Children's development occurs along a number of different pathways.

1. • Gross motor: using large groups of muscles to sit, stand, walk, run, etc., keeping balance, and changing positions.

2. • Fine motor: using hands to be able to eat, draw, dress, play, write, etc.

3. • Language: speaking, using body language and gestures, communicating and understanding what others say.

4. • Cognitive: thinking skills, including learning, understanding, problem-solving, reasoning, and remembering.

5. • Social: interacting with others, having relationships with family, friends and teachers, cooperating and responding to the feelings of others.

Children develop along these pathways at different rates. The great majority develop normally, eventually becoming adults able to work and lead fulfilled social lives. Some children, however, have specific developmental delays or disorders, and a minority develop slowly in all aspects of their development. These children are said to have intellectual disability. Some children with mild or moderate intellectual disability, will either be partly dependent on others or will be able to lead lives that are normal in most respects. A small minority are affected with severe intellectual disability and will remain dependent on others throughout their lives.

In this chapter we will discuss:

1. • how to assess development in the early years of life, giving details of the ‘milestones’ that children achieve and pass during their development

2. • specific developmental problems:

3. • language delay

4. • stammering

5. • reading difficulties

6. • clumsiness

7. • autism spectrum disorder (ASD): delay and disorder in multiple areas of development.

For each of the above we will discuss the way the problems present, their likely causes, how to assess them, and how to provide help. We will discuss intellectual disability, previously called mental retardation, in Chapter 5.

Assessment of developmental delay

Developmental delay is a term used to describe children who are slow to develop in the first 5 years of life. It is usually children of this age who are brought to a health professional by their mother because of a worry that development is not normal. Such children need careful assessment. There are four possible outcomes to an assessment of development.