Pediatricians try to locate the source of the delay and design a treatment plan based upon this information(30). Once the cause is identified, the family and pediatrician better know what to expect and the child can receive appropriate support(30). There are various components to the pediatric assessment(30). In a developmental assessment, the doctor reviews the child's current competencies (including skills, knowledge and personality) and considers the best ways to help with future development. A family assessment is also undertaken allowing for family members to interpret the child’s behaviors and identify priorities and concerns.

A multidisciplinary assessment utilizes a group of professionals that work directly or indirectly with the child and family. Professionals interpret different phases of the child's development and types of skills and behavior. For example, a team including a pediatrician, speech-language pathologist, physiotherapist, neurologist and early intervention caseworker may all work on one case collectively with each professional focusing on their specific area of expertise. Play-based assessments can also be informative. They can involve observations of the child playing alone, with caregivers or peers, in free play or special games. Play provides a framework for diagnosis that can be used to encourage the child to show his abilities, learning style, feelings and social skills.



Dianosing Developmental Delays:
Different Age Groups (30)

Infancy
Infants with medical problems at birth have a greater chance of developing developmental disabilities/delays. High-risk infants should be in programs to track their progress due to this increased likelihood of delay that may gradually appear in the first years of life. The majority of children speak their first words before 18 months, and by three years, most speak short sentences. Therefore, a child that is not speaking words or sentences by three years of age may have a developmental delay/disability.


Toddlerhood
Between 12 and 30 months, a child begins to show independence from a secure base with her primary caregiver. Toddlers learn to walk and explore new territory with energy and curiosity that lead to exploration and skill mastery. Children with developmental delays may be identified as being less adventurous and more reserved. Typically, toddlers tend to struggle for autonomy, display egocentricism, negativism and temper tantrums. Toddlers that do not evidence such behaviours, may be delayed in development. Dramatic growth of cognitive skills and language in the second year allows toddlers to think and problem solve. Children that are not progressing in language skills may be identified readily as having a developmental delay.


Preschool
This relatively tranquil period, from three to five years of age is a time when preschoolers typically become more independent. They master several motor skills and develop greater emotional and social maturity. Children in this period are generally creative, imaginative and curious. The preschooler with a developmental delay may act more egocentrically and show demanding behavior during this time period.


School age
Six to twelve year olds experience slow and steady physical growth and rapid social and cognitive development. They develop a sense of industry and learn the basic skills required in society. Children begin to appreciate rules and develop a conscience, influencing their compliance. Thinking becomes less egocentric and more mature, supporting the ability for school-age children to solve problems and make independent decisions. Self-esteem and competence increase with the child’s achievements, however, children with developmental delays may not show signs of this growing competence and self-esteem.




Glossary of Disorders

The following link provides a glossary of various developmental disorders.

Download Glossary of Disorders




Commonly Used Developmental Screening Tools

Name of Screening Tool	Age Range	Description	Time
Ages and Stages Questionnaire 2nd Edition	0-60 months	Parents indicate children's skills in language, personal-social, fine and gross motor, and cognition Clear drawings and simple directions Approximately 30 items for each age range	10-15 minutes
Parents’ Evaluations of Developmental Status	0-8 years	Designed to detect and address a wide range of developmental issues including behavioral and mental health problems 10 carefully constructed questions eliciting parents' concerns Identifies when to refer, screen further or refer for additional screening, counsel, reassure, temporize, or monitor behaviour, development and academic progress	~2 minutes
Infant Toddler Checklist for Language and Communication	6-24 months	Parents complete 24 multiple/choice questions Screening for delays in language development as the first evidence that development is atypical	5-10 minutes
Bayley Infant Neuro-developmental Screener	3-24 months	10 - 13 directly elicited items per 3 – 6 month age range Assesses 1) neurological processes (reflexes, and tone); 2) neurodevelopmental skills (movement, and symmetry) and 3) developmental accomplishments (object permanence, imitation, and language)	10-15 minutes
Brigance Screens	0-90 months	Tap speech-language, motor, readiness and general knowledge, and social-emotional skills Nine separate forms, approximately one for each 12 month age range Screens use direct elicitation and observation except the Infant and Toddler Screen which can be administered by parent report	10 minutes
Battelle Developmental Inventory Screening Test	12-96 months	Items use a combination of direct assessment, observation, and parental interview Taps a range of discrete domains include receptive and expressive language, fine and gross motor, adaptive, personal-social, and cognitive/academic	15-35 minutes
Pediatric Symptom Checklist	4-18 years	35 short statements of problem behaviors including both externalizing (conduct, attention, etc.) and internalizing (depression, anxiety, adjustment, etc.)	D/K

DSM-IV Diagnosis