Developmental Delays

Developmental delays occur when a child does not reach developmental milestones at the expected time. These milestones may relate to physical function, intellectual abilities, communication, or behavior. Some examples of early developmental milestones include a child’s first smile, word, or steps. If a child falls well behind their peers in reaching one or more of these early milestones, they may have a developmental delay. Other developmental delays only become apparent once a child is a bit older. For example, school-aged children may fall significantly behind their peers in skills such as reading, writing, and math. Sometimes, developmental delays resolve — that is, the child is able to “catch up.” In other cases, developmental delays persist and become developmental disabilities. Individuals with developmental disabilities do not outgrow them over time. However, their function can often improve with a tailored intervention plan. Depending on the individual, this may include medical treatments, therapies, special education services, assistive technology, and more.

Developmental Delays and Disabilities

Causes of developmental delays

A variety of factors can contribute to developmental delays/disabilities. These include the following:

Birth injuries

A birth injury is any type of harm to a baby that occurs during or near to the time of birth (including in late pregnancy and early infancy). Some common types of birth injuries that cause developmental delays include following:

In many cases, birth injuries are preventable. If medical professionals fail to provide adequate care, and this harms the baby, it constitutes medical malpractice (see “Legal help” for more information).

fetal oxygen deprivation; hypoxia; hypoxic ischemic encephalopathy; birth asphyxia

Hypoxic ischemic encephalopathy (HIE; birth asphyxia) can cause permanent brain damage with resultant intellectual and developmental disabilities (I/DD)

Genetic and chromosomal conditions

Two commonly-known heritable causes of developmental delay are Down syndrome (Trisomy 21) and fragile X syndrome (FXS). Children with Down syndrome have an extra copy of chromosome 21 (1). Children with fragile X syndrome have a genetic mutation that inhibits their ability to produce an important protein (2).

Other causes

Developmental delays usually stem from something that occurs before birth, during birth, or in very early infancy. However, developmental delays sometimes begin later in childhood, as the result of an injury, infection, or another complication (3).

Neurodevelopmental disorders associated with developmental delays

Neurodevelopmental disorders are impairments in the developmental growth of the brain and central nervous system. These disorders affect the baby or child’s ability to achieve certain milestones, including learning specific skills and tasks that other children in a similar age range can do.

Listed below are specific neurodevelopmental disorders that can be caused by birth injuries:

  • Developmental cognitive disability (intellectual disability): A developmental cognitive disability is a disability that begins in childhood and is characterized by limitations in intellectual function and life skills. Children and adults with developmental cognitive disabilities may have difficulties with communication, conceptual skills, social skills, self-care, home living, community use, self-direction, health and safety, functional academics, leisure, and work.  There are many types of services and supports that can help people with cognitive developmental disabilities. Many children benefit from special education services, through which they can have an individualized education program (IEP). Some people with cognitive developmental disabilities also require support throughout their lives. This can range from help finding/maintaining a job to full-time caretaking.
  • cerebral palsy; neonatal brain damage; CP; birth injury; disability; special needs

    Cerebral palsy is often caused by damage to the brain occurring around the time of birth

    Developmental motor disability (cerebral palsy): Cerebral palsy, abbreviated CP, is a disorder caused by damage to the brain that occurs around the time of birth. It affects body movement and muscle coordination. Individuals with cerebral palsy also may experience seizures, abnormal speech, hearing and visual impairments, and cognitive impairments. Although cerebral palsy is a lifelong condition, training and therapy can help improve function.

  • Attention-deficit disorder (ADD) and Attention-deficit/hyperactivity disorder (ADHD): ADD and ADHD are some of the most common neurobehavioral disorders, characterized by problems with inattentiveness, over-activity, impulsivity, or a combination of these. For these problems to be diagnosed as ADD/ADHD, they must be out of the normal range for the child’s age and development. It usually is first diagnosed in childhood and persists into adulthood. It can be addressed with medications and/or behavioral interventions. Although ADHD can persist throughout an individual’s life and negatively impact things like education, work, and interpersonal relationships, many people are able to manage it effectively.
  • Learning disabilities: Learning disabilities become evident in childhood and are characterized by difficulty learning, sorting, and storing information. Children with learning disabilities may have difficulties with skills such as listening, speaking, reading, writing, reasoning, or mathematics. These challenges may interfere with academic performance and, in some cases, activities of daily living. Some children with learning disabilities may benefit from special education services. With proper intervention, training, and strategies, many individuals with learning disabilities can lead successful, independent lives.
  • Microcephaly: Microcephaly is a condition in which an infant or child’s head is much smaller than normal. Brain injuries/abnormalities stunt growth of the skull. Microcephaly is often caused by birth injuries. If there is an interruption in blood supply to the baby’s brain early in development, this can cause microcephaly and permanent brain damage (hypoxic-ischemic encephalopathy, cerebral palsy, etc). Currently, there is no cure for microcephaly, but there are supportive treatments to help the child better cope with the condition (4).

Milestones for developmental delays

Developmental delays are diagnosed when a baby or child does not reach milestones around the expected time. Developmental milestones are sets of skills or behaviors that are typically exhibited by a certain age. The following information comes from the American Academy of Pediatrics (5).

Developmental milestones: 1 month of age

  • Ability to turn the head when lying face-down
  • Ability to close the hand into a fist
  • Jerking arm movements
  • The head flops back if it’s unsupported
  • Fully developed hearing
  • Preference for black and white patterns
  • Preference for looking at human faces
  • Recognition of certain sounds
  • Turning of the head towards familiar noises
  • The eyes wander, cross, and focus
  • Preference for sweet smells
  • Preference for soft fabrics
  • Can smell the mother’s breast milk

Signs of developmental delays at 1 month of age

  • Unable to feed properly
  • Unable to respond to loud sounds
  • Unable to focus and follow with the eyes
  • Stiff or floppy limbs
  • Constant trembling of the lower jaw

Developmental milestones: 3 months of age

  • Opens and shuts hand
  • Shakes hand toys
  • When on stomach they can lift their head and support their upper body
  • Smiles at the sound of a parent’s voice
  • Babbles
  • Starts using hands with eyes
  • Socially smiles
  • Enjoys playing with others

Signs of developmental delays at 3 months of age

  • Does not smile in response to parent’s voice
  • Does not smile at people
  • Cannot support the head easily
  • Failure to respond to loud sounds
  • Inability to push down with the legs when they’re on a hard surface

Developmental milestones: 7 months of age

  • Ability to roll both ways
  • Ability to support weight on the legs
  • Ability to reach with one hand
  • Responds to own name
  • Explores with the hands and mouth
  • Can tell emotion by the tone of a voice
  • Responds to “no”
  • Enjoys playing with others

Signs of developmental delays at 7 months of age

  • Very stiff or floppy body
  • Shows no affection
  • Does not respond to sounds
  • Does not laugh or squeal
  • Does not babble
  • Does not seem to enjoy being around others

Developmental milestones: 1 year of age

  • Sits without assistance
  • Crawls and tries to walk
  • Pulls self up to stand
  • Puts objects in and takes them out of containers
  • Uses index finger to point
  • Tries to scribble
  • Responds to words such as “no”
  • Says simple words such as “Mama,” “Dada,” and “Uh-oh”
  • Can find hidden objects
  • Shyness around strangers; distress and crying when when parents leave

Signs of developmental delays: 1 year of age

  • Does not crawl
  • Does not say single words
  • Cannot stand
  • Does not learn to point or use gestures

Developmental milestones: 2 years of age

  • Can walk independently
  • Can carry a toy, walk and run
  • Can start to run
  • Can kick a ball
  • Can scribble
  • Recognizes names, faces, objects, and body parts
  • Starts forming sentences
  • Follows instructions
  • Can sort shapes and colors

Signs of developmental delays: 2 years of age

  • Cannot walk
  • Does not form sentences
  • Does not follow instructions
  • Does not know the function of ordinary household items

Developmental milestones: 3-4 years of age

  • Can hop and stand on one foot
  • Can kick, catch, and throw a ball
  • Can move up and down a set of stairs
  • Can move forward and backward easily
  • Can draw shapes
  • Tells stories
  • Understands the concept that some things are the same and others are different
  • Has a sense of time
  • Starts to count
  • Plays and cooperates with other children
  • Becomes more independent

Signs of developmental delays: 3-4 years of age

  • Cannot throw a ball
  • Cannot jump in place
  • Cannot draw
  • Ignores other children
  • Does not use sentences with more than three words
  • Does not want to dress themselves or use the toilet

Developmental milestones: 4-5 years of age

  • Can stand on one foot
  • Can skip, hop, swing, and do somersaults
  • Can draw a person with a body
  • Can print letters of the alphabet
  • Speaks in sentences over five words and uses past and future tense
  • Can remember name and address
  • Can count
  • Increasingly exhibits independence
  • Follows rules
  • Wants to be similar to friends

Signs of developmental delays: 4-5 years of age

  • Excessive aggression
  • Excessive fear or timidity
  • No interest in playing with other children
  • Difficulty eating, sleeping, and/or using the toilet
  • Exhibits hygienic problems, such as washing hands and brushing teeth
  • Cannot understand two part commands such as, “Pick up the plate on the table.”

Between ages 6 and 12, children generally become independent. Rapid change occurs physically, emotionally, socially, mentally, and morally. Mood swings are common as children go through puberty. Parents can help children with their development during this time by exhibiting patience, asking questions, and helping with problem-solving skills. Read signs and be aware of their social situations. Giving constant advice and lots of positive attention help children to navigate their future.


Developmental delays caused by medical malpractice: help from lawyers

If you are seeking the help of a birth injury lawyer, it is very important to choose a lawyer and firm that focus solely on birth injury cases. Reiter & Walsh ABC Law Centers has been helping children with birth injuries since its inception in 1997.

If your child was diagnosed as having developmental delays, learning disabilities, cerebral palsy, hypoxic-ischemic encephalopathy (HIE), or any other birth injury, we can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy, and a secure future, and we give personal attention to each child and family we represent. Please contact us today to begin your free case review. You pay nothing throughout the entire legal process unless we win or favorably settle your case.

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Video: Our attorneys discuss developmental delays and birth injuries

 

In this video, lawyers Jesse Reiter and Rebecca Walsh discuss how birth asphyxia can cause learning disabilities and developmental delays.

Sources

  1. Birth Defects. (2018, February 27). Retrieved October 2, 2018, from https://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html
  2. Fragile X Syndrome (FXS). (2018, August 09). Retrieved October 2, 2018, from https://www.cdc.gov/ncbddd/fxs/facts.html
  3. Developmental Disabilities. (2018, April 17). Retrieved October 2, 2018, from https://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html
  4. Birth Defects. (2016, December 07). Retrieved from https://www.cdc.gov/ncbddd/birthdefects/microcephaly.html
  5. From the American Academy of Pediatrics. (n.d.). Retrieved October 2, 2018, from https://www.healthychildren.org/