Developmental Delay & OT



Developmental Delay


As a child grows and develops, he learns different skills, such as taking a first step, smiling for the first time, or waving goodbye.  These skills are known as developmental milestones.  There is normal variation around what age children will achieve a specific developmental milestone.  Developmental delay refers to a child who is not achieving milestones within the age range of that normal variability.  Most often, at least initially, it is difficult or impossible to determine whether the delay is a marker of a long-term issue with development or learning (i.e. known as a disability) or whether the child will ‘catch-up’ and be ‘typical’ in their development and learning.   There are five main groups of skills that make up the developmental milestones.  A child may have a developmental delay in one or more of these areas :


  • Gross motor: using large groups of muscles to sit, stand, walk, run, etc., keeping balance and changing positions.


  • Fine motor: using hands and fingers to be able to eat, draw, dress, play, write and do many other things.


  • Language: speaking, using body language and gestures, communicating and understanding what others say.


  • Cognitive: Thinking skills including learning, understanding, problem-solving, reasoning and remembering.


  • Social: Interacting with others, having relationships with family, friends, and teachers, cooperating and responding to the feelings of others.


Usually, there is an age range of several months where a child is expected to learn these new skills.  If the normal age range for walking is 9 to 15 months, and a child still isn’t walking by 20 months, this would be considered a developmental delay (2 standard deviations below the mean).  A delay in one area of development may be accompanied by a delay in another area.  For example, if there is a difficulty in speech and language, a delay in other areas such as social or cognitive development may coexist.


OT for children with developmental delays focus on paying attention to task behaviors, practicing delayed gratification, expressing feelings to others in appropriate manner, selecting and engaging in leisure activities appropriately with peers, complying with school rules and practicing self-regulation as appropriate for the child's age. The OT may also recommend and teach a child to use adaptive equipment, such as wheelchairs, bathing equipment, dressing devices or communication aids.

Children with developmental delays may experience problems with handwriting. An OT may be called upon as part of a comprehensive early treatment program to help a child practice and learn the fine motor skills needed for proper writing. These therapies may include posture and positioning practice, play therapies to help children strengthen muscles and improve coordination and, often in coordination with an education professional, handwriting evaluations and curriculum recommendation and implementation.