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developmental delaysEarly detection of a developmental delay is an art. Small children don’t always respond on command.  Pediatricians do the best job they can in the limited time they have with patients, but getting a detailed assessment from a parent’s memory about their child’s progress is tricky (Committee on Children With Disabilities).  It is not wise for a parent to over react to their child’s ability, however, specialists don’t want a child with a developmental delay to slip through the cracks.

Early Detection of Developmental Delays is a Team Approach
A team approach with the parents, caregivers, and all health care workers will provide the most holistic method.  Parents are around their children the most and they can provide more detailed information about their child’s speech, language, physical, cognitive and social emotional skills.  Having a recorded history of the milestones achieved would be highly beneficial for the child, teachers, health care workers and the family.

Often physicians will tell a parent that a child will “outgrow a problem.”  This is true for approximately 90% of children in their preschool years, however, early identification of a problem leads to early intervention which benefits everyone. If a parent is up to date about their child’s development and has a special concern, a physician can more easily note the problem and make a referral.  If a parent’s response is vague, such as, “Is Johnny okay?” a pediatrician may have difficulty answering that question in detail.

American Academy of Pediatrics (AAP) Guidelines
Here are the recommended guidelines for a pediatrician for the screening of developmental delays (Committee on Children With Disabilities):

  • Informal developmental evaluation of children less than 3 months of age during well-child visits.
  • Standard developmental screenings of children at 9 months, 18 months, and 24 to 30 months.
  • Referrals for more testing and intervention for children not passing.

What the Research is Reporting

  • A recent study of 17 pediatric practices revealed that many pediatricians were not following the AAP guidelines, even if they had concerns about a child’s development (King et al, 2010).
  • Although 53% of the practices studied reportedly conducted developmental screenings, none followed AAP screening guidelines. Apparently most doctors have information about development but remain more focused on identifying a medical diagnosis than in determining the level of speech, language and motor skills (Nathan, 2011).

With the ongoing changes in the medical profession, more physician assistants and nurses will probably be giving your child a primary care evaluation and only the most serious problems addressed by the pediatrician.  Parent report will be essential to ensure a child’s developmental health.

New methods for evaluating a child’s progress is slowly being implemented such as, Child Health & Development Interactive System (CHADIS).  CHADIS is a web-based screening, diagnostic and management system that administers and analyzes pre-visit, online questionnaires completed by parents, teens or teachers provided electronically to the pediatrician or health care worker.

With the increased incidence of Autistic Spectrum Disorders and other delays, it is important that a parent monitor their child’s growth and development starting at birth. Developmental delays that go unnoticed can affect a child’s academic performance, social interaction, and communication success.

What Can a Parent Do to Solve this Problem?

  • Inform yourself about developmental milestones that are age-appropriate
  • Record your child’s development so that you can have a specific dialogue concerning a possible developmental delay with your pediatrician or other health care provider
  • Provide stimulating activities and age-appropriate toys so you can follow your child’s progress while you are evaluating his/her ability
  • Refer to reputable sites on the internet and/or books that contain developmental scales for comprehensive information about milestones that your child should achieve in the areas of speech, language, hearing, vision, physical, cognitive, and social-emotional skills.

It takes a village to raise a child.  Staying informed about typical child development is a partnership between parents and the medical community. Children develop at different rates, as you know, normal is only a setting on your dryer. Don’t panic if you see that your child isn’t meeting milestones at exactly the right age as his peers, it is the progression of skills that is most important. Building on your child’s strengths and enhancing his/her weaknesses in all developmental areas will prepare your child for his/her life learning skills.


Child Health & Development Interactive System (CHADIS).

Committee on Children With Disabilities. Developmental Surveillance and Screening of Infants and Young Children. Pediatrics.

King TM, Tandon ST, Macias MM, et al. Implementing developmental screening and referrals: lessons learned from a national project. Pediatrics, 2010; 125: 350–60.