DEVELOPMENTAL DELAY Developmental delay is seen at any age and involves a lack of ability to reach milestones. It can be seen in behavior, cognition, motor skills, vision, speech, and hearing. Delays that are common in each category include the following: •
Cognition—this includes differing problems with mental retardation or specific learning disabilities in reading and mathematics.
•
Motor—this includes cerebral palsy, spina bifida, and muscular dystrophy.
•
Vision—this includes refraction disorders, night blindness, and juvenile cataracts.
•
Hearing—this includes sensorineural or conductive hearing loss.
•
Speech—this includes specific problems with articulation, expressive language disorder, and receptive language disorder.
•
Behavior—this includes autism and ADHD.
Cognitive delays are evaluated with IQ testing. Mild mental retardation is most common and affects the child’s school performance and vocational skills. More severe cognitive impairment can affect all of the other areas of life, including behavior, motor skills, vision and hearing, and can lead to seizures in some children, who often need skilled care for basic needs. Specific learning disabilities do not generally affect global cognitive functioning. They include deficits in speech, language, or the ability to read, spell, write, or do arithmetic. Children with these deficits are generally discovered in primary school when the child’s skills are tested independently. Most of these children do well with certain educational accommodations. Motor disabilities can involve the trunk, the ability to speak and swallow, and the movement of the extremities. Cerebral palsy is usually discovered in infancy, while muscular dystrophies, polio, and spinal muscle atrophies can be diagnosed later in life. Cerebral palsy is not progressive but is permanent. It can affect any area of the body. Most patients have spasticity, although cerebellar involvement can be seen as hypotonia. Other disabilities are possible, including epilepsy, learning disabilities, mental retardation, and language delays. Other motor disorders, such as muscular dystrophy,
10
