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Development Delay: Causes and Signals

Development Delay: Causes and Signals

The cult of individuality has been raised to a superlative degree in our society. The desire to stand out, not to be like everyone else, has already become a sign of good taste and a true sign of creative nature. Children, too, began to win their right to be extraordinary: modern parents are ready to consider not only the needs of the child, but also his wishes.

However, it is not necessary to try on the philosophy of individualism to the pace of development of the baby: they are verified by the course of evolution and have their own terms.

The first signaling system is the reflex reactions of our body to stimuli from the outside and inside, which help us to experience different physical sensations (pain, cold, heat) and to implement instincts. But people and beasts have these abilities.

At the summit of the food and hierarchical pyramid of the animal world of man, speech was raised – a product of the second signal system, inherent only to higher beings. Today, scientists can, with an impressive degree of probability, assert: the monkey became a man at the moment when it straightened its back and firmly stood on its feet.

Without verticalization (the ability to assume a sedentary and standing position) speech, and after it, intelligence, we would never have developed. “The doctors have long been convinced of this,” confirms Vladimir Studenikin, Chief Researcher of the Department of Psychoneurology and Psychosomatic Pathology at the Russian Scientific Center of Medical Sciences, RAMS – If after a stroke the patient is completely immobilized and cannot walk, his cognitive abilities, including memory and attention, begin to fade rapidly. For the same reason, babies with cerebral palsy are artificially placed in a sitting position. ”

Normally, verticalization begins after six months when the child learns to sit. Speech develops in children only by the end of the first year of life, that is, by the time they rise from their knees.

But preparation for an important metamorphosis starts even earlier. Motor (otherwise – motor) development starts immediately after the birth.

Gradually, the muscles are strengthened, and the child develops key skills: first learns to hold his head, then grab a toy with his hand, later begins to crawl, then sit, and finally gets up and goes. At the same time, the child’s mental development flows: as the child matures, the cerebral cortex ripens and the actions become conscious.

For example, if a 7–8-month-old child is offered a piece of apple, he will be able not only to grab and hold it in his hand (which is a sign of stronger coordination), but he will also try a tooth, because at this age he already understands: an apple is food, and the place that suits her best is the mouth. In this gesture, sprouts of social maturation are already outlined, because here there is an attempt to feed oneself.

On the other hand, the allocation of motor, mental, intellectual, emotional and social development is very conditional: all these aspects are too intricately intertwined. “Nevertheless, problems always begin with motor development,” explains Vladimir Studenikin. – If the cause of the motor delay is serious enough, in the next stage psychomotor, and then speech, can be stratified on it. When verticalization is delayed, the cerebral cortex matures in slow motion.

If the baby later raised his head, later crawled, later he sat down and stood up, there is a high probability that he will start talking a little later. ”

Parents play an important role in the development of the child. “Children have their own needs: they must not only be fed and bathed,” recalls Vladimir Studenikin. – They need to communicate with mom no less. Easy wellness (non-therapeutic) massage, which she does to the baby herself every day, does not just improve blood circulation through the vessels, which in itself is very useful for the brain.

Body contact stimulates the development of the child, even if it is an ordinary stroking. ”

If there is no interaction with parents, one should not count on the normal development of the child. For at least 2 years, the baby and the mother are connected to each other by an “invisible placenta”. If this “placenta” is broken, the child will be artificially deprived, will not be able to manifest all the abilities inherent in it.

Educational toys and games will never be a full replacement. Amazingly, the lack of parental attention can not only lead to a delay in psychomotor, speech, and emotional development. “Children from home babies eat fully, but at the same time they are not gaining weight well,” adds Studenkin. “So the power of parental heat cannot be overestimated.”

In rare cases, the reason for being late is purely mechanical. “For example, if a baby has a dislocated hip joint during childbirth, doctors immobilize it for some time with the help of special tires,” explains Vladimir Studenikin. “If the“ treatment ”is delayed for 8 months (more often due to the ignorance of the orthopedist or the negligence of the parents), verticalization will not be able to pass on time: to sit down, the child needs to move a lot and strengthen muscles. Fortunately, artificially induced developmental delays can almost always be corrected.

Lagging behind the schedule may occur for other, more serious reasons, and then the forecast for the baby is ambiguous. Often failures occur during pregnancy. “The cerebral cortex begins to form during the period of prenatal development of the child,” explains the children’s neurologist Elena Gladkova. – In the first trimester, there is a laying of all organs and tissues, including a special motor zone in the frontal lobe, which is responsible for motor functions.

Any negative impact during this period can interfere with the proper formation of brain cells. ” Such an obstacle could be infections that a woman had had during the pregnancy, birth injuries, a mother’s profession, which involves contact with hazardous substances, poor ecology, electromagnetic radiation from computers and household appliances, bad habits: cigarettes and alcohol.

The damage often leads to the so-called perinatal lesions of the nervous system, which translate into delays in motor, mental and speech development.

According to the Scientific Center for Children’s Health, Russian Academy of Medical Sciences, in the first year of life more than 80% of children are at risk. By the way, until 1998 another term was used – “perinatal encephalopathy” (some doctors still use it).

Perinatal lesions of the nervous system – an extensive concept. These include almost innocuous syndromes such as unilateral violation of muscle tone, and the three most severe scenarios – epilepsy, hydrocephalus (cerebral edema), cerebral palsy.

The severity of such lesions depends primarily on what caused them and when the failure occurred: to catch the flu in the first trimester is much more dangerous than in II or III.

Most often, perinatal lesions cause chronic or acute hypoxia (lack of air) of the fetus during pregnancy. In such conditions, the nerve cells of the brain of the baby no longer receive enough oxygen and glucose, which serve them as food, and die.

Chronic hypoxia usually develops during toxicosis or preeclampsia, acute – during childbirth due to various complications, for example, if the umbilical cord is wrapped around the baby’s neck and it becomes difficult to breathe.

All experts are unanimous: it is very important to detect a delay as early as possible, then the child will have much more chances to overcome it. But it often happens that doctors do not manage to suspect that something is wrong in time, despite numerous examinations that begin during pregnancy.

Immediately after birth, the baby’s condition is assessed on the Apgar scale – this measure allows to detect hypoxia at an early stage. Inadvertent oversights are not uncommon at this stage.

In the hospital, a child also takes a blood test for 5 serious genetic diseases that must be treated from the first days: (hypothyroidism, cystic fibrosis, phenylketonuria, adrenogenital syndrome, galactosemia).

This study excludes congenital abnormalities, the benefit of laboratory results can be trusted. Then the baby falls into the care of a pediatrician, who, noticing the delay, sends him to a neurologist. However, sometimes the pediatrician does not pay attention to the warning signs only because the crumb gains weight well and withstands great need by the hours.

Or does not take seriously the concern of parents, pre-writing it to suspiciousness. That is why the doctor needs to be changed, if his competence raises doubts, and be sure to show the kid to the neurologist (at 1 month, 3 months, 6 months and a year) for the sake of prevention.

This is the only way to detect a hitch in time.

“The brain encephalogram makes it possible to see whether the development of the cerebral cortex corresponds to the age of the child or not,” says Elena Gladkova. – Ultrasound examination of the brain shows the presence of hemorrhages, damaged areas due to hypoxia, hydrocephalus, and so on. These two studies are prescribed for suspected perinatal damage to the nervous system and hereditary pathologies. ”

Doctors can not always make the final verdict immediately. So, they give the diagnosis “cerebral palsy” not earlier than a year, “autism” – only after three years (at the age of 3, the child must be seen by a child psychiatrist). Up to 3 years, doctors use the term “delayed speech development,” and after 3 years they speak of “general speech underdevelopment” (in the first case, the baby has significantly more chances for recovery).

This ambiguity is caused by the fact that the anatomical maturation of the brain and nervous system, which is responsible for the development of motor and mental functions, is parallel, but does not coincide completely. With the individual characteristics of the body also have to be considered, because someone starts walking in a year, and someone – in a half.

To make the prognosis objective, doctors are forced to wait for a certain period, by the end of which a healthy child must acquire one or another motor or mental skill. Norms were derived empirically as a result of years of observations, but still these are not constant constants.

Thanks to new discoveries in medicine, the reference dates continue to float, and conflicting information appears in the popular science literature. “Doctors rely only on officially recognized averages,” explains Vladimir Studenikin. – And it is important for parents to remember the upper and lower limits of each “standard”. Do not think that a child who did not laugh at 3 months is certainly sick, but if he did not laugh at 6 months, this is a clear sign of mental retardation.

Individual rates of development certainly exist, but they never go beyond the age limits. ”

Although exceptions to the rules are still there. “For large children, some terms are shifted for natural reasons, and there is nothing wrong with that,” says Elena Gladkova. – If at 3 months the baby weighs 9 kilograms, it is more difficult for him to roll over on his side, stand on all fours and so on. Some children do develop according to a personal program that does not fit into the usual frame. They do not sit or crawl, but at some point they immediately stand up and start walking. ”

But only additional research will help to establish the true reason for being late.

In most cases, perinatal lesions are for a child without a trace or almost without a trace, but only if treatment is started without delay. According to statistics, in 30–40% of cases, the general efforts of the doctors and parents can restore the health of the baby, so that in the future he will not be different from his peers. “But there are still“ relatively favorable ”outcomes, – continues Vladimir Studenikin. – Not long ago, at such a turn, doctors used the term “minimal brain dysfunction,” but it no longer appears in the latest international register of diseases.

Doctors correct the violations, but not completely: such children may have behavioral difficulties and minor problems with motor skills – they walk, but not firmly, they take objects, but they are uncomfortable, they say, but it’s unclean. ”

If doctors have discovered a developmental delay in a baby, it is important not to miss the time. “It is imperative to treat perinatal lesions of the nervous system,” says Vladimir Studenikin. – Sometimes it is enough vitamins, massage and light vascular drugs. In more serious situations, intensive actions and nootropics are necessary – drugs that nourish brain cells. ”

Rehabilitation centers and psychologists should be treated with caution. “Up to 2.5 years, children are not able to communicate with their own kind,” warns Vladimir Studenikin. – Stress that they experience in the classroom, can cause tics, urinary incontinence, stuttering. By the way, the same thing happens in today’s fashionable development centers for healthy kids. ” Children are taken to serious rehabilitation institutions from 2–3 years old.

Special programs for the restoration are educators, pathologists and psychologists. Up to 2-3 years to correct developmental delays will be a neurologist, orthopedist and speech therapist.

  • Up to 3-4 months – “gulch”: pronounces vowels
  • 4−6 months – babbling: pronounces consonants (“gu-gy-gee”)
  • From 6 months – a syllable is formed (“ma”)
  • From 6 to 12 months – a set of short words appears (“give”, “on”, “woman”)
  • To 1.5 years – says short phrases (“Mom, give”)
  • By 2 years – uses a large set of words, builds sentences with predicate, subject and addition
  • From 1 month up to 3 months – holds the head
  • 3−3.5 months – captures objects with hand (having mastered this trick, after 2-2.5 weeks the baby firmly shifts the toy from one hand to another)
  • Up to 4−4.5 months. – turns from back to side
  • From 4.5 to 5.5 months. – turns from back to belly
  • Up to 6 months – turns from belly to back
  • From 5.5 to 7 months. – sitting
  • From 5.5 to 11 months. – creeps
  • From 6.5 to 10 months. – stands with support
  • From 10 to 13 months. – starts walking

From 0 to 4 months

  • Pupils are inactive or mowed their eyes
  • does not respond to loud noises;
  • does not notice his pens (by 2 months);
  • not enough items (by 3 months);
  • does not smile to mum (by 3 months);
  • does not hold the head (by 3 months);
  • does not walk and does not try to imitate sounds
  • does not fall on the heels, if you put it on a hard surface (by 4 months).
  • Muscles to the touch very hard or weak, like a rag doll;
  • constantly watery eyes, there is an increased sensitivity to light;
  • the head sinks back when the child is sitting;
  • pulls only one pen;
  • does not like to caress;
  • shows no signs of affection for the person who cares about him;
  • does not pull objects in the mouth;
  • does not make joyful sounds (by 5.5 months);
  • does not roll from back to stomach in both directions (by 6 months);
  • does not sit by itself (by 7 months).
  • Does not crawl or crawl, but drags at the same time legs;
  • do not stand without support;
  • does not look for objects when he sees that they have been hidden;
  • does not say a single word;
  • does not use gestures (for example, does not shake his head in disagreement);
  • does not stick a finger on objects and pictures;
  • does not go (maximum to 18 months).
  • Speaks less than 15 words;
  • does not use two-word sentences;
  • does not imitate the behavior of adults, their gestures, new words;
  • does not follow simple instructions (“come up”, “look”);
  • does not distinguish a large object from a small one.
  • Often falls or with difficulty overcomes the steps;
  • fuzzy words;
  • does not use the pot (good or bad);
  • cannot build a tower of 4 cubes;
  • handles small items poorly;
  • can’t draw a semblance of a circle;
  • cannot speak in short phrases;
  • does not come into play;
  • not interested in other babies;
  • rarely looks into eyes;
  • Little interested in toys.

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