Developmental delays and developmental disabilities sound like they refer to the same issues. They are sometimes used interchangeably, even though they shouldn’t be. Adding to the confusion is the fact that they’re both measured by the same developmental milestones. However, there are significant differences between them, and each has a different outcome.
From the time babies are born, their development follows an expected progression of events, and these are marked by well-known developmental milestone. Parents watch for all the significant “firsts,” but many smaller developmental tasks must be learned in a step-wise fashion to ensure that adequate progress is made from one major milestone to the next. While development proceeds in a specific order for every child, the amount of time each step takes is different for each individual.
When a child’s physical, cognitive, behavioral, emotional or social development falls behind the normal ranges for his age, it is considered to be a developmental delay. Some children may be delayed in one area of development; others may have a global delay, which means they lag behind in all areas. With appropriate intervention, children with developmental delays can learn the missing skills and continue toward normal development.
Developmental disabilities are life-long disabilities resulting from mental or physical impairments that exist before the age of 22. This includes mental retardation, autism spectrum disorders, cerebral palsy, sensory-related disabilities, metabolic disorders (phenylketonuria) and degenerative disorders (Rett Syndrome). Developmental disabilities affect areas of receptive and expressive language, socialization, learning, self-care, self-direction and overall ability for self-sufficiency. Many children with developmental disabilities will show developmental delay by missing the milestones. But some, such as children on the high-functioning end of the autism spectrum, may reach every milestone on time. In addition to issues related to milestones, children with developmental disabilities also exhibit a wide range of other emotional, behavioral and physical symptoms.
Diagnosis and Treatment
Whether you suspect developmental delay or disability, a developmental screening is the first step. This is a tool used to identify children who may need further evaluation. The next step is a more in-depth evaluation, which identifies the child’s strengths and weaknesses in all areas of development and determines if a delay or disability exists.
If the diagnosis is developmental delay, the goal for treatment is to address the underlying cause of the delay and to implement a plan to teach the missing skills. If a developmental disability is suspected, then additional psychological assessments will be necessary to determine an accurate diagnosis and define a treatment plan. Some behaviors associated with developmental disabilities can be helped with medication. A treatment plan may focus on behavioral supports, social-skills training, special education, occupational, physical or speech therapy, and other therapies such as applied behavioral analysis and DIR/floortime, a specific technique used to strengthen developmental skills.
Development isn’t a straight line of progress. Children go through learning spurts and then can regress back to earlier behaviors, and this makes early diagnosis a challenge. But increasingly, experts recognize the importance of early diagnosis and intervention to improve long-term outcomes. The American Academy of Pediatrics recommends that all infants and young children should be periodically screened for developmental delays. If you are concerned about your child’s development, you can obtain a free evaluation through your state’s early childhood program. In many states this service is called Child Find, but you can also contact your family physician, local elementary school, county health department or the resources below for additional information.