’s absolutely no kid that will not improve over time with the correct help,” says Dr. Bradshaw.
Talk with your pediatrician if you have concerns
Every child has a unique skill set and develops at different rates. Parents should not assume that their child is developmentally delayed if he or she has yet to master the milestones suggested for their age. Parents know their kids best, so if you have concerns about your child’s development, contact your pediatrician.