She was a two-year-old from Mumbai born preterm. Weighing 790 grams at birth, she spent the first two-and-a-half months of her life in a neonatal ICU. Eventually, she faced delays in developmental milestones due to her premature birth.
When Shreya (name changed) was five months old, her parents noticed that she still couldn’t hold her head up, alarming them.
“Holding their head up is the first gross motor skill that babies acquire by three to four months of birth,” says Dr Kumar Salvi, consultant, pediatrics and neonatology, Fortis Hiranandani Hospital, Vashi, Mumbai, the doctor who treated Shreya.
Shreya was diagnosed with diplegic cerebral palsy (a neurological condition affecting muscle control) caused by periventricular leukomalacia (a type of brain injury seen in premature babies).
Shreya’s lower limbs were stiff, restricting movement in the area and her ability to roll over.
“She was put on Early Stimulation Program (ESP), (an intervention program for children with developmental delays) along with physiotherapy and medications to help strengthen her gross motor skills,” says Dr Salvi.
The interventions helped Shreya be developmentally on par with her peers.
What are developmental milestones?
According to Dr Preeti Galagali, adolescent health specialist and pediatrician from Bengaluru, developmental milestones are age-appropriate skills that a child is expected to develop. They are reference points for parents to prepare themselves for changes in their child’s development.
Dr Galagali says, “It is common to see children display temper tantrums at the age of two and chastising them for it is counterproductive. Similarly, toilet training before they start walking makes them frustrated.”
Developmental milestones help parents create space for the child’s optimal development by giving them opportunities to exercise their skills.
“A 15-month-old can hold a cup and drink from it. If a parent doesn’t acknowledge this development and continues feeding their child, they rob the child’s opportunity to hone a new skill,” adds Dr Galagali.
According to Dr Narsimha Rao, professor and HOD of pediatrics, Kamineni Academy of Medical Sciences and Research, Hyderabad, infant developmental milestones are categorized into physical, motor, cognitive, language and communication and socio-emotional milestones.
Developmental delay: Early Signs
Signs of developmental delay can be detected as early as the first few minutes after birth.
According to Dr Rao, birth asphyxia, wherein a newborn doesn’t let out its first cry within five minutes of birth, is a sign.
“Performing appropriate resuscitation measures within the first two minutes can help evade potential developmental issues,” he says.
“Inability to suck from the breast or feeding bottles, inexplicable and excessive crying, inconsolability, floppiness and lack of response indicate a developmental delay,” adds Dr Galagali.
Dr Galagali points out that lack of a social smile around six to eight weeks can also indicate a developmental delay.
Causes of developmental delays
Dr Rao points out some of the most common causes behind developmental delays are:
- maternal infections
- genetic mutations
- chromosomal abnormalities
- decreased thyroid hormone production
- neonatal jaundice
Early interventions are key
According to the Centre of Disease Control and Prevention (CDC) US, connections in the brain, also called neural circuits, are most adaptable in the first three years of life. They are responsible for learning, behavior, and health. Therefore, early interventions (from birth to three years) can change a child’s developmental path for the better, helping their ability to learn new skills and increase their success in school and life.
According to Dr Salvi, based on the type and severity of developmental delay, ESPs like speech therapy, occupational therapy and physiotherapy interventions can be done.
Source: This is an excerpt from the detailed chart from Centre for Disease Control and Prevention, US. Do refer to the CDC for more details.
Takeaways
- Developmental milestones are age-appropriate skills every child is expected to reach.
- Parents play a key role in creating opportunities for children to develop a skill.
- Early diagnosis and interventions can help prevent and manage developmental delays.
