Developmental delays in children with cerebral palsy: 3 to 4 years

Developmental disabilities such as ADHD, autism, Asperger’s syndrome, and cerebral palsy affect approximately 13 percent of children in the U.S. Many of these children are not diagnosed until they reach school age, where the Comparison with a large group of peers reveals deficiencies.

Children with cerebral palsy are often diagnosed around 18 months because they walk as they should. But if the symptoms are mild enough, the diagnosis may not come until years later, when the child is struggling to master more complicated and refined movements. Children who experience brain injury from events such as physical abuse, car accidents, near drowning, extreme suffocation, may also not develop signs of cerebral palsy until later in life.

Because cerebral palsy affects the brain’s ability to communicate effectively with muscles, symptoms are commonly related to movement. This includes the muscles in the mouth that affect speech. Speech deficits can be difficult to assess before the age of three or four, whether or not the child has minor cognitive deficits.

Preschool teachers and daycare workers often identify developmental disorders in 3- and 4-year-olds because they are able to see them regularly perform tasks and participate socially in a group of children of similar ages. Informing parents of their child’s lagging performance can trigger a visit with a healthcare professional where a proper diagnosis can be made.

The manifestations of cerebral palsy vary greatly in terms of type and severity, so any “guide”, including this one, is just that … a guide. If you suspect developmental abnormalities, seek appropriate healthcare professionals for guidance. Here are some specific warning signs for 3- to 4-year-olds who may be experiencing developmental delays:

A typical 3-year-old should be able to run, climb, crouch (without falling), kick a ball, hold a writing utensil, and scribble both up and down and side to side. They should be able to communicate in short sentences, talk and eat without drooling, stack 4 or more objects, copy a circle, “pretend” play, understand simple directions, show interest in other children, make eye contact, and show interest in toys.

In addition to the above, a typical 4 year old may throw a ball overhead and catch it most of the time, ride a tricycle, jump in place, stay calm when a parent leaves, show interest in games interactive, engage in fantasy. play, respond to people outside the family, show self-control when angry, dress and undress (even with help), speak in sentences of more than 3 words.

Also, a child losing a skill that he had previously mastered can be a sign of developmental delay.

By law (IDEA – Individuals with Disabilities Education Act of 2004), special education services are available, at no cost, to families of children 3 years of age and older for any type of diagnosed developmental delay or disability.

Special education is available through each state’s Board of Education. Any elementary school can provide you with the local contact information you need if you think your child may require specialized help. The school, by law, is required to “identify, locate and evaluate” children with developmental disabilities. They have a free screening process to help you assess your child’s needs.

Preschool is an important transition for any child. Parents of all children should be actively involved to help with this transition, but parents of children with developmental delays should do so even more. An IFSP (Individualized Family Service Plan) is a written plan that focuses on the child and the family and the services a family needs to help them improve their child’s development. It differs slightly from an IEP (Individualized Education Program) that focuses on the educational needs of the child.

The IFSP reflects the developmental level of your child with cerebral palsy, your family’s income, and the parents’ concerns and priorities. It sets goals for both the family and the child and recommends specific services, such as therapy, that should be used to achieve the goals. An IFSP specifically identifies the projected start days, the projected duration of services, and any other steps that must be taken to transition the child to preschool. It also assigns a service coordinator to the case.

There are variations, but the University of Illinois College of Education developed a helpful guide. It details 6 strategies that parents, family members, and service providers should follow as part of the transition to preschool. In general, 1) begin planning for transition early, 6 to 9 months before the planned transition date, 2) express positive views about the new environment, including pride in the child’s growing maturity and independence, 3 ) sensitively encourage the child to express fears and ask questions and never take concerns lightly 4) engage the child in concrete experiences such as exposing him to larger groups of children (such as story time at your local library) 5) teaching child specific skills and routines that will be helpful in the new program, such as putting away toys and simulating “circle time.” 6) Communicating and sharing information between programs (such as feeding, positioning, and handling techniques) in advance.

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