Every child develops at her or his own pace – some will be faster than you’d expect, and others will be slower than you’d expect.

There will be children who crawl earlier than average, but walk later than average. Meeting development milestones is a complex process – sometimes children develop quickly for a while, then have a period of months when they develop no further, or even slip back a little.

But with some children, it is clear that they are just not developing in the same way as other children the same age. The term global development delay, or GDD, is used when a child shows delays in several areas of development, and this has continued for at least six months.

The delays may be in:

• speech or language development
• gross motor development or big movements such as walking or sitting
• fine motor development or little movements such as drawing or holding a toy
• thinking, understanding and learning
• how they relate to other people, make friends and regulate their own emotions
• tasks of daily life such as dressing and going to the toilet.

Global developmental delay is fairly common. Sometimes, it just happens for no obvious reason, and eventually children catch up and develop normally along with children their age. But at other times, the delays are signs of more serious conditions.

If you are concerned that your child is not developing at the rate you would expect, it is a good idea to have your child assessed by your GP or by an early childhood nurse. The earlier you work out the reason for the delay, the better. Early intervention programs can give many children with global development delays a head start and allow them to reach their full potential. Therapies can reduce the chance of further physical, social or behavioural problems.

Causes of global developmental delay

There are many possible causes of global developmental delay. Some are permanent, but others aren’t.

They include:

• being born prematurely
• a genetic condition such as Down syndrome
• a chromosomal condition such as fragile X syndrome or Rett syndrome
• a metabolic conditions such as the lack of a thyroid
• problems in pregnancy such as heavy bleeding, an infection such as rubella or the mother having excess alcohol or drugs
• problems during or immediately after birth such as heavy bleeding or a lack of oxygen
• visual impairment or loss
• deafness or hearing problems
• language or speech problems
• injuries to the brain from things like accidents, physical abuse or near drowning
• infections of the brain such as meningitis or encephalitis
• frequent or ongoing illness and hospitalisation
• lots of family stress, resulting in lack of loving care and attention in the first months of life
• poverty and malnutrition.

If a condition such as intellectual disability or autism spectrum disorder is later diagnosed, the name for the disorder replaces the term developmental delay.

If you have a child with a developmental delay, it can take quite a while to find out why. That’s partly because child development is complex, and partly because there are so many possible reasons for a developmental delay, and partly because the health system can be hard to navigate.

You are likely to see a general practitioner, before being referred to a specialist, usually a paediatrician. The doctors will talk to you, and want to know in particular about any other relatives who might have had similar delays. They will examine your child and assess them. They might then refer them on to a hospital or clinic with a multidisciplinary team for further tests.

Your child might or might not have some of the following tests:

• hearing tests
• speech and language assessment
• vision tests
• blood tests
• genetic tests
• chromosomal tests
• a magnetic resonance image (MRI) scan to look for abnormalities in the nervous system and brain
• neurological tests such as an electro encephalogram (EEG), which records electrical brain wave activity a psychological assessment.

The team might also want to see how your child behaves and interacts with others at home, at a preschool or in a community setting.

Sometimes, a clear diagnosis can be reached. Sometimes it can’t. If you’d like, you can always ask for a second opinion.

Treatment and therapy
Ideally, your child will be supported by a multidisciplinary team that could include:

• your GP
• medical specialists such as a paediatrician, a neurologist, a surgeon or others
• an occupational therapist who helps children with tasks like picking things up dressing or eating independently, and who can advise on suitable play activities
• a physiotherapist who helps children with skills like walking, and can also deal with problems like poor balance and muscle weakness
• a speech pathologist who helps with language development and can treat speech problems
• a child psychologist, who can monitor overall development and manage behavioural or emotional problems
• an audiologist, who can assess and advise on your child’s hearing
• a special education teacher, who can help deliver the early learning program and support the child in pre-school and school.

The multidisciplinary team will talk to you about your child’s strengths and challenges, and will work with you to develop a management plan.

That is likely to include:

• working out who is your first point of contact
• setting up a plan for regular assessments to check on progress
• some early intervention services.

Getting a diagnosis of global developmental delay can be unsettling. You will probably need time to come to terms with the diagnosis and what it means for you. You are likely to feel a lot of different emotions at different times, including anger, denial, anxiety, depression and more. You might be concerned that it’s not the final diagnosis – that there may be more to come.

That’s true, but it’s also the start of the process where your child can get the sort of help they need.

You can talk to your doctors and therapists, and try to get a greater understanding of the nature of the developmental delay, and what treatment can hope to achieve. This may sometimes be the first stage of a long journey to a firm diagnosis of another condition.

What you can do

You and others in your family can play a key role in helping and perhaps overcoming a global development delay.

Therapists might suggest parents take steps such as:

• spending more time bonding, holding and responding to the child
• using simpler language which the child can understand
• giving children extra time to play and practise skills
• letting the child use touch, looking and listening to learn
• breaking tasks down into several steps that the small child can master more easily
• speaking to the child’s teacher about the special help needed
• finding things the child enjoys and can succeed at, such as feeding a pet or helping with cooking
• being sure to praise their successes to build self-confidence.

Babies and young children learn through play, and a warm, loving environment can help them thrive.

Try not compare your child to others, just appreciate them as unique individuals.

Psychological and emotional support

It’s a good time to look for psychological and emotional support. There is a lot to think about, and a lot to deal with. You might be able to get the support you need from your partner, your family and your friends, but you can also look for support from a professional such as a psychologist, counsellor or social worker.

It is also important that you take a break from caring, that you look after yourself and that you also attend to others in your life, such as a partner and other children.

Service providers

There are many services to support children with global development delay. Children with this condition still have the ability to learn and develop. Parents whose children have global developmental delays can get a package of services from a provider, such as the Cerebral Palsy Alliance.

Sources

The Royal Australasian College of Physicians, Paediatric and Child Health Division, (Position statement, Early Intervention for Children with developmental disabilities), ACT Government Parentlink, (Developmental delay), Royal Children’s Hospital, (Developmental delay: an information guide for parents) Raising Children Network (Developmental delay).

Last updated November 2017