How to identify delays

How to identify delays
It’s normal for some children to develop more slowly than other kids their age. When should you be concerned?

It’s normal for some children to develop more slowly than other kids their age. When should you be concerned?

Caleb was only a few months old when his mother, Emanuelle Roy-Paradis, started to worry that something was wrong. “Whenever I put him on his stomach, he would lift his arms to avoid touching the ground. He would also cry for hours if he was exposed to certain stimuli, like loud noises. Everything bothered him, to the point where he avoided moving altogether. At 14 months, he still couldn’t sit up by himself.”

Caleb, who now sees a physiotherapist, has a slight motor delay, possibly caused by a sensory hypersensitivity. He took his first steps at 20 months. Now, at 21 months, he can even run. “He’s catching up,” his mother says happily.

What do we mean by “delay”?

When a child is significantly behind in reaching the developmental milestones expected by a certain age, this is called a delay. “For example, children have usually taken their first steps, or started the process that leads to walking, by 12 months,” explains Dr. Anne-Marie Goyette, a developmental pediatrician at the Montreal Children’s Hospital. “If a 16-month-old can stand and move around while holding on to furniture, I’m not concerned, because I know they’re on their way to walking. But a 17-month-old who can barely stand probably has a delay.”

“In terms of language, a 12-month-old who isn’t babbling (repeating syllables like “ba ba ba” or “ta ta ta”) almost certainly has a delay, because by then we expect babies to be saying their first words. But if the child is babbling and pointing to objects, there’s nothing to worry about.”

Children with a delay can catch up if they receive proper stimulation. But if they continue to lag behind, the delay may be a symptom of a broader condition that has not yet been diagnosed. “Children with a developmental disorder can definitely improve, but they will always have certain difficulties,” says Dr. Goyette.

Global developmental delay

A global developmental delay (GDD) occurs when a child is significantly behind in at least two of the following areas: gross or fine motor skills, cognitive functions, communication, personal and social development, and activities of daily living (autonomy).

This temporary diagnosis is limited to children aged five and under, except in rare cases. “We make this diagnosis while waiting for the child to become old enough for a full evaluation,” says Dr. Goyette. “For example, cognitive ability tests are not performed until about age four.”

Once children reach age five, their issue can be more clearly identified. A global developmental delay often signals a language disorder, an intellectual disability, an autism spectrum disorder, cerebral palsy, or a combination of these. Sometimes, the child’s delay is the result of a genetic disorder or exposure to alcohol during pregnancy (fetal alcohol spectrum disorder).

Who can help?

If you’re concerned about your child’s development, the first step is to make an appointment with a physician or pediatrician. Depending on the situation, the doctor may run tests or redirect you to a CLSC, where your child can be assessed by a specialist (such as a speech-language pathologist, psychoeducator, or occupational therapist). If necessary, you may be referred to a university hospital or specialized child development clinic.

According to Dr. Goyette, there are many benefits to placing kids with a developmental delay in a daycare centre. “It boosts their autonomy, social development, language ability, and motor skills. A quality daycare centre can help children reach their full potential.”

Learn about all the major stages of child development (in French only):


Photos: GettyImages/tomazl and damircudic


Naître et grandir

Source: Naître et grandir magazine, July–August 2019
Research and copywriting: Nathalie Vallerand
Scientific review: Solène Bourque, psychoeducator