Whether it’s a first word or a tremulous step, all grandparents look forward to their grandchild’s milestones—those cute little movements and sounds that show a baby’s developing on schedule.
But what happens when those milestones are delayed, or never occur at all? What happens when a baby doesn’t make eye contact, or can’t raise her head? A developmental disability could be at fault. In these cases, it’s crucial to recognize and diagnose the problem as quickly as possible—for the good of your grandchild’s health and future.
The question is, how?
The Centers for Disease Control (CDC) calls developmental disabilities, "a group of conditions due to an impairment in physical, learning, language, or behavior areas." They:
"One in six kids will have one during childhood," says Katie Green, MPH, CHES, Health Communications Specialist for the National Center for Birth Defects and Developmental Disabilities (part of the CDC). "In most cases, there are no known factors as to why a child developed it."
Autism spectrum disorder (ASD), cerebral palsy (CP), hearing loss, intellectual disability, and attention deficit/hyperactivity disorder (ADHD) are among the biggest of these disabilities, and detecting them early is vital to receiving help. "Most children are not identified with a developmental disability until they're heading off to school," says Green. "That means a lot of them miss the opportunity for early intervention—services that typically start before the age of 3."
The sooner a child begins services, the better off she’ll be down the line. If you suspect your grandchild has a developmental issue, you must speak up. "What we don’t want folks to do is wait," says Katy Beh Neas, Executive Vice President of Public Affairs at Easter Seals. "Because the first five years are so critical to a child’s development, and the first 12 months are really, really important."
Many grandparents know this, but still find it hard to point out developmental issues to their grandchild’s parents. Maybe there’s emotional baggage or family conflicts. Maybe there’s an underlying fear of being called a busybody, causing offense, or worse, being wrong.
Whatever your relationship with your grandchild’s parents, when it comes to talking about disability, it’s best to leave emotional appeals behind. Instead, go for the science.
"The person who's raising the concern should be as objective about it as possible," says Green. "At the CDC, we have some really objective tools called the Milestone Development Checklists. [If a grandchild is missing milestones,] a grandparent can point to it and say, 'This is what I'm seeing.' It avoids comparing one child to another, and compares them to most children that age." The checklist gives parents a data-based tool to refer to, as well as resources they can access immediately. "A grandparent can complete it themselves and hand it to the parent, or give the parent a blank copy," suggests Green. That way, "They come to the conclusion themselves."
Even if you don’t suspect a disability, it can be helpful to monitor your grandchild’s development. The Ages & Stages Questionnaires are screening tools from Easter Seals’ Make the First Five Count program that track a child’s progress from birth to age five. "Screening is 20 minutes. It’s free. It’s online. You don’t need to get dressed to do it," says Beh Neas. "We do the analysis and send a report back to the family saying, 'Here’s where your child is in five areas, whether it’s social, fine motor, etc.,' and then they have something to work from."
Once a child’s disability has been established and therapies have begun, it might seem like there’s little a grandparent can do to pitch in. Wrong. Grandparents can be there mentally and physically, for both grandbaby and parents.
Initially, having a child diagnosed with a developmental disability can be tough on moms and dads. "What we hear from parents a lot is that they need time to grieve the baby they thought they were going to have, instead of the baby they do have," says Beh Neas. "They need time to work through that. Grandparents can be there to support the child and help." Emotional support throughout is key, she adds: "Being a cheerleader for the parent and the child is one of the most important things a grandparent can do. Tell that parent all the things that baby’s going to do!"
Grandparents can also take part in the therapies themselves, whether it’s floortime for children with autism, or learning sign language for kids with hearing loss. "Therapies tend to work well when there's a lot of family support of those therapies," says Green. "Grandparents can certainly take part in those."
With all this in mind, here are five of the most common developmental disabilities in babies and young children.
Autism Spectrum Disorders (ASD)
According to the CDC, autism is, "a group of developmental disabilities that can cause significant social, communication and behavioral challenges." People with autism may need lifelong assistance, or very little at all. While most ASD cases are not confirmed until after age 4, they can be reliably diagnosed at age 2, and detected at 18 months, or even before.
Incidence: Approximately 1 in 68 children are considered to be on the autism spectrum. The rate is much greater in boys (1 out of 42) than girls (1 out of 189).
Early signs: There are a number of early ASD indicators, including the absence of eye contact, a lack of visual interest in objects, not attempting to communicate verbally or through gestures, and not responding to smiles, cuddles, or familiar voices.
Cerebral Palsy (CP)
Cerebral palsy affects posture and movement to different degrees, ranging from minor balance issues to a total inability to walk. The vast majority of people with CP—almost 90 percent—are born with it, and many have concurrent problems, like intellectual disabilities or vision loss.
Incidence: About 1 in 323 U.S. children have CP, making it the biggest childhood motor disability.
Early signs: According to the CDC, “The signs of CP vary greatly because there are many different types and levels of disability,” but failing to reach movement milestones (sitting, rolling over, etc.) is the primary sign there’s a problem.
Attention-Deficit/Hyperactivity Disorder (ADHD)
"One of the most common neurodevelopmental disorders of childhood,” ADHD is often characterized by an inability to pay attention and lack of impulse control, and frequently "lasts into adulthood." Kids with ADHD are more injury-prone and "almost 10 times as likely to have difficulties that interfere with friendships (20.6% vs. 2.0%)"
Incidence: As of 2011, slightly more than 1 in 10 American kids age 4-17 have an ADHD diagnosis. Boys are more than twice as likely to be diagnosed than girls.
Early signs: Some signs of ADHD (fidgeting, daydreaming, forgetting, talking too much, etc.) can be confused for normal development. In general, however, the more severe the case, the easier and earlier it can be diagnosed.
Hearing loss can vary in severity, and the earlier it’s diagnosed, the better for a child’s language and communication development. About 97 percent of newborns are screened for audio issues, so they may be detected before you notice a problem on your own.
Incidence: In the U.S., roughly 2-3 of every 1000 babies are born with some detectable hearing loss.
Early signs: Not reacting to loud noises, failure to "turn to the source of a sound" after 6 months, and lack of single-word speech development ("dada," etc.) by age 1 are all signs of hearing loss.
An intellectual disability can go almost unnoticed, or can greatly impact a child’s development and ability to care for himself down the line. They’re caused by a variety of factors, from infection in utero to genetic conditions like Fragile X syndrome.
Incidence: Though an exact number is difficult to pinpoint, it’s estimated that 4.5 to 8 million Americans live with an intellectual disability.
Early signs: Delays in speech, motor skills, social rules, memory, consequences, and problem solving can be early indicators.
Ultimately, a grandbaby's development depends on a range of factors. But if a grandparent can make a positive difference, there's no reason you shouldn't.
How well do you get along with your grandchild and other family members? Want to know if your personalities mesh?Find out here.