A neurologist is a physician who specializes in diagnosing and treating conditions affecting the brain, spinal cord, and nervous system. Child developmental delay refers to when a child does not reach expected developmental milestones within the typical age range, and it can affect movement and cognitive abilities. Early signs may include delayed speech or difficulty with motor tasks like sitting and grasping.
Role of Neurologists
When a child is referred for evaluation for child developmental delay, a neurologist conducts a thorough assessment to identify any developmental delays. The assessment typically includes a detailed review of the child’s medical history and a physical and neurological examination; the provide may also administer other standardized developmental screening tests. Pediatric neurologists may also order imaging studies or other diagnostic tests.
Developmental delays can affect one or multiple areas of development; neurologists examine speech and language, motor skills, social behavior, and cognitive functioning. Because no two children develop at exactly the same pace, a neurologist compares a child’s progress against established milestone ranges. They potentially perform other tests before reaching any conclusions.
Milestones at 15 Months
The first 15 months of life are a period of rapid growth. A child who is not meeting key milestones during this window may warrant further evaluation.
Signs of potential developmental delay from birth to 15 months include:
- By 2 months: Not smiling at people or not calming down when spoken to
- By 4 months: Not cooing or making sounds, or not bringing hands to mouth
- By 6 months: Not laughing or making squealing sounds
- By 9 months: Not recognizing familiar faces, or showing no facial expressions
- By 12 months: Not using gestures such as pointing or waving, or not saying single words like “mama” or “dada.”
- By 15 months: Not walking independently, or not using any words
These milestones cover a range of developmental domains, and missing one does not automatically indicate a problem. A pediatrician can determine whether further assessment is needed by a neurologist.
Milestones at Three Years
By age three, children are expected to show significant progress in language, social skills, and coordination. A three-year-old who is experiencing a child developmental delay shows signs of difficult with these milestones. Children at this age are generally expected to speak in sentences of two to three words and follow simple instructions; they also typically show interest in other children.
A child who is unable to climb stairs or shows no interest in interactive play may benefit from an evaluation. Unusual difficulty separating from caregivers or an inability to understand simple directions can also be a sign of delay. Language and social development are closely linked at this stage, so regression or loss of previous skills in either area may require medical attention.
Milestones at Five Years
At age five, the focus shifts toward school readiness and more refined motor and language skills. A five-year-old with a developmental delay may struggle with tasks that other children at this age perform with ease. Again, missing one or two of the established milestones does not necessarily mean a child has a developmental delay, but an evaluation can provide more answers about the cause of these missed milestones.
Expected milestones around this age include being able to tell a simple story, count to 10, and copy basic shapes like a square or triangle. A child who is unable to stand on one foot for at least ten seconds, who has difficulty being understood by people outside the family, or who shows extreme behavioral challenges may need evaluation. Some variation exists between children, but a child who struggles to separate fantasy from reality or who shows limited interest in other children warrants professional assessment.
Learn About Child Developmental Delay
Developmental delays can vary in presentation and symptoms, and early identification gives children the best opportunity for targeted support. Neurologists evaluate a child’s milestones across speech, motor, cognitive, and social domains to form an accurate picture of development. From the first months of life through the preschool years, specific milestones serve as reference points for identifying when a child may need additional care. If you want to learn more about identifying developmental delays in childhood, consult a neurologist near you.
