Global Developmental Delay

Babies and children usually learn important skills such as sitting up, rolling over, crawling, walking, babbling (making basic speech sounds), talking and becoming toilet trained as they grow up. These skills are known as developmental milestones and happen in a predictable order and usually at a fairly predictable age. While all children reach these stages at different times, a child with developmental delay may not reach one or more of these milestones until much later than expected. 

A child may be described as having Global Developmental Delay (GDD) if they have not reached two or more milestones in all areas of development (called developmental domains). 

These areas are: 

• Motor skills: either gross motor skills like sitting up or rolling over and fine motor skills, for example picking up small objects 
• Speech and language: which also includes babbling, imitating speech and identifying sounds, as well as understanding what other people are trying to communicate to them 
• Cognitive skills: the ability to learn new things, process information, organise their thoughts and remember things 
• Social and emotional skills: interacting with others and development of personal traits and feelings, as well as starting to understanding and respond to the needs and feelings of others. 

The most common causes of GDD are problems with the child’s genes or chromosomes, for example Down Syndrome or Fragile X Syndrome. Sometimes, problems with the structure or development of the brain or spinal cord may be the reason for a child having GDD. 

Other causes can include prematurity (being born too early), childhood infection (for example meningitis) or metabolic diseases, such as having an underactive thyroid gland (hypothyroidism) or other problems affecting babies before they are born. Toxic (poisonous substances) such as alcohol in the case of fetal alcohol syndrome can also contribute. For some children, the cause of the GDD is never identified. 

As they grow, children’s developments will be assessed regularly and if they aren’t meeting the expected development milestones and levels of abilities, they may be then referred to OTFC Group for further specialist assessment. It is likely a Paediatrician will see your child and if they suspect GDD they may ask questions regarding the child’s progress. They may look at a child’s development (checking out what exactly a child is able to do and when they became able to) and carry out medical tests to try to identify a cause for the developmental difficulties. 

Some families will be referred to a genetics service to see if there is a genetic cause for the difficulty.  Some children may be referred to further specialists such as psychologists, speech and language therapists or occupational therapists for further evaluations. 

This will depend on the underlying cause of the GDD. Infections are never inherited, although an infected mother can pass on an infection to her unborn child or during the birth. Down Syndrome, the most common identifiable cause of significant developmental delay, is a condition caused by a change in the chromosomes so that there is one too many. 

However, it is usually not inherited – the main risk factor being increasing maternal age.  Conversely Fragile X Syndrome, the most common identifiable cause of inherited developmental delay is always passed on from one or other parent who may be unaware that they are at risk of doing so. 

Prenatal diagnosis is dependent on the underlying cause of the condition. If there is a strong family history of individuals having GDD, then your GP should refer you to a genetics specialist to discuss testing.