Developmental Disabilities

Articles

Mar 1

The National Association of Councils on Developmental Disabilities (NACDD) recognizes March as developmental disabilities awareness month. During this month, they highlight the facts and aim to raise awareness about inclusion for those who are differently abled. A child’s development in ways physical, mental, and behavioral will impact how they are able to function in their daily lives. One important fact to remember as a parent is that all children develop at different paces. Although we can point to general milestones for development, a delay does not necessarily mean there are developmental issues present.

How Do Developmental Disabilities Occur?

Many developmental disabilities are formed prior to birth. Infection, injury, or other causes can also result in developmental disabilities. The most common types of developmental disabilities are intellectual disability such as Down Syndrome, cerebral palsy, autism spectrum disorders, and attention-deficit/hyperactivity disorder (ADHD). Genetic conditions and family history can indicate potential intellectual disabilities or likelihood of developing autism, for instance. Other factors such as low birthweight or premature birth can increase the chance of developmental disabilities in children. Jaundice, if left untreated in newborns, can lead to the development of cerebral palsy.

Intellectual Disability

The degree of intellectual disability can vary greatly from one child to the next. Typically, intellectual disabilities are present when a person’s ability to learn is limited. Children will often be unable to keep up with the expected level of comprehension or may face difficulty with self-care tasks. Some signs of intellectual disabilities in infancy would be latency in learning things like how to crawl, walk, or talk. Birth defects, fetal alcohol syndrome, fragile X syndrome, and other causes of intellectual disabilities can occur before or after birth.

Down Syndrome

The most common chromosomal difference, Down Syndrome occurs in approximately one in 700 babies each year. This condition is due to an extra copy of chromosome 21, which is why you can also hear Down Syndrome referred to as Trisomy 21. Typically, Down Syndrome is characterized by physical and intellectual differences from children without this condition such as:

A lower range of IQs based on brain development
Looser muscle and joint function
Shorter in stature
Almond-shaped eyes
Small ears, hands, and feet
Shorter necks
A flattened face and nose bridge

Each year nearly 6,000 babies are born with Down Syndrome in the United States. The three different forms that occur are Trisomy 21, Translocation Down Syndrome, and Mosaic Down Syndrome. All of these forms of down syndrome have to do with the replication of chromosome 21 with some differences in how many cells have overproduced.

Trisomy 21 is when each cell has 3 instead of the usual 2 chromosomes.

Translocation Down Syndrome affects only about 3% of the population with Down Syndrome in the US and refers to when a whole 21 chromosome is present but is located in a different chromosome altogether rather than being a separate chromosome.

Mosaic Down Syndrome affects only 2% of people with down syndrome and is the mixture of some cells having 3 copies of chromosome 21 while others only have the standard 2. This results in children potentially having less of the traits associated with down syndrome.

Cerebral Palsy

Affecting the body’s ability to move and keep balance, cerebral palsy is the most common motor disability in children according to the CDC. Cerebral palsy is caused by non-typical brain development or brain damage during development. This injury creates difficulty for the brain to control the body. Often, individuals with cerebral palsy require assistive equipment to help them walk, talk, or go about their normal routine. Similar to intellectual disabilities, there can be a wide range of differences in ability from one person to the next. Babies with developing cerebral palsy will typically indicate a lack of muscle control or they may present noticeable body stiffness.

Autism Spectrum Disorders (ASD)

Behaviorally, autism spectrum disorder (ASD) can be recognized as social difficulty or difficulty communicating in general. There are no physical indicators that can lead to a diagnosis of ASD, rather, individuals with ASD will typically learn, think, communicate, and solve problems differently than the majority of others. The range of abilities can vary as well — some children show signs of possessing gifted abilities and others may struggle. Some indicators of ASD in children are certain behaviors such as not wanting to be cuddled, wanting to be alone, not making eye contact, the overall problem relating to others, or having difficulty expressing needs and desires. The direct causes of ASD are still being researched, but some factors such as genetic disposition, other genetic conditions being present, and becoming a parent at an older age all present a significant risk of developing ASD.

Occupational Therapy for Autism

Occupational therapy is one of the three most commonly offered therapies for children within school systems or in some cases, as with Tilton’s Therapy, skilled Occupational Therapists visit pediatric patients in their natural environment. This form of therapy is beneficial for children with autism because of their potential range of disabilities with sensory and motor functions. Autism can result in overly sensitive sensory functions, weakened muscle functions, difficulty with motor functions as well as a lack of social skills, or being in group settings. With these possible barriers, it is helpful to have a therapist who is experienced in being present with children who experience these differences so they can address the challenges they may present in a school setting.

There are many different forms of evaluations that an Occupational Therapist will use in order to provide clarity on the individual's unique needs. It is recommended that parents or caregivers speak with an Occupational Therapist to address questions about what types of testing would be beneficial for your child.

Occupational Therapists work with children with autism in a variety of ways. They can do both individual or group activities to engage children’s muscles and keep them focused. In some scenarios, such as with the Tilton’s Therapy team, the Occupational Therapists come to the child’s home or natural environment to help assist the parents with ways they can engage children through activities at home.

Attention-Deficit/Hyperactivity Disorder (ADHD)

As a common neurodevelopment disorder, attention-deficit/hyperactivity disorder affects a child’s ability to focus and maintain attention. Impulse control is another area of development that is affected by ADHD. Most children who are diagnosed with ADHD present signals such as being overly active or constantly fidgeting, talking more than others, having trouble waiting for their turn, are often lost in a daydream or are more forgetful than others. The cause of ADHD is still unknown and is under research. Many scientists believe that genetic factors are one cause, but other risk factors include exposure to environmental toxins such as lead, using alcohol or tobacco while pregnant, premature birth, low birth weight, or injury. Before doctors recommend medication, they will typically engage in behavioral therapy and parent education for the best outcome. Although ADHD develops before birth and during childhood, it often persists throughout the lifetime into adulthood.

Developmental disabilities can impact individuals in every way and every part of their life. Early intervention for children with developmental disabilities is key. Occupational, physical, and speech therapists work with children to address their specific needs. Therapists help children reach their highest level of independence and promote their abilities. Occupational therapy can help children develop fine motor skills or engage in basic self-care tasks. Speech therapy can work with children to address problems feeding, help their language fluency, and improve many other areas of communication. Therapists can also recommend or provide assistive equipment to increase the likelihood of independence. While it can be difficult for some children or families to grow accustomed to the changes or differences, there are so many ways to improve the lives of children with developmental disabilities throughout their life.

Spina Bifida

Spina Bifida occurs as a birth defect that may cause complications with the entire spine system (spinal cord, nerves, and spine). Spina bifida is a neural tube defect, these defects affect 7 out of 10,000 births in the United States. There are 3 forms of Spina Bifida that occur in children; Spina Bifida Occulta, Meningocele, and Myelomeningocele. Spina Bifida occurs during the baby’s early growth stages while an embryo forms an opening in the neural tube, causing the neural tube defect. In Spina Bifida, the neural tube doesn’t close at some point along the spine.

Spina Bifida Occulta is a relatively mild form of Spina Bifida. The spinal cord and spine are intact in their standard placement but the lower spine has issues forming. The area may have a dimple, birth park, or a patch of hair over it or there could be no visible display of the defect.

Meningocele is when the sac filled with fluids that surround the spinal cord grows outside of the body near the spine.

Myelomeningocele is the most severe form of Spina Bifida and is present when the spinal cord and nerves develop outside of the child's body. The fluid-filled sac forms typically on the baby’s back which results in many complications from organ function to extra fluids swelling the baby’s head.

Some of the factors that can raise the chances of a baby having Spina Bifida are:

Lower Socioeconomic status — can lead to poor diet
Teenage pregnancies
Babies born first have a higher chance of having Spina Bifida
Women who have miscarriages have a higher chance of having a baby with a neural tube defect

It is possible to test while pregnant to see if the baby is at risk of Spina Bifida. Through blood tests, prenatal ultrasounds, and amniocentesis (testing the fluids that surround the baby in the womb) you can have a clearer understanding earlier on as to the baby’s development.

Parents may have to make the decision to have a cesarean section to further develop the baby so they don’t have additional complications with the baby's spine through vaginal birth. Babies born with a form of Spina Bifida usually will need to be under close medical supervision to keep infection at bay.

There are many steps that can be taken in order to help the baby have fewer issues in the future. Some of these may include:

Surgery to close the spinal gap
Address bowel and bladder issues
Address orthopedic issues as children with spina bifida may break bones easier because their bones are more brittle
Braces to assist the spinal growth
Rehabilitation and medicines to assist in the baby’s comfort

Tourette Syndrome

Tourette Syndrome is defined by kidshealth.org as “a condition that causes uncontrolled, sudden repetitive muscle movements and sounds known as tics.” There are both motor and vocal tics and they can present themselves as simple or complex. Motor tics are physical movements such as facial expressions, eye, or head movements whereas vocal tics are verbal and can include saying different words, humming, sniffing, etc. To infer whether a tic is simple or complex depends on the number of muscle groups involved in the tic. Complex tics usually look more elaborate, such as repeating language heard or self-harming behavior. Simple tics usually are less elaborate such as shrugging or sighing. Through monitoring and development, children may outgrow the tic or it may look different as time progresses.

Tourette’s is a genetic disorder that usually is noticed in children aged 5-9. Studies show that boys are more likely to be affected than girls. Children may excel with the assistance of a neurologist to track their brain’s development. A child diagnosed may also do well to see a therapist as it could help identify moments and reasons for the types of tic involved.

Living with Developmental Disabilities

2-3% of children have an intellectual disability, which can impact their ability to learn and communicate. The results of a child’s IQ test can indicate the level of intellectual disability if a test is available. Typically, the earlier you identify the type of disability, the faster you can learn how to address it and provide the care your child may need.

There are many different factors that can cause a developmental disability in a child from a genetic predisposition to environmental circumstances. Stress on the mother while pregnant can significantly impact the embryo during those critical stages of development. Certain foods, any alcohol, specific medications, or drug use can also play a role in the development of a child.

Making sure every child has equitable access to the type of education and training they deserve to have an equitable opportunity to succeed in these realms is extremely important. Federal law requires school systems to identify how to best assist students with all ranges of abilities. As more research is found there is more suggestion that individual attention and small groups provide more comfort and space for children with developmental disabilities to grow and learn.

Occupational Therapy for Developmental Disabilities

Occupational Therapy is useful for many children and the families of children who have developmental disabilities. Therapists can help identify what skills need advancement, strategize, and practice activities with them to start honing those skills.

Occupational Therapists provide services such as:

Developing hand-eye coordination through games and activities
Helping family members understand how to practice activities at home that will enhance cognitive functions
Assisting with basic skills such as eating, getting dressed, basic care needs, and helping them to learn to do these things on their own
Developing fine motor skills so school activities like writing and computer work are more accessible
Enhancing social skills so kids can be more social in school and with peers
Identifying other accessibility tools that could benefit the child (i.e.: wheelchairs, communication or bathing aids, dressing devices, and more).

Physical Therapy for Developmental Disabilities

Approximately 14% of toddlers within the United States are classified as having a developmental delay. A developmental delay describes slower than typical mental development in areas of motor function, reasoning, speaking, thinking, and playing. As many as 1 in 4 to 5 toddlers may be at risk of developmental delay. Identifying this delay early helps provide more affordable options while the child is in preschool and can be a signifier of the type of assistance they may need as they get older.

Physical Therapists can work with children on gross-motor function to help them develop the skills necessary to live with maximum independence.

Speech Therapy for Developmental Disabilities

Speech-language pathologists can be especially helpful as they have the knowledge to provide learning opportunities for children with developmental disabilities to help them learn new ways of communication. A speech-language pathologist helps a child with articulation, oral feeding, voice, resonance issues, fluency issues, and can help set a course of action on specific ways for each individual child to develop these skills.

Some specific language-oriented disabilities that may require the assistance of a speech pathologist are:

Expressive Language troubles
Receptive Language troubles: troubles understanding language
Reading and writing
Pragmatic troubles: troubles identifying which language to use in socially appropriate ways

Looking for additional resources and fun activities to do at home? Check out all the latest free activities for your kids to play in a therapist-recommended way! All of our activities highlight a specific developmental focus, so you can choose the things that would most impact your child.