High Risk Infants

A developmental delay is diagnosed when a child does not reach a developmental milestone (for example, sitting, walking, or combining words) at the expected age, despite allowing for individual variation in the rate of development. Each year, many children are born at increased risk of a developmental disability or delay. Infant and preschooler development is a complex, dynamic process that begins at birth and evolves as infants interact with their caregivers and environment. Approximately 10 percent of infants will reflect developmental delay.

The key to intervention and rehabilitation lies in identifying those infants at significant risk of develop mental disability. However, early identification remains difficult. The normal variation in development among children is broad. Also, development must be monitored in several areas (motor, cognitive, psychosocial) simultaneously, and it can be easy to overlook a small delay in only one area. Parents and pediatricians may be reluctant to discuss their fears that a child may have a developmental delay. Lastly, the age at which developmental difficulties manifest, often depends on the developmental stage of the child. It is common for hyperactivity, language delays, and emotional disorders to be diagnosed at about three to four years of age. However, learning disabilities and mild mental retardation are frequently not diagnosed until a child enters school. Assessment of developmental risk includes medical and social history, physical examination, and developmental observation of the child. Often developmental surveillance tools, such as standardized tests that screen several or all areas of development, are used to help identify the child with delay.

Not all children with developmental disability have known risk factors at birth and many times the cause of delay is not known. An infant with an established risk typically has a diagnosed medical condition known to be associated with a high probability of developmental disability. Examples of conditions with established risk are chromosomal abnormalities (such as Trisomy 21), sensory impairments (such as visual or hearing impairment), and neurological defects.

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