In the third part of our series on developmental delays and early intervention, we look at Cognitive Developmental Delay, or in simple terms, delay in thinking or understanding,
By Sindhu Sivalingam
Nine-year-old Akshay often found it difficult to keep up with peers when it came to understanding lessons at school. It was only much later that his parents recognised the need to get him assessed. To their utter shock, Akshay was diagnosed with a cognitive delay. Why didn’t Akshay’s parents realise there was a problem? How did they miss out on ‘obvious’ signs? What if they had intervened early? For all this and more, keep reading or understanding.
Cognitive development is about how a child’s brain develops thinking skills such as attention, concentration, memory, perception and logic. For instance, logic in a little child is his understanding of cause and effect, “If I pull, the toy comes closer to me”.
When a child is diagnosed with cognitive delay, it means he lags in that area of development as compared to his peers. A child with a cognitive delay may probably not have problems with his five senses, however, the way he understands information received by his senses is different from that of a normally developing peer.
For example, a child with cognitive delay may have the ability to hear, but she may not be able to listen, pay attention or understand when you call her or talk to her. She may even get agitated by what may seem to you as a normal conversation. The perception to her, in this case, may either be too low, too high (she cannot take the decibel level) or irrelevant (you may be speaking, but it may feel like just ‘noise’ to her, or she is unable to decode language).
A cognitive delay can impact development in other areas such as:
The causes of cognitive delay may include:
Cognitive delay can also be a symptom of underlying developmental disorders such as:
‘Play’ plays a big role in ensuring your child’s healthy development. After all, young children understand their world better through play. It also helps you and your child bond. Here are some tips:
Be mindful of what stimulation you can provide for your child. Let it not go against his will or preference. Discuss this with your therapist.
As a parent, when you have a concern, trust your gut and act at once. Speak to your paediatrician who will guide you to the appropriate therapist. In case of Cognitive Developmental Delay (CDD), you will be referred to an Occupational Therapist (OT).
An OT will help your child develop skills required for everyday activities and interactions with people and environment. The OT might take support from a team of experts including a psychologist, a special educator and a paediatrician for accurate evaluation and for charting out an effective intervention plan.
How to spot a delay
Take note if your child is repeatedly delayed in reaching multiple developmental milestones. Some key symptoms to look out for are:
Other specific signs to look out for in children aged three years and above:
History-taking may be a tedious process but be assured that it helps in arriving at an accurate evaluation.
Here’s how the therapist will plan the therapy:
Step 1 - Starts with improving the child’s sensory response to external stimuli.
Step 2 - Uses everyday activities to teach the child basic life skills, hand-eye coordination, etc.
Step 3 - Works with the child on specific issues the child may have (social skills, movement, speech, etc.)
The brain is neuroplastic and therefore, it continuously evolves with the experiences a person has. So, a caring, understanding and encouraging environment (both at home and school), and the right therapy can have an immense impact on your child’s progress.
It is important to understand from your child’s therapist how you can support your child at home. Your therapist may suggest that you:
Your child’s cognitive delay can be effectively treated with timely intervention and a supportive home environment. Remember, it's very important to act early. Always keep track of your child’s developmental milestones and talk to your doctor about them during your routine visits.
We hope you found this article useful. You can look forward to more such informative articles in the coming weeks as we will be covering other areas of child developmental delays.
With inputs from Mohammed Zaheer, an Occupational Therapist in Chennai working in the field of paediatric rehabilitation.
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