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Developmental Delay

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    McCluskey CDFR 4300 Developmental Delay At least 8 percent of all preschool children from birth to 6 years have developmental problems and demonstrate delays in one or more domains. (Pediatric Perspective, 2003). Developmental delays occur when a child does not reach the developmental milestones by the expected time. It can affect one or more of the five areas of development: physical, cognitive, communication, social and emotional, and adaptive.

    If a child is experiencing a delay in the area of social/emotional then their ability to communicate could also be affected. According to IDEA developmental delay is defined as: Child with a disability for children aged three through nine (or any subset of that age range, including ages three through five), may…include a child- 1.

    Who is experiencing developmental delay as defined by the State and as measured by appropriate diagnostic instruments and procedures in one or more of the following areas: Physical development, cognitive, communication, social or emotional, or adaptive development; and 2. Who, by reason thereof, needs special education and related services. [34 CFR 300. 8(b)] The North Carolina General Statute 122C-3(12a) defines a developmental disability as “a severe, chronic disability of a person which: s attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the person attains age 22, unless the disability is caused by traumatic head injury and is manifested after age 22; is likely to continue indefinitely; results in substantial functional limitations in three or more of the following areas of major life activity: self-care receptive (understanding) and expressive language learning mobility (ability to move) self-direction (motivation) the capacity for independent living economic self-sufficiency reflects the person’s need for a combination or sequence of special, nterdisciplinary, generic services, individual supports, or other forms of assistance which are of a lifelong or extended duration and are individually planned and coordinated; an individual from birth to age 9, inclusive, who has a substantial developmental delay or specific congenital or acquired condition, may be considered to have a developmental disability without meeting at least three of the above ‘areas of major life activities,’ if the individual, without services and supports, has a high probability of meeting those criteria later in life. ” The only difference between the federal definition and the state of N. C. s the mentioning of Traumatic Brain Injury in the state’s definition. There are two risk factors associated with developmental delay. The first is genetics and the second is the environment. A child can be at risk genetically because of genetic or chromosomal abnormality. Downs syndrome is an example of developmental delay caused genetics. Environmental risk factors occur when a child is exposed to harmful materials before or after they are born. This could be a result of a mother using drugs during pregnancy, poor nutrition, or being infected with a disease. The child’s life experiences are also included as an environmental risk factor.

    Child related risk factors for developmental delay are perinatal: low birth weight, premature, viral infection, heart disease, and respiratory problems; metabolic: significant feeding problems, persistent hypoglycemia, and other metabolic disorders; and neurological: intraventricular hemorrhage, intracranial pathology, and other neurological problems. Other risk factors are the parent: lack of health care, poverty, low IQ, drug abuse, and maternal depression; the community: lack of support, violence, and social isolation; and the family: dysfunctional parenting, multiple children in the family, and domestic violence. IAFP/FPEN, 2007). Some experts estimate that 70-80% of children with developmental delays are not being identified prior to entering school. (IAFP/FPEN, 2007). The best way to help identify children who are at risk for developmental delay is to ask the parents during their well-baby checkup if they have any concerns about their child’s development. Discussing developmental milestones also helps to identify developmental delays. Parents should be somewhat familiar with the developmental milestones for their child’s age so they can know what to expect.

    The following are the developmental milestones for a normal developing child in the area of Social/Emotional: 4 months- recognize most familiar adults; 6 mos. -reacts to strangers 9 mos. -plays peek-a-boo, and engages in exchanges of gestures, sounds, and facial expressions; 12 mos. -imitates gestures such as hugging a doll; 15 mos. -plays with other children; 18 mos. -engages in pretend play; 24 mos. – imitates behavior of others, especially adults and older children, increasingly aware of herself as separate from others, increasingly enthusiastic about company of other children; 36-48 mos. interested in new experiences, Cooperates with other children, Plays “Mom” or “Dad”, increasingly inventive in fantasy play, Dresses and undresses, Negotiates solutions to conflicts, more independent; 48-60 mos. – wants to please friends, wants to be like her friends, more likely to agree to rules, likes to sing, dance, and act; shows more independence and may even visit a next-door neighbor by herself, aware of sexuality, able to distinguish fantasy from reality, sometimes demanding, sometimes eagerly cooperative.

    By knowing the above mentioned developmental milestones a parent can know if their child is developing on target or if they should be concerned. First Signs, a non-profit organization recommended that parents and providers be aware of the following red flags concerning a child’s development. * No big smiles or other warm, joyful expression by 6 months or later * No back and forth sharing of sounds, smiles, or other facial expressions by 9 months * No babbling by 9 months * No words by 16 months No two-word meaningful phrases (without imitating or repeating) by 24 months * Any loss of speech or babbling or social skills at any age Even with the use of above mentioned, there are still children who go undetected for developmental delays. Those who work with children should continue to use their knowledge and training to identify children with developmental delays. Child care providers should continue to use developmental screening tools available to them. They should also use other methods such as: observation, documentation, identifying risk factors, and protective factors in a child’s environment.

    Developmental screenings and developmental evaluations are two play-based assessments used to identify developmental delays. Developmental screening is a quick and general measurement of skills. The purpose of the screening is to assess whether the child needs further evaluation. The screening comes in the form of a questionnaire about the developmental milestones answered by the parent or the provider or a test provided by a health or educational professional. The test is used to identify children who may be having problems. It can identify a child as more delayed or less delayed than they are.

    The screening shows the child may have a developmental delay and should be referred for more testing. Developmental evaluation is more in-depth assessment. It measures the child’s skills and should be administered by a trained professional. Evaluations are used to develop a profile of the child’s strengths and weakness in the developmental areas. The purpose of the evaluation is to determine if early intervention and/or a treatment plan are necessary. A child my need early intervention and/or a treatment plan depending on their developmental evaluation.

    Early intervention services include a variety of resources and programs. These resources and programs provide support to the family to enhance the child’s development. These services include the following: assistive technology, hearing services, educational programs, occupational and/or physical therapy, speech/language, respite services, etc. These services can be provided by public or private agencies. FPEN/IAFP (2007, January). Social and Emotional Development: Screening Strategies for Primary Care Providers http://www. iafp. rg/pdfs/SocialEmotional. pdf http://www. howkidsdevelop. com/developDevDelay. html A Pediatric Perspective. (1998, July/August). Developmental delay vs. developmental disorder in young children: Understanding the difference. Retrieved from http://www. gillettechildrens. org A Pediatric Perspective. (2003, July). Identifying Patterns of Developmental Delays Can Help Diagnose Neurodevelopmental Disorders. Retrieved from http://www. gillettechildrens. org Developmental Fact Sheet. (2009, August) Retrieved from http://www. nichcy. org

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