Global Developmental Delay: Understanding the Medical Condition in Children

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Global Developmental Delay (GDD) is the general term used to describe a condition that occurs during the developmental period of a child between birth and 18 years. It is usually defined by the child being diagnosed with having a lower intellectual functioning than what is perceived as ‘normal’. It is usually accompanied by having significant limitations in communication. It is said to affect about 1-3% of the population.


The most common causes of GDD are chromosomal and/or genetic abnormalities such as Down's Syndrome and Fragile X Syndrome or abnormalities with the structure or development of the brain or spinal cord such as Cerebral Palsy or Spina Bifida. Other causes can include prematurity – being born too early - or infections, such as Congenital Rubella or Meningitis. There are a number of diagnostic tests that can be done to identify the underlying cause of GDD. Sometimes these causes can be treated to cure the developmental delay, or at least to prevent it worsening. However, often the cause is never able to be fully determined. SIGNS OF GLOBAL DEVELOPMENTAL DELAY CAN INCLUDE:

▪ The child is unable to sit on the floor without support by 8 months; ▪ The child is unable to crawl by 12 months;
▪ The child has poor social skills/ judgment;
▪ The child is unable to roll over by 6 months;
▪ The child has communication problems
▪ The child has fine/ gross motor difficulties
▪ The child shows aggressive behavior as a coping skill In some children GDD is suspected soon after birth because of feeding difficulties or muscle-tone. In others it is suspected later when learning or behavior difficulties occur at school.

Diagnostic Examinations
Once suspected, tests can confirm the presence of developmental delay. Since the causes can be numerous, the diagnostic tests aim to cover broad areas and may include:

- Metabolic tests and screening
- Genetic (Chromosome) testing
- Hearing and vision test
- Lead screening
- Thyroid screening
- Electroencephalography (EEG), Computed tomography (CT) scans, Magnetic Resonance Imaging (MRI) - Psychological assessment

Psychological assessment

Psychological assessment often involves an in depth interview with the parent(s) and possibly a psychological assessment of the parent(s) as well. Parents are also asked to complete structured questionnaires about their children's functioning, including observations of playground behaviour, interaction with other children and various skills children are expected to perform at certain ages (e.g., tying shoe laces, dressing independently). Children are tested for motor skills, academic skills and language skills. 


There is no single treatment for GDD but there are ways to help some of the conditions that may be causing the delay. Once a pediatrician or neurologist has completed testing of the child, he/ she may advise on treatments for whatever underlying medical conditions that may exist. For example, hearing or visual impairment or therapeutic input by a Speech and Language Therapist Occupational Therapist and Physiotherapist. It is possible that no cause will be found or that the cause that is identified may be difficult, if not impossible, to treat. On the other hand, being aware of the conditions that are causing the delay can help parents, teachers and medical professionals to better counsel and guide children who are experiencing developmental problems.


Speech and Language Therapy
Speech and language therapy is concerned with the management of disorders of speech, language, communication and swallowing in children and adults Augmentative Communication
is an umbrella term that encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension...
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