Developmental Milestones and Neurodevelopmental Disorders
Experts believe the most critical times in child development are in utero and the first year of life. And cumulatively, the first five years are crucial in establishing social cognition, emotional regulation, coordination of the different systems (hand-eye, hand, mouth, eyes working together, ears working together etc) and other cognitive processes.
The Centers for Disease Control and Prevention (CDC) has an app and checklists that parents can use to track their child’s development up to the age of five. There are other comprehensive developmental checklists that highlight red flags as well.
An institutional environment is not conducive to building a one on one relationship between a child and their caregiver. One on one caregiving establishes an emotional bond.
There are many reasons why institutionalized children miss developmental milestones including in utero and birth trauma, genetic factors and inadequate nutrition. A child’s environment also plays an important role, for example, often babies and young children spend more time in cribs than on the floor playing.
These missed milestones may be clues that something is wrong and be indicative of neurodevelopmental differences like sensory processing disorder, ADD/ADHD, autism, and visual and auditory processing disorders.
Some of these neurodevelopmental differences (ADD/ADHD/Visual Processing Disorder etc.) are hard to identify and only become apparent when children are in an academic setting. It usually takes several years of the child being in school to determine the patter and get a diagnosis. The earlier a child is diagnosed, the quicker the delays can be bridged, so early intervention is very important.
Identifying Developmental Delays
If developmental delays are suspected, the next step is to identify them. The typical place for an adoptive family to start is to consult with the child’s pediatrician to understand what might be the issue. It is a good idea to have a pediatrician familiar with adoption, since they have a deeper understanding of the complex issues surrounding adoption. An assessment of the delays is done by different healthcare professionals. And the pediatrician may refer families to occupational therapists, speech language therapists or child development psychologists for further evaluation.
Some states like California have an early start program that provides early intervention until the age of three. Your pediatrician will know if your state has a similar program and can provide a referral.
There is an international adoption center in Oakland, California that provides many services, including evaluations for adoptive parents and their children. These types of centers are more knowledgeable about adopted children and may catch the delays earlier than a normal pediatrician.
Some adoptive families have been in the situation where their pediatrician doesn’t find any significant delay, only to have delays like learning challenges, sensory issues, etc. show up a few years later when their child is in school. Therefore, it is important to trust your instincts, talk to other adoptive families and look for the additional resources to help the child earlier.
When delays are found, parents typically use a multi-pronged approach to healing interventions.
- Addressing diet, nutrition, gut health.
- Addressing neurodevelopmental differences and disorders using the concept of neuroplasticity, which is the ability to change the brain through reflex integration, occupational therapy, speech therapy, physical therapy, neurofeedback etc., depending on the challenges.