Understand Your Child

Specific Conditions - Developmental Delay

What is it?

Developmental delay is the term used when a young child is slower to reach milestones than other children. Delay may occur in the way a child moves, communicates, thinks and learns, or behaves with others.

What are the features of it?
The features noted will vary according to the area(s) of delay, but can include:
• Difficulties producing controlled speech (eg making speech and/or sequencing) Difficulty controlling breathing and phonation
• Slow language development
• Difficulty combining physical movements into a controlled sequence, learning basic movement patterns, or difficulty remembering the next movement in a sequence
• Difficulty establishing the correct pencil grip, and age appropriate speed of writing
• Poor balance (sometimes even falling over in mid-step)
• Problems with spatial awareness (eg fitting objects into appropriate sized spaces – such as puzzles, and knowing left from right)
• Trouble picking up and holding onto simple objects due to poor muscle tone
• Trouble with body awareness, such as applying more force than intended, determining the distance between themselves and objects and invading other people’s person space without recognizing this.
• Difficulty achieving and maintaining continence (of bladder, bowel or both). Bedwetting or nocturnal enuresis is common

Common challenges experienced by those with Global Developmental Delay:
• Lacking hand-to-eye coordination, which causes problems with basic skills such as throwing and catching
• Heavy reliance on seeing how things are done to learn movements (verbal input is often insufficient)
• Unco-ordinated physical movements, awkward postures and running styles
• Inadequate whole body (gross motor) control skills (eg they may find it difficult to stand on one leg or handle equipment like a bat or racquet)
• Require more than typical time and effort to master a new physical skill
• May not retain the skill if practice ceases (eg swimming lessons that cease over the school holidays can see these children need to relearn the skills gained before the holidays)
• Unable to anticipate what might happen next (eg cannot ‘read the play’ to realise that the ball may be sent their way)
• Failure to respond quickly to their surroundings (eg may stand still when a ball is kicked to them)
• Have a lower level of athletic abilities compared to other children of the same age
• Show evidence of hand dexterity (fine motor) control problems such as untidy writing.

Management strategies that supports the child with Global Developmental Delay (at preschool/school or home)
• Encouragement
• Opportunities to succeed
• Extra time to complete tasks
• ‘Fun’ time
• Visual cues
• Simple language and instructions

Occupational therapy approaches and activities that can support the individual or their carers include:
• Develop the underlying skills necessary to support whole body (gross motor) and hand dexterity (fine motor) skills
• Build confidence to enable a child to willingly participate in activities
• Educate the child’s carers about appropriate expectations
• Master a skill first and then gradually increase the demands of it (much more slowly then with more typical learners)
• Present the activities at the ‘Just right Challenge’ level (that is not too hard for the child) or lower than this to build self confidence and encourage task engagement, as it is common for these children to shut down when they perceive the task to be too hard
• Simplifying tasks to the smallest possible components
• Use of simple and concise language
• Brief instructions, that does not require them to remember instructions
• Physical and visual models or instructions wherever possible, not just verbal
• Backwards chaining (mastering the last step of the activity first and then the second to last)
• Chunking of information (learning to perform or associate multiple steps together, once the individual steps are mastered separately)
• Activities to support attention