Developmental Delay


If you are concerned about your infant’s or toddler’s development, you may contact your state’s program and refer your child for a multidisciplinary evaluation.  A full multidisciplinary evaluation assesses a child's physical health, vision, hearing, cognitive development, adaptive functioning (basic skills like feeding, toileting, dressing, social interactions and communication at home, play), motor, sensory processing, communication skills, and social / emotional development.  Referring your child, and having him / her evaluated, is free of charge to the family.            

Developmental delay occurs when a child has not reached developmental milestones by the expected time period.  The term “developmental milestones” refers to the skill development process in which children go through during child development. If a child is not learning a skill that other children are learning at the same age, this may be a "warning sign" that the child is at risk for developmental delay.  Risk factors for developmental problems could be genetic and environmental. As risk factors increase, a child could be at greater risk for developmental delay.

For IDEA purposes, it may be helpful to know that your local school district may use the term Developmental Delay (DD) in working with children. If your local school district decides to use the term, it must use the same definition and age range as the state does. Your local school district may not use the term at all if your state has chosen not to use the term.

Developmental delays can occur in all five areas of development or may just occur in one or more of those areas. The five areas of development are: Physical development, cognitive development, communication development, social and emotional development, and adaptive skills. Growth in one area of development can affect growth in the other areas.  This means that if there is a difficulty in one area (such as physical development), it may impact other areas (such as speech and language).

Physical Development  
  • Difficulties with gross motor skills - using the large muscle groups that assist in walking, running, standing, sitting, changing positions and maintaining balance
  • Difficulties with fine motor skills - ability to grasp, pinch, eat and dress
  • Has stiff arms and/or legs
  • Has a floppy or limp body posture compared to other children of the same age
  • Uses one side of body more than the other
  • Seems to be clumsy compared with other children of the same age
  • Has poor muscle tone
  • Coordination and balance is below “normal”
  • Seems to have difficulty tracking objects or people with eyes
  • Rubs eyes frequently
  • Turns, tilts or holds head in a strained or unusual position when trying to look at an object
  • Seems to have difficulty finding or picking up small objects dropped on the floor (after the age of 12 months)
  • Has difficulty focusing or making eye contact
  • Closes one eye when trying to look at distant objects
  • Eyes appear to be crossed or turned
  • Brings objects too close to eyes to see
  • One or both eyes appear abnormal in size or coloring

Cognitive Development (intellectual abilities)
  • Struggles with basic learning, problem solving, and remembering tasks
  • Shows delays in basic reasoning skills and play (e.g. stacking, sorting, nesting, early puzzles)
  • Shorter attention span than expected given age
  • Has trouble solving basic problems
  • Has trouble thinking logically

Communication Development (speech and language)
  • Fails to develop sounds or words that would be age appropriate
  • Not able to communicate at age appropriate levels
  • May not respond to own name
  • Issues with verbal communication, body language, gestures and understanding what others are saying
  • Speech may be delayed, or there may be no speech at all
  • Does not use nonverbal communication (pointing and gesturing) at age appropriate levels
  • Uses fewer gestures and those they use are limited in function
  • Struggles to receptively or expressively label places, people, objects
  • May be some hearing loss, which also affects language
  • Talks in a very loud or very soft voice
  • Seems to have difficulty responding to name, even for something interesting
  • Turns body so that the same ear is always turned toward sound
  • Has difficulty understanding what has been said or following directions (after 3 years of age)
  • Doesn't startle to loud noises
  • Ears may appear small

Social and Emotional Development
  • Difficulty interacting with others and developing relationships with family and friends
  • Has trouble understanding social rules
  • Focuses on objects for long periods of time and may enjoy this more than other activities
  • May not seek love and approval from a caregiver or parent
  • May become unusually frustrated when trying to do simple tasks (that most children of the same age can do)
  • Rarely makes eye contact
  • May not appear to notice others and seems to tune people out
  • Often does not build relationships with others their age at a developmental level expected
  • Rarely shares attention with others, such as by showing something, pointing, or pointing out interests or accomplishments
  • Does not demonstrate emotional reciprocity (taking turns)
  • Rarely imitates the actions of others in play or otherwise
  • Does not know how to play with toys the way they were intended
  • Seems to be in his / her “own world”
  • Is not interested in other children

Adaptive Behavior (everyday skills for functioning)
  • Difficulty bathing, dressing, grooming, and feeding one’s self
  • May have difficulty performing age appropriate skills independently
  • Social skills may be poor (relationships with family and friends)
  • Cannot choose own activities
  • Problems using early literacy, writing, and math skills
  • Has trouble seeing the consequences of actions
  • May be clumsy
  • Not displaying toilet training readiness at appropriate age
  • Exhibits problem behaviors and immaturity
  • Displays some obsessive/compulsive behaviors
  • Has difficulty following rules and routines
  • Displays over-sensitivity to certain sounds, textures, visual stimuli

Strategies for Developmental Delay