What Is a Developmental Delay and How Can Games in Routine Activities Help?

When parents become concerned that their children may not be developing as expected, one of their first questions is "Exactly what is a developmental delay?" The best person to answer that question is your child's pediatrician or a specialist like a developmental/behavioral pediatrician or a child psychologist, but here are some general guidelines for some of the major areas of development, especially social–emotional functioning, language, and thinking, up to the age of 3 years. Please note: These are very general guidelines. Not every child with typical development will be able to do every single one of these things at the "correct" time. There are also exceptions; for example, children who are adopted internationally during their first year, and did not have the benefit of hearing English for the first 6–12 months of life, are often delayed in their communicative milestones until the third year, when they frequently catch up with their peers. If your child seems to be missing a number of these milestones, do consult with your child's doctor.

3-MONTH-OLDS

By the time a child is 3 months old, she should be able to do the following:

• Coo and perhaps produce a variety of vowel sounds.

• Visually fixate on an object and track it when it moves.

• Lift her head up when she is on her tummy.

• Smile to show pleasure.

• More often than not, stop crying and be able to be soothed when a caregiver attends to her needs.

6-MONTH-OLDS

By the time a child is 6 months old, he should be

• showing a wider range of facial expressions and vocalizations, including laughter.

• able to anticipate some of your actions — that when you bring your hands close to him, you are about to tickle him; when you bring a spoonful of food close to him, you are about to feed him; when you go to the refrigerator, you are about to get him a bottle, etc.

• reaching out his arms when he wants you to pick him up.

• beginning to imitate some of your facial movements (such as sticking out his tongue).

• beginning to take solid food.

• beginning to have a somewhat predictable sleep schedule.

• sitting (or close to sitting) independently.

• most important, paying more and more attention to people by looking at their faces and watching what they do.

9-MONTH-OLDS

By the time a child is 9 months old, she should

• be interested in following the source of her mother's attention (Where is she looking? Where is she pointing?).

• check her mother's face in response to uncertain situations (How does Mommy feel about this stranger?).

• have some meaningful gestures (waving bye-bye, clapping hands) and be able to make some movements associated with songs like "The Itsy Bitsy Spider" or "If You're Happy and You Know It."

• show a clear preference for her caregivers over strangers and be beginning to show you affection by "kissing" (may be more like face sucking) and nuzzling you.

• have a beginning sense of object permanence (knowing that things still exist when they go out of sight) and be interested in games such as "peekaboo."

• be able to reach for the object she prefers from two objects (two shirts, two books, two pieces of food) you hold up.

• have a beginning understanding of sharing and turn taking (for example, offering you a bite of her food).

• have the ability to shift her attention back and forth between you and something else (such as a toy you are playing with together).

• be able to recognize the meaning of some words even if she is not yet able to speak.

• be able to show you, by looking at you and either moving her body or vocalizing (though not typically with words), when she wants you to continue an activity.

• smile in response to her parents' smiles, at least some of the time.

1-YEAR-OLDS

By the time of a child's first birthday, most babies demonstrate the following in social and communication skills:

• They know their family members.

• They react differently to people they know well as compared to strangers.

• They like to be hugged by familiar adults or siblings.

• They seek out familiar adults or siblings for comfort if they are hurt or scared.

• Between the ages of about 1 and 2, many children do not want to be separated from their parents; they may cry and fuss when left with an unfamiliar person and cry when they see the parent leave.

• Your child should be looking you in the eye many times each day. Of course, the child may avoid looking at you if he's feeling shy, or teasing you, if he doesn't want to do what you're asking him to do, or if he's very busy with something else, but with familiar people when he's interacting comfortably, there should be a lot of eye contact.

• They enjoy playing back-and-forth games like peekaboo.

• They should understand that when an adult holds out her empty hand, palm facing upward, it means she wants the child to give her something. They may not necessarily do what you want — but they understand what you mean.

• They should enjoy imitating the faces that you make, like a happy, sad, or surprised face, or imitating simple movements or sounds. Most babies aren't very successful at imitating older children or adults, but they think it's fun to try.

• Children by about 1 year old should try to see where you're pointing, even though they may not be very good at it. They should look at an object that you point to if it isn't too far away. They should also look in the direction that you are looking in, especially if you seem very interested in what you are looking at.

• Most babies are starting to point to things they want, although pointing can appear as late as 15 months. They also should be starting to point to things they want to show you.

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