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Global developmental delay

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WHAT IS GLOBAL DEVELOPMENTAL DELAY?

Global Developmental Delay (GDD) is the general term used to describe a condition that occurs during the developmental period of a child between birth and 18 years. It is usually defined by the child being diagnosed with having a lower intellectual functioning than what is perceived as ‘normal’. It is usually accompanied by having significant limitations in communication. It is said to affect about 1-3% of the population.

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It just means that the child's delay in development is not occurring in only one area of the curriculum, but in other areas as well.

Basically, the child is not "keeping up" with the other children of his age across a wide area of the curriculum.

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It can sometimes mean that. But not always.There can be other reasons why the child is not achieving across the board. It can be due to social problems at home, severe emotional trauma of some kind or even (physical) medical issues.

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ok thanks, just saw in my sons most recent notes from his paediatrician it said global delay, i thought it meant delays in ALL areas, in which case it would have been wrong as hes doing well in some areas but hes very behind in others, anyway it makes sense now.

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A child can have GDD and ASD. Global means across all areas. However those with an ASD often have a "spikey profile" ie. good at some things and bad at others. Standardised Assessments by various professionals [sALT, EP, Clinical Psychologist, OT] should identify if the child is low IQ or average or gifted, whether they have a "specific learning difficulty such as dyslexia, difficulties with executive functions, short term or working memory. GDD would mean the child was performing lower across all areas.

 

In what areas is he doing very well in?

 

It is very important to get the diagnosis right. For years my son's former school said they had 'no concerns' as they simply did not seem to have very high expectations for him. At 9 he was not reading or writing. I knew he was capable from things he said and did, so we sought further assessments. Two EPs said he was right on average for some skills, above in others, and performed poorly in short term and working memory [which is linked to his poor auditory memory and auditory processing disorder - which links into his speech disorder]. He also has severe dyslexia/dyscalculia. But he is smart. It is very frustrating for him.

 

Don't be afraid to ask questions, and to ask professionals to explain things to you, especially if you feel they are giving an incorrect diagnosis, or overlooking certain talents and abilities.

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He was never delayed in areas such as walking, running, jumping, riding a bike ect, in those areas he is pretty good. He is athletic. he is delayed in areas like reading and writing, his speech has now improved enough to be signed off from speech therapy although he was very delayed with speech until 6 months ago ish. He does have a lot of delays, his teacher said at parents evening lase week hes delayed to the age of 2 and a half- 3 yrs. But i know his IQ isnt low (its not been tested yet) its hard to explain but he is clever/bright in his own ways. So global does mean in ALL areas? Thats what i thought, but he isnt delayed in all areas so why has paed said global delay i wonder...

 

Also he is delayed in toilet training, understanding, and generally acts younger than he is, no danger sense, tantrums/meltdowns, not able to express himself very well still, aggression towards others.

But hes bright, and he gets extremely frustrated by his limitations :(

Edited by trekster

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Professionals tend to use the term "global" in a very loose fashion. What they usually mean by it is that a particular child is "behind" in a number of areas in the curriculum that they think are important (usually strictly academic subjects). So if a child is "poor" in Language (reading, writing, listening, talking) and also in Number, that is enough for some professionals to label his lack of development "global". Of course this is a nonsense. There are hardly any children I have come across who do not have some kind of "strengths".

So the adjective "global" (in my experience) is often used sloppily by professionals. It can lead to children being negatively labelled and hence expectations for that child being lowered.

Professionals need to be challenged to explain exactly what they mean when they use the label. It's always an uphill struggle.

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I think an indepth assessment by Clinical Psychology or Educational Psychologist would help identify areas of strength and weakness. If you don't agree with GDD say so.

 

His delay in reading and writing is related to his speech delay/disorder [and although he has improved he is still on the spectrum so he must still have clinically significant difficulties with expressive and receptive speech and social communication so he should NOT be discharged from SALT. What standardised assessments have they done?].

 

It makes sense that if you are struggling to speak or understand that will have a knock on effect with reading and writing. But there could also be specific learning difficulties such as dyspraxia, dysgraphia, dyslexia, poor short term or working memory, speech and language disorder - that could be a factor as well.

 

If it were me I would phone and ask to speak to the Head of the SALT Department. Ask what standardised assessments have been carried out. Ask why they are saying they will discharge him. Are they saying he is no longer on the autistic spectrum? I would then send in a letter stating that the SALT department should NOT discharge a child with an ASD who is not yet reading or writing, without assessment results stating he no longer has any receptive or expressive or social communication/interaction difficulties. Ask for your child to be assessed by a SALT who has experience of working with children with ASD and speech disorders. If you don't act, he will be discharged and it will take alot more effort to get them involved again.

 

My son is average cognitive ability and he has weekly SALT 1:1 and weekly group therapy and the SALT works with the teacher to plan how his learning is delivered and recorded.

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Thanks all, hes already been discharged from SALT back in october/november... I wasnt happy about it but she said he was age apropriate with his speech. But in her discharge report she stated he was still delayed??? Very confusing! He doesnt speek clearly yet, he has some kind of impediment like a lisp but not only with the "s" sound. He definatly struggles to express himself and cant easily tell me what he did in school/had for lunch/did yesterday ect. He doesnt yet understand the consept of yesterday and tomorrow and hes now 4yrs 8 months. She said he was age apropriate though so im not sure if the issues are just down to his age or if they are down to ASD. Why do profesionals give such conflicting opinions. SALT took it apon her self to declare she didnot think my son was autistic!!! She was there to assess his speech not weather he is or isnt autistic. The paediatricians he has seen both think he has ASD and so do I, im his mum and i see his behaviour every day. And since the day he was born i have known something was different with him. The paediatrician didnt say global delay to us face to face, it came in a copy of a letter shes sent to the geneticist, hes having genetic screening to rule out fragile x etc. Still not diagnosed with ASD after 4yrs 8 months! Were awating an appt date to have him assessed by ADOS and also the geneticist. Hes had a lot of tests for other things, all negative. So looking more and more like ASD.

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Just to add, he was discharged from SALT by a new SALT that had only seen him twice! We moved area, so he had to leave his language unit and there fore was referred to the new SALT. He had previously been seeing a speech therapist since the age of 18 months, so for over 2 and a half years. And he had been in a language unit for a year prior to our move and had been assessed by his SALT hed seen for that year as needing to return to the language unit in september rather than going in to main stream school as he was still moderatly delayed, if we had not moved area he would have still been in the unit. So you can understand my worry/panic when this new SALT sees him twice for a total of 2-3 hours and decides he should be discharged. Very worried mummy!

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