Strategies for Understanding & Managing a Diagnosis of Global Developmental Delay (GDD)
This leaflet will provide you with useful information and what you can do to best help your child who have been diagnosed with Global Development Delay
What is Global Developmental Delay (GDD)?
It is a condition in which children are significantly delayed multiplate areas of development. Development takes place in many areas, including:
- Motor skills: gross (big) and fine (small)
- Language ability: receptive (listening) and expressive (speaking)
- Cognitive skills (thinking)
- Social skills (interactions and friendship)
- Emotions (behavior and mood)
- Self-help skills (daily caretaking activities)
A diagnosis of GDD means there are delays across multiple of these areas, not just one. The amount of delay your child experiences may not be the same in all of these areas.
How is it diagnosed?
To determine if a child has GDD, healthcare providers will:
- Look at your child’s current abilities
- Compare your child’s current abilities to the age expected that skill to be present
- Talk about delay and ability level in terms of age level equivalents (i.e. 6-months level, 2-year-old level)
A child with GDD is going to have ability levels that are below what is expected for his/her actual age. This is expected, it is part of the diagnosis of GDD.
GDD does not mean your child will not keep growing, learning, and acquiring new skills. There are many therapies and daily activities that can help children acquire new skills and overcome a wide variety of developmental challenges.
Advice for Supporting a Child with Global Developmental Delay (GDD):
The following tips will hopefully make daily home life easier for both you and your child with GDD:
1. Learn how GDD applies to your child. The more you know about your child’s current development skills, his/her strengths and weakness, and how to encourage appropriate development, the better equipped you’ll be to help your child in everyday challenges.
2. Take it step-by-step. Development is a step-by-step process; one skill leads to another.
- It is good to keep in mind that all children develop at different rates in different areas.
- All children have developmental strengths and weaknesses.
- It is important to know what is your child’s current growing level, then find out what are the next skills she/he needs to work on.
- Trying to jump ahead to something much further on in development without building the basic skills to get there will be hard to do and likely frustrating for you and your child.
- Remember to take this growing process one step at a time, be patient, have realistic expectations, and appreciate all of the small improvements - they add up over time.
- Always ask healthcare providers for specific advice on how you and your child can work at home toward the next skill or ability she/he needs.
3. Catching-up. Parents with children with GDD often ask about when their child will catch-up with their peers. Many children with GDD never fully catch-up to their same age peers. It is more beneficial to think about your child reaching his/her full potential than catching-up to other children.
Advice for Promoting Motor Development:
- Help with positioning. For children with motor delays, you may need help learning how to position their body in the right way to improve their muscle strength. Encourage and help your child with proper movement. For example, helping your child adjust his/her position may be important in learning to sit, stand, and walk. You will likely remember to correct your child’s positioning better than your child will remember to do so at first, so it will be good to get advice on how to do this and watch for opportunities to provide this support.
- Adaptive equipment. Some children benefit from adaptive equipment to help their body move or stay in place better. There are many types of adaptive, or corrective, equipment from braces for feet, legs, and arms, to equipment to help them sit, stand, or walk. Your child may be evaluated for adaptive equipment and then fitted for it. As your child’s body and skills grow over time, new equipment may be needed. Properly fitting adaptive equipment is key to best help your child
Advice for Promoting Language and Communication:
1. Use nonverbal communication: We all communicate in many ways, from facial expressions and gestures, to words and sentences.
- Encourage the use of nonverbal communication until your child is using verbal (or signed) communication.
- You can communicate much through facial expression and gestures, for example pointing is a very important gesture that helps children communicate
2. Speak clearly:
- Make sure your child is paying attention when you are talking to him/her
- Say his/her name first, to get their attention, then say what you wanted to share
- Use simple language and short sentences
- Use the one step at a time method when asking your child to complete a task. For example: “First put your shirt on.” when that is completed “Now brush your hair.”
3. Give time to process and respond: Children with GDD may need more time to take in the verbal information they hear before responding. Be sure to give your child enough time to think about what to do before expecting them to act on your request or give an answer.
4. Name and label: Use the names of common objects, or label them, when talking. For example, instead of saying, “Do you want this?” you could say “Do you want your bottle?” or instead “Sit here.” you could say “Sit on the chair.” The more you say the names of words in context the more your child will come to understand them.
5. Make comments, don’t just ask questions: Children are asked a lot of questions, all the time. Questions are not bad, but it is important to also make comments. Questions put children on the spot to come up with the right answer, which may be difficult at times and may feel like quizzing, and questions also usually lead to short responses. To encourage more conversation, it helps to make comments instead of questions. For example: instead of saying, “Do you like your lunch?” where the answer will probably be ‘yes’ or ‘no’ you could comment, “It looks like you like your sandwich. I really like cheese sandwiches.”
Remember: Questions lead to answers and comments lead to conversation
6. Read: Reading is a great way to promote language. Reading connects words to pictures and objects for children.
Remember when you are reading:
- Not to read too fast
- Give your child time to explore the pictures on the page as you read.
- Point to pictures, name them to encourage learning new words
- Talk about what is going on in the story beyond just what is written on the page
- Read often.
7. Use visual supports: Pictures, symbols, timetables, social stories, comic strips can all help your child process information more easily and understand what is happening around him/her and what is expected of him/her. These visual supports are a form of communication your child may really connect to.
8. MADA. MADA is Qatar’s assistive technology center. They have many ideas and good advice on how to use assistive technology, from using pictures to Ipads, to helping encourage and promote communication for children with delays. You can make an appointment to meet with them and they will complete an assessment to see how they can help. This is a free service.
Advice for Promoting Cognitive Skills:
1. Play: Children learn through play, this includes learning motor, language, cognitive and social skills. Interactive play provides enjoyable opportunities for you and your child to interact, communicate, and practice skills. Children are learning about the world around them all the time in play. For example, a child learns about:
- Heavy and light when lifting up different toys
- Size and shape when putting a toy in a container or working on a puzzle
- Cause and effect from push button toys
Remember: play is one of your child’s best teachers. so, follow your child’s interests and lead in play and play at their level.
2. It not just about academic: Often times when it comes to cognitive development parents are very concerned about their child knowing his/her numbers, letters, reading, math etc and being ready for school. These are all important parts of academic development, but there are many other important cognitive or thinking skills children need. Academics skills learning can wait for young children.
- Helping your child explore the world around them in ways that don’t involve learning academic skills and facts is important.
- Helping your child build their cognitive ability in context is important. For example: Helping with everyday tasks like getting dressed, picking up toys, and cooking, are as much learning opportunities as learning to say the alphabet or counting.
- Talking about the numbers, letters, and colors in context is better than quizzing. An example of this is talking about the color of your child’s favorite toy, piece of clothing, etc. is more relevant than just naming colors when asked.
3. Variety: Exposing your child to a variety of play activities, new experiences, people and places helps build their understanding of the world around them and their cognitive skills. All children have their favorite toys to play with and places to go, but it is always good to introduce new and different items and activities into their schedule.
4. Human interaction is best:
- Avoid screen time and electronics as much as possible.
- Children under 2 years of age should have very little to no electronics time.
- Children over 2 years do not need more than 1-hour of electronics time a day.
- Whatever your child is learning from electronics they can also learn from interacting with you and other children.
- The interaction with other people is much more cognitive enriching and social than interaction with a screen.
Remember: Children learn the best from other people, not from electronics. You can teach your child much more than a TV program or app
Advice for Promoting Social Skills:
- Provide social opportunities. Often children with delays have less social opportunities with peers than typically developing children. Find places and ways for your child to interact socially with children who are both their chronological(actual) age and their developmental age. Being around other children will help your child learn natural social skills, as well as work on other developmental skills. Peer interaction is important for children with GDD.
- Provide a bridge. You may need to help your child approach and interact with their peers and help other children approach and interact with your child. You can do this by playing alongside your child and other children, helping to include your child’s play in with other children around them, and helping to include your child in ways you know they can participate.
Advice for Promoting Self-Help Skills:
Children increase their independence though self-help skills. Children of almost every age can learn to help themselves with some activity of daily living. Gaining self-help skills often leads to increased confidence, pride in one’s self, and parents benefit because their child is learning to take care of tasks on their own. Self-help skills can range from a child learning to hold their own bottle to a child getting dressed on his/her own.
1. Know what to focus on: To learn a new self-help skill a child must first have the developmental ability to learn and work on that skill. Here are some areas of self-help to think about: feeding, toileting, dressing and undressing, bathing, grooming, helping with small chores around the house, etc.
2. Model, Support, Practice:
- Model: When you have decided on a self-help skill to encourage and work on, start by first modeling how to complete it. Your child should watch you go through the steps:
- Show them what you are doing
- Talk about each step as you go along
- You can take pictures of each step and put them together as a visual reminder
- Support: You will need to provide support in completing the activity at first.
- Your child may just complete 1 part of a task to begin with, then a second part, then a third…little by little they will acquire the skill to do the whole task.
- Depending on the skill you may help your child move their hand or body to practice what to do
- You may use hand-over-hand guidance. For example: Guiding you child’s hand to learn how to use a spoon, or putting your hand over child’s hand to help them learn how to brush their teeth.
- Practice. Your child will need a lot of practice to learn new skills.
- You both will need patience
- Give him/her time to practice before asking them to complete the skill on their own
- Give your child a lot of praise for their effort, not just for completing the task
Advice for Managing Challenging Behaviors:
All children can behave in ways that parents find difficult or challenging to manage. Having a wide range of emotional responses, both positive and negative is normal. Having tantrums (bad temper) and challenging behaviors is normal too. Sometimes developmental delays can increase these normal challenges. The first steps in managing challenging behavior is understanding the purpose of the behavior and spotting what triggers it. Here are some strategies for managing challenging behaviors in children:
1. Increase emotional awareness:
- Talking about, naming, and acknowledging emotions is important for children to gain greater emotional control.
- Naming emotions like happiness, anger, frustration, etc. is important. For example: “It looks like trying to put that puzzle piece in is frustrating you.”
- Naming emotions in yourself and your child as they happen is great ways to increase emotional awareness.
- Labeling emotions of characters in a book and talking about why they feel the way they do is important.
- To gain greater emotional control, children first have to understand their emotions.
2. Provide structure: All children need structure, this helps them feel secure and understand better what is happening around them and learn what is expected of them. To do that follow these tips:
- Set up predictable routines using a calendar, symbols or visual timetable for your child.
- Have schedules and routines for mornings, meals, after school, and bedtime.
- Try to keep to this routine as much as possible. If there is an unavoidable schedule change, prepare your child for it in advance either by talking about the change or using pictures and picture sequences to explain it visually.
3. Figure out what triggers challenging or disruptive behaviors: Reasons for why children may behave in challenging ways might be:
- Trouble understanding what’s happening around them – for example, what other people are asking them to do
- Difficulty doing what is asked of them even though they understand – for example not having the fine motor ability to put on sock by his/her self and being frustrated with the activity or concerned about being scolded
- Frustration because they cannot effectively communicate their own wants, needs and emotions
- Anxiety because of lack of understanding of what’s happening around them or what’s expected of them, If you understand what affects your child, you’ll be better at identifying problems and preventing or modifying situations that cause difficulties.
4. Reward good behavior: Reward and praise any appropriate behaviors that your child shows you. Be very specific about what they’re being praised for. For example: “Good listening.”, “Thank you for pointing.” When you praise your child for a behavior, it is likely to happen again.
My Child Without Limits: http://www.mychildwithoutlimits.org/understand/developmental-delay/
Early Intervention Program: http://www.shafallah.org.qa/
Pre-integration Program: http://www.shafallah.org.qa/
Best Buddies Qatar: http://www.bestbuddies.org.qa
Qatar Society for Rehabilitation of Special Needs: https:// www.qsrn.org