Global developmental delay symptoms in children

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In Singapore, KK Women’s and Children’s Hospital has seen 300 to 400 mild to severe cases of Global developmental delay per year over the last three years. Read more about this condition here...

Apart from autism and ADHD, a special needs condition we have been hearing more often these days is "Global developmental delay". What exactly is global developmental delay? And what are some global developmental delay symptoms in children?

Global Developmental Delay (GDD) is a condition that occurs during the developmental period of a child between birth and 18 years. It is said to affect about 1-3% of children in the world.

In Singapore, KK Women’s and Children’s Hospital (KKH) has seen 300 to 400 mild to severe cases of GDD per year over the last three years. National University Hospital (NUH) sees more than 120 cases of GDD each year.

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Global developmental delay symptoms and causes

Every child develops at his or her own pace. However, there are some red flags which signify developmental delays in children, in the areas of physical, emotional or mental growth.

A developmental delay is more than being “a little behind” in skills. It means a substantial lag.

There are six main areas of development in which kids can have delays:

  • language or speech
  • vision
  • gross motor and fine motor skills. This includes big movements like walking and sitting, and finer movements like drawing and holding a toy.
  • thinking and cognitive skills
  • social and emotional skills like relating to other people, making friends and regulating their emotions
  • daily skills like dressing and going to the toilet

Sometimes, a delay occurs in many or all of these areas. The term global development delay, or GDD, is used when a child shows delays in several areas of development, and this has continued for at least six months. 

This might include learning to walk or talk, movement skills, learning new things and interacting with others socially and emotionally.

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Global developmental delay causes

Global developmental delay can have many underlying causes:

  • being born prematurely
  • a genetic condition such as Down syndrome
  • chromosomal condition such as fragile X syndrome or Rett syndrom
  • a metabolic conditions such as the lack of a thyroid
  • problems in pregnancy such as heavy bleeding, an infection such as rubella or the mother having excess alcohol or drugs
  • problems during or immediately after birth such as heavy bleeding or a lack of oxygen
  • visual impairment or loss
  • deafness or hearing problems
  • language or speech problems
  • injuries to the brain from things like accidents, physical abuse or near drowning
  • infections of the brain such as meningitis or encephalitis
  • frequent or ongoing illness and hospitalisation
  • lots of family stress, resulting in lack of loving care and attention in the first months of life
  • poverty and malnutrition.

Very often though, the exact cause cannot be fully determined.

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Diagnosing global developmental delay

There is no known cure for children with GDD but getting a diagnosis early would help the child get appropriate psychological, educational and social intervention.

Diagnosing a child with a developmental delay may take time, because child development is a complex process, and every child develops at their own pace. Also, there can be many different reasons for a developmental delay. 

The paediatrician usually studies the medical history, observes the child, does a physical examination and may order some relevant tests.

The doctor may also want to know more about the child's behaviour and social interactions.

The following tests may have to be done to confirm the developmental delay:

  • hearing tests
  • speech and language assessment
  • vision tests
  • blood tests
  • genetic tests
  • chromosomal tests
  • MRI scan to look for abnormalities in the nervous system and brain
  • neurological tests such as an electro encephalogram (EEG), which records electrical brain wave activity 

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Is there any treatment for global developmental delay?

As mentioned earlier, there is no single treatment for global developmental delay. It is important to remember that children with delay learn in a similar way to all children, but usually take longer to develop new skills.

For some children, the delay in their development will be short ­term and can be overcome with additional support or therapy.

In other cases the delay may be more significant and the child will need ongoing support. This indicates that they may also have a learning disability.

Early intervention is key. Identifying developmental delays in the child early on would help the child catch up faster.

“With the right intervention, children with GDD can learn life skills that allow them to integrate into mainstream society and have a better quality of life as much as possible,”  clinical psychologist Ms Chai tells Today.

Depending on the child's symptoms and diagnosis, the paediatrician can advise you better on the different therapies available and necessary for your child.

For instance, an occupational therapist helps children with tasks needed for daily living, like dressing or eating independently. A physiotherapist may be able to help with skills like walking, and problems like poor balance and muscle weakness.

A Speech and Language Therapist (SLT) can help assess and diagnose speech and language difficulties, and work with you and your child in improving his or her communication. 

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Global developmental delay: Organisations that can help

Under the Early Intervention Programme for Infants and Children (EIPIC) in Singapore, children below seven who are assessed to be at risk of moderate to severe developmental delays are referred for early intervention.

EIPIC provides therapy and educational support services for infants and young children with special needs.

About 2,600 children were enrolled in the programme in 2017, and a total of 3,200 EIPIC places will be made available by the end of 2018, according to MSF.

Applicants should be:

  • 6 years old and below
  • Singapore Citizen or Permanent Resident
  • Diagnosed with developmental, intellectual, sensory, or physical disabilities or a combination of disabilities.
  • Recommended for EIPIC by a doctor from the Child Development Unit (CDU) at KK Women’s and Children’s Hospital (KKH), National University Hospital (NUH) or Singapore General Hospital (SGH), or a private paediatrician (You can get a doctor at any polyclinic refer your child for assessment at CDU at KKH, NUH or SGH).

SG Enable provides referrals to government-funded EIPIC centres in Singapore.

The following voluntary welfare organisations can provide more information on the appropriate therapy required:

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Dealing with the global developmental delay diagnosis

A child with developmental delay has the same needs as any other child. All children benefit from a warm, secure and nurturing environment.

Feeling wanted and accepted helps build the child's self-esteem, and gives them the confidence to try new things. 

Remember, children learn most skills from their family. Hence, it is important that parents:

  • spend extra time bonding, holding and responding to the child
  • use simpler language which the child can understand
  • give children extra time to learn and practice new skills
  • let the child use touch, looking and listening to learn
  • break tasks down into several steps that the small child can master more easily
  • speak to the child’s teacher about the special help needed
  • find things the child enjoys and can succeed at, such as feeding a pet or helping with cooking
  • praise their child's successes to build self-confidence.

Children with a severe delay may need a lot of assistance with daily living skills such as eating, talking and dressing. As parents, dealing with global developmental delay symptoms can be stressful and depressing.

Getting advice from counsellors and experts and joining GDD support groups online might help in relieving some of your anxiety. Having emotional, mental and physical support from your friends and relatives is crucial as well.

Also READ: Watch out for these developmental red flags!

(Source: WebMD, Cerebral Palsy Alliance, RCHToday Online, SG Enable)

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