Understanding developmental disorders in children

There's nothing quite like being a parent. As you watch your little one grow, you keep on wondering how your child is developing, whether she's the same as other kids. It can be particularly difficult for a parent whose child is different. Dr Leena Deshpande, a developmental paediatrician, explains various developmental delays children might have and how you can keep an eye out for them.

A child has various milestones from birth holding, rolling over, sitting, walking, smiling, and babbling. As he grows older than, he starts speaking; starts saying words and then sentences. The normal developmental pattern in children is

• Complete head control by 5 months
• Sitting unsupported by 9 months
• Walking independently at least by 18 months
• Speaking at least one word by the first year, two word phrases by second and three word sentences by the third

However, if you notice that one or more of these milestones are not achieved you should immediately seek help. There are various neurological, hereditary and/or genetic conditions that can interfere with smooth progression of a child's development. The prevalence of developmental problems in children is between 10-20%. But they are not being diagnosed early.

This is in part is due to unawareness. Because parents don't know what's expected of their child, they don't seek help until it's too late. So it is important for the parents to be aware of what normal development is and what is abnormal. To be fair a lot of information is available online and parents should use them. If they think that their child isn't developing normally they should consult a paediatrician who will be able to diagnose problems early and also refer further tests if necessary.

There are a range of neurodevelopmental disorders children might suffer from.

• Developmental delays in physical and speech skills not reaching developmental milestones at expected age.
• Global developmental delay - a delay occurring in two or more of the following areas: language or speech, movement, social or emotional and thinking.
• Autistic spectrum disorder - an umbrella term to encompass all the neurodevelopmental disorders. Autism is a severe form of neurodevelopmental disorder where a child has problems in communication, socialization and has various behavioural problems in the form of repetitive behaviour, restricted play interests and sometimes very unusual interests.
• Cerebral palsy - a neurological condition that affects the motor nerves. It often leads to slower than normal movements and trouble performing the more basic tasks like sitting down or putting head up.
• Attention Deficit Hyperactivity Disorder (ADHD) - a mental disorder that makes it difficult for individuals to restrain their spontaneous responses responses that can involve everything from movement to speech and attentiveness.
• Learning disabilities like dyslexia, dysgraphia, etc. Dyslexia affects a person's ability to read - difficulty to read properly, reading words backwards and confusing letters. Dysgraphia affects a person's ability to write - forget syllables and have poor spelling and handwriting.

Some developmental disorders are associated with syndromes like Down's syndrome, fragile X syndrome, etc. Children with neurological problems like epilepsy are also at higher risk.

Read more about causes, symptoms, diagnosis and treatment of ADHD.

Early detection, early intervention, better outcome

I can't stress enough the importance of early detection. Some developmental disorders can be easily treated if detected early. Routine developmental surveillance is essential to identify children with problems. Every child should have his development checked at almost every visit to his doctor. Children who have spent more time in the neonatal intensive care - due to premature birth, low birth weight, high jaundice, infection, sepsis, etc. - are the high risk group. They are at a higher risk of developing neurodevelopment problems in the future. Hence they should be kept under surveillance, at least for the first two years of life.

Early detection leads to early intervention. Many studies have shown that early intervention improves the long term outcome of a child with neurodevelopmental disorder. The concept of neuroplasticity, which has been widely accepted since 1960s and after, reiterates this desire. Neuroplasticity (brain plasticity) is the ability of the brain to reorganise itself after an injury to it. Intervention i.e. stimulating brain in the right way soon after injury helps the brain to reorganise by forming new neurons and take over the activity of the injured area.

The trouble with having children is that it's like watching little pieces of your heart run around. We understand it might be hard to deal with if your child is different, but realise that every child is special and early care and detection will go a long way.

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