Development in paediatrics is an important aspect of childcare not to be confused with growth. The milestones which is the level of skill achieved is generally measured over a period of time. Often, parents get worked up not knowing that all skills are achieved over a range of months and there is not a single time set in stone, for its achievement. So what is normal in lay parlance may very well be an atypical development and vice versa.
The usage of development as normal and abnormal amounts to labeling a child and much anxiety in a parent. Instead your child could be neuro typical vs neuroatypical. Each child charts his own course and is widely determined by genetics and environment (nature and nurture)
Let me enumerate this with an anecdote. Sitting at my clinic one day, in walked a parent with a three year old boy in tow. The parent was having difficulty getting the child into the room…and once there the child could not be stopped from exploring the room. The mother a bit flustered, sat down all the while trying to get the child to behave. The child avoided eye contact and for much of the time didn’t respond to his name. He was busy opening the tap and seemingly would not understand the instructions being given by the mother. The frustration was so obvious in the mom’s eyes. Though unrelated to the child’s present complaints, on probing the mum revealed he had been recently diagnosed with autism with ADHD and they had returned from overseas to seek help as well as family support.
I enumerated this coz for anyone who can`t see the symptoms he was just a being a child an ill behaved child but for the child going out of his house,this maybe an explosion of senses, what we call the sensory issues.
So what are the flag signs in development:
When did your child achieve his first social smile?
Did he roll over, sit and stand on time?
Were there any delays in vocalization, making sounds and involving in social plays?
In the second year:
How many words does your child speak at 18 months? Does he combine two words by two years?
Does he respond to his name?
Does he ask for objects by pointing?
Does he involve in repetitive movements called “stimming”?
Does he involve in stereotypical movements spinning objects, lining objects or seem preoccupied with parts of objects?
Does your child`s behavior result in frequent meltdowns?
Does your child refuse to eat foods of certain texture?
Does visits to new places/malls/hotels turn out to be difficult experiences?
Does your child not follow your instructions?
Socially does your infant engage in peek a boo, your child show interest in other kids?
These are a few milestones which serve as red flag for a pediatrician. A screening for autism and evaluation by a developmental pediatrician is the next step. The approach to developmental delays is multifold. Often it involves a team of paediatrician, speech therapist, occupational therapist, special educators, audiologist and physiotherapists. Your paediatrician forms the core of this team and hence an integral person to put your child s development back on track.
My advice to parents
Always believe your instinct, especially to mothers. Often there maybe family history of delays or very often doctors and family telling you it`s okay to wait. It`s not. Early intervention is the key. Brain development is the maximum in the first five years and any intervention needs to be early. Lastly being neuroatypical can come with advantages and disadvantages. Work on your child advantages and lessen the effect of disadvantages and that’s a blog for another day.