I – Introduction
The developmental disabilities are group of conditions due to impairment in learning, physical, language, or behavior areas. The impairment of learning will be determined through the child’s developmental milestone, proper monitoring, and screening at early stages. Parents play a vital role of the interventions necessary for the development of a child and seek assistance from health specialists of the child’s condition. These conditions start during the developmental period of young children and have a great impact in the daily functioning, and it last throughout a lifetime.
- Definition of Developmental Delay
Developmental Delay refers to children ages three through nine who experienced developmental delays. It is measured by diagnostic instruments and procedures appropriately. The diagnosis is applied in one or more of the following areas such as physical, communication, and cognitive, adaptive development, social or emotional that adversely affects the educational performance of a child. Other disability categories are used if they are more descriptive of the strengths and needs of a young child or it needs special education or related services. Some local school systems have the options of utilizing the developmental delay as a disability category.
- Developmental Milestone
A developmental milestone is the child development that refers to the process wherein children go through the changes in skill development during predictable periods; a child acquires a skill within a specific period. Developmental delay occurs when a child has not reached the milestones by the expected period. For example, the normal ranges for a young child to walk or most children learn this skill or developmental milestone is between the ages of 9 and 15 months, and if a 20-month-old child has still not started walking, then this would be considered as a developmental delay. Milestones develop in a sequential way. It means that children need to develop some skills before he can develop new skills. For example, children first learn how to crawl, to pull up, and then stand before walking. The milestone that a child acquires is built on the last milestone being developed. The developmental delays occur in five areas of development or just happen in one or more of the areas, social, and emotional, cognitive, speech and language, gross motor skill, and fine motor skill developments. In addition, the growth in every area of development relates to the growth in the other areas. For example, if there is a difficulty in speech and language, then it is possible to influence a development in social and emotional. II – Developmental Monitoring and Screening
The growth and development of children are followed through a partnership between parents and a health care professional. During visitation, the doctor looks for any developmental delays or problems and talks with the parents about any concerns the parents might possibly have. This is known as the developmental monitoring. If there is, any problems noticed during the developmental monitoring, and then developmental screening is the next level. A developmental screening is a short test to inform the parents if their child is learning basic skills, or if there are delays of the development. If children have developmental delays, it is essential to obtain aid from a health care professional immediately. Early identification and intervention have a major impact on the ability of a child to learn new skills, and to reduce the necessity for costly interventions in the end.
- Role of the Pediatrician and Parents
Children with special health care needs should have a developmental monitoring and screening similar to those children without special needs. The monitoring of healthy development is paying attention to symptoms related to the condition of the children and mental, physical, emotional, and social well-being of the children. The parents should not be surprised if the pediatrician would say to be patient, never worry, and give the young child a time to develop according to his phase. The usual thing parents hear is about the early stages of investigation of seeming delays of a child. Most children develop at different rates, and all pediatricians are aware about the sudden burst in the children development than slow or steady growth.
The doctor would ask the parents some questions and play with the child during an examination to observe how the child speaks, behaves, learns, plays, and moves. Any delay of these areas could be a sign of a certain problem. In addition, recommendations from the American Academy of Pediatrics that all children should be screened for developmental delays and disabilities during the regular well-child doctor visits at 9, 18, and 24 or 30 months old. The developmental screening test is a general and quick measurement of the children’s skills. Its purpose is to identify children who are in need of supplementary evaluation. A screening test can be in one of the two formats, a questionnaire that is handed to parents, or a childcare provider that would ask about developmental milestones that is given to the child by a health or educational professionals. This screening test is meant to identify children who have problems. The screening test can under-identify or over-identify children with delays. Consequently, a diagnosis cannot be made by simply using a screening test. If the results of a screening test suggested that a child has a developmental delay, then the child should be referred for developmental evaluations.
It has no detailed results or enough information from a diagnosis; it is presented that children are referred for an in-depth developmental evaluations. The developmental evaluations are conducted by well-trained health professionals. The health professional uses the results to create a profile of the strengths and weaknesses of a child. The evaluation needs to look at five developmental areas; fine motor skills, gross motor skills, or physical development, intellectual abilities or cognitive development, speech and language or communication development, social skills, emotional control or social or emotional development, and self-care skills or adaptive development. The results of the developmental evaluation are used to decide if the child needs an early intervention services or a treatment plan.
III – Causes and Risks Factors
Causes and Risk Factors
The developmental disabilities start anytime during the developmental period; it lasts throughout a lifetime. Most developmental disabilities start before a baby is born; however, some can happen after birth because of infection, injury, or other factors.
Most of the developmental disabilities are caused by complex mix of factors. These factors include genetics; parental health and behaviors such as drinking alcohol or liquor and smoking cigarette during pregnancy; some complications during birth; infections the mother have during pregnancy or the baby have it at very early in life; and exposure of the child or mother to high levels of environmental toxins such as lead. For some developmental disabilities like fetal alcohol syndrome that is caused by drinking alcohol during pregnancy. The cause is clear but for most, it is not.
There are two categories on risk factors for developmental problems, genetic and environmental. Children with genetic risk are born with genetic abnormality or chromosomal abnormality. Environmental risk results from the exposure to harmful agents, before or after birth. In addition, environmental risk includes life experiences of a child. For example, a child who is born premature, mother's depression, face severe poverty, poor nutrition, or lack of care. Risk factors have cumulative impacts in the development of a child. As numbers of risk factors increase, a child is at greater risk for a developmental delay.
- During pregnancy
The maternal infections like cytomegalovirus infection or CMV during pregnancy can cause hearing loss among babies at about 25 percent. Most common causes of intellectual disabilities are fetal alcohol spectrum disorder or FASDs, genetic and chromosomal conditions such as fragile X syndrome and Down syndrome, and toxoplasmosis, infections during pregnancy. A child who has sibling is at higher risk of having an Autism Spectrum Disorder or ASD. In addition, a premature birth, low birth weight, multiple birth, and infections during pregnancy are associated with increased risks for many developmental disabilities.
- After Birth
About 90 of every 100 infants who are infected with CMV at birth appear healthy. The health disabilities or problems are due to CMV infection, it appears 2 or more years after birth or it never appears at all. There are cases that about 80 of every 100 infants with CMV infection have never developed disabilities or symptoms. The signs of CMV infection that are present at birth are liver problems, seizures, premature birth, small size at birth, lung problems, spleen problems, and small head size. While the permanent health disabilities due to congenital CMV infection are hearing loss, vision loss, mental disability, small head size, lack of coordination, seizures, and death in rare cases.
Fetal alcohol spectrum disorders (FASDs) are groups of conditions that occur in an infant or child whose mother drank alcohol during pregnancy; however, FASDs are preventable if a pregnant woman does not drink alcohol during pregnancy. A Down syndrome is a condition that a child has extra chromosomes. It remains the most common chromosomal condition diagnosed in the United States of America. Each year, about 6,000 babies born in the United States have Down syndrome. Implying that Down syndrome occurs about 1 out of every 700 babies correspondingly. Fragile X syndrome or FXS is the most common cause of inherited intellectual disability and Toxoplasmosis is an infection caused by the parasite from cats in particular. In addition, untreated newborn jaundice can cause brain damage called kernicterus; children with cerebral palsy or CP, vision and hearing problems, and teeth problems.
Typically, a developing child who suffered an accident or injury will damage the brain. It is far too frequent occurrences. Damage to the brain causes death, the worst thing to happen. It can cause a lifelong disability for the child that includes cognitive or intellectual impairments. Traumatic brain injuries or TBI are the leading cause of developmental disability and death in children . In the early years of life at birth to 5 years old, children’s brains are developing at its most rapid rate, and brain trauma hinders a child to develop the skills controlled by the portion of the damaged brain. The common causes of TBI are a car accident, falls, and blows to the head. In infants, a severe shaking can cause injury to the brain as it affects the skull known as shaken baby syndrome or SBS, a form of inflicted head trauma.
The results of brain injuries can cause vital impairments physically such as blindness, headaches, hearing impairments, loss of sensation in limbs; cognitively such as memory loss, academic problems, difficulties making judgments, communication skill deficits; and emotionally such as depression, mood swings, and anxiety difficulties with social interactions. An abusive head trauma or AHT can cause by direct blows to the head, shaking a child, dropping or throwing a child.
IV – Treatment and Prevention
The early intervention services are modified to meet the individual needs of the children and are a very significant resource to children who experienced developmental delays. The Early intervention services include useful devices or technology children need, counseling and training for a family, medical services, audiology or hearing services, counseling and training for a family, nursing services, nutrition services, occupational therapy, physical therapy, speech and language services, and psychological services. The early intervention is a system of services that aids babies and toddlers with developmental disabilities or delays. It focuses on helping eligible babies and toddlers learn the brand-new skills and the basics that characteristically develop during the first three years of their lives such as physical or reaching, rolling, crawling, and walking; cognitive or thinking, learning, solving problems; communication or talking, listening, understanding; social or emotional or playing, feeling secure and happy; and self-help or eating, dressing.
The services are provided by private organizations and public agencies for children who are found eligible for these services after developmental evaluations. In San Diego County, children ages 3 and below can access these services through the help of the California Early Start program. While children over 3 years of age, they can access these services through the local San Diego School District. Early intervention services include varieties of different resources and programs that provide support to families to enhance the development of the children. These services are specifically modified to meet the individual necessities.
Early intervention is very important. If a child is found to have some developmental delays after a developmental evaluation, it is significant that intervention occurs early on in childhood for numbers of reasons. Generally, a child needs to learn the developmental skills in a consecutive way. For example, a child needs to learn to sit up on his own before he will be able to stand. Early intervention helps children advance in all areas of development. If a child has a delay in his speech, it can affect other developmental delay in social and emotional Sometimes. Thus, it is very important that a child receive an early intervention immediately. Early intervention is critical for the children to develop good self-esteem. Without early interventions, the self-image of children suffers and they become avoids going to school. For example, a child with a language delay feels embarrass to speak in front of his classmates and teacher at school. Early intervention helps prevent these embarrassing moments for a child before they start going to school.
V – Conclusion and Recommendation
During the developmental period of young children, there is a great impact for the children to develop physically and mentally well, to function as normal children in the society, and throughout their lifetime. Diagnostic instruments and procedures are necessary to the children’s physical, communication, and cognitive, adaptive development, social or emotional aspects to prevent developmental delays. The educational performance of a child is very important as he grows and become an adult. Every child develops at its own rate; nobody can tell when a child can learn his skills. However, the developmental milestones give an idea of the changes to expect from a child, as he grows older in general.
As parents, they know what the best is for their children. If their child is not meeting the milestones for his age or if they think, there could be some problem with their child’s development, they seek the help of the physician or pediatrician immediately and share some concerns. Parents are the ones responsible for the development of their children, especially the mother during her pregnancy. Mother should take the possible precautions to avoid developmental delays caused by environmental risks. In the case of the genetic risks, as parents, they know about the significance of the physical health and well-baby check-ups for their child. Regularly, take a child to the clinic or doctor for proper immunizations and do the developmental screenings. Doctors can provide insights about the development of a child, and parents are the ones to be more aware and observe their child behavioral and developmental growth.
Every child goes through developmental stages, typical and predictable changes in different areas of development. The children progress at their pace of its own accordingly. All the screenings and monitoring are interactive sessions with the children development specialist. The child-friendly play activities focus on all areas of development such as social and emotional abilities, small and large motor skills, speech and language, and behavior. The parents should complete a checklist and talk with the screener about their child’s development and behavior. There are recommendations made as to whether more evaluations that are specific are necessary. If it necessary, the family should link to other agencies for more services. Just as a child needs well-baby checks to determine if he is growing in healthy ways, the parents and professionals need to monitor thoroughly a child for developmental and behavioral wellness. If a child has developmental or behavioral issues, the earlier it is detected, the better the outcome for the child is.
The early intervention treatment services improve the development of children. Early intervention services help children from birth through 3 years of age to 36 months to learn important skills. The services include therapy to help the children walk, talk, and interact with others, as well. The Individuals with Disabilities Education Act or IDEA articulates that children who are younger than 3 years of age are at risk of having developmental delays, eligible for early intervention treatment services even if the child have not received a formal diagnosis. The treatment for particular symptoms like speech therapy for language delays does not require a formal diagnosis. While early intervention is particularly significant, an intervention at any age is helpful. As it is commonly said, that early prevention is better than cure.
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