Developmental Delays

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Try one of these related symptoms.

Socially awkward

Developmental delay

Impulsive behavior

Bad grades

Behavioral issues

Cognitive delay

Difficulty walking

Hyperactive child

Speech problems

Learning difficulties

Delayed puberty female

Difficulty with fine motor skills

About the Symptom

It refers to a child who has not gained the developmental skills expected of him or her, compared to others of the same age.

Possible Causes

Generally, Developmental delays can be related to:

Doctor's Diagnostic Questions

Your doctor may ask these questions to check for this symptom:

Reviewed By:

Unnati Patel, MD, MSc

Unnati Patel, MD, MSc (Family Medicine)

Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.

Yoshinori Abe, MD

Yoshinori Abe, MD (Internal Medicine)

Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.

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Content updated on Feb 6, 2025

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FAQs

Q.

Is it Autism Spectrum Disorder? The Reality and Medical Next Steps

A.

There are several factors to consider when evaluating possible autism spectrum disorder. Key signs include social communication differences, repetitive behaviors, and sensory sensitivities, and the medical next steps are to track specific behaviors, ask your pediatrician for screening, pursue a formal evaluation, and begin early intervention if indicated. Because other conditions can look similar and urgent issues like regression, self-harm, or seizures need prompt care, see the complete guidance below for age-based red flags, adult pathways, and how to access services that fit your situation.

References:

* Sharma, S. K., & Guralnik, S. L. (2023). Autism Spectrum Disorder: New Insights into Causes, Diagnosis, and Treatments. *Journal of Autism and Developmental Disorders*. Advance online publication.

* Veenstra-VanderWeele, J., & Cook, E. H. (2021). Autism Spectrum Disorder: Diagnostic Advances and Treatment Innovations. *Child and Adolescent Psychiatric Clinics of North America, 30*(4), 603-617.

* King, K. P., & Ousley, O. Y. (2020). Medical Assessment and Management of Autism Spectrum Disorder. *Pediatric Clinics of North America, 67*(5), 957-975.

* Hyman, S. L., Levy, S. E., & Myers, S. M. (2020). Screening, Diagnosis, and Medical Management of Autism Spectrum Disorder. *Pediatrics, 145*(1), e20193447.

* O'Brien, T. B., & Sahin, M. (2022). Neurobiology of autism spectrum disorder. *Current Opinion in Neurobiology, 76*, 102604.

See more on Doctor's Note

Q.

Worried About Developmental Signs? Why Noonan Syndrome Occurs and Medically Approved Next Steps

A.

Noonan syndrome happens due to genetic mutations in RAS-MAPK pathway genes, either inherited or new, which can affect growth, heart development, facial features, muscle tone, learning, puberty, and blood clotting. There are several factors to consider, especially the high rate of heart issues and the wide range of severity, so early recognition matters; see below to understand more. Medically approved next steps include seeing a pediatrician and geneticist, getting an echocardiogram and genetic testing, starting early therapies and growth support when appropriate, and seeking urgent care for worrisome symptoms, with key details that could change your plan outlined below.

References:

* Pezzoli L, Caciolo C, Di Stasio E, et al. Clinical management guidelines for Noonan syndrome and related disorders: an update. Orphanet J Rare Dis. 2023 Dec 15;18(1):389. doi: 10.1186/s13023-023-03009-3. PMID: 38098007; PMCID: PMC10723820.

* Roberts AE, Allanson JE, Pagon RA, et al. Noonan Syndrome. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024. 2000 Sep 20 [updated 2023 Mar 23]. PMID: 20301306.

* Tidwell T, Seidenberg P, Bhambhani V. Noonan Syndrome: Clinical and Molecular Aspects. Am J Med Genet C Semin Med Genet. 2021 Dec;187(4):461-471. doi: 10.1002/ajmg.c.31948. Epub 2021 Oct 27. PMID: 34704627.

* Pierpont ME, Roberts AE, Omenn GS. Neurodevelopmental and behavioural phenotype in Noonan syndrome. Dev Med Child Neurol. 2022 Jul;64(7):826-834. doi: 10.1111/dmcn.15174. Epub 2022 Mar 1. PMID: 35230739.

* Bhambhani V, Tidwell T, Seidenberg P. Molecular genetics and diagnosis of Noonan syndrome. Mol Syndromol. 2020 Jul;11(4):175-188. doi: 10.1159/000508544. Epub 2020 Aug 26. PMID: 33029007; PMCID: PMC7527635.

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Q.

Is it Williams Syndrome? The Genetic Reality & Medically Approved Next Steps

A.

Williams syndrome is a rare genetic deletion on chromosome 7 that often leads to distinctive facial features, developmental delays with strong social and verbal tendencies, and heart or blood vessel narrowing such as supravalvular aortic stenosis. It can only be confirmed with genetic testing, and the medically recommended next steps are to see your doctor, request genetic and cardiology evaluations, and begin early therapies if delays are present, since cardiovascular issues can be serious. There are several factors to consider, so see the complete guidance below.

References:

* Pober BR. Williams-Beuren Syndrome. 2000 Oct 16 [Updated 2023 Jul 20]. In: Adam MP, Feldman GN, Mirzaa GK, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024. PMID: 20301399.

* Collins RT 2nd, Kaplan P, Somes G, Romesburg J, Eubanks EP, Pachter L, DelBello MP, Reiss A, Loker J, Mervis CB. Medical management of Williams syndrome. Am J Med Genet C Semin Med Genet. 2021 Sep;187(3):363-372. doi: 10.1002/ajmg.c.31934. Epub 2021 Aug 17. PMID: 34403063.

* Menghini D, Addona F, Di Stazio F, Vicari S. Neurocognitive and Neurobehavioral Profile of Williams Syndrome: Evidence for an Uneven Cognitive Landscape. J Clin Med. 2023 Jan 28;12(3):1021. doi: 10.3390/jcm12031021. PMID: 36769415; PMCID: PMC9917027.

* Collins RT 2nd. Cardiovascular Health in Williams Syndrome. Curr Opin Cardiol. 2019 Sep;34(5):455-459. doi: 10.1097/HCO.0000000000000639. PMID: 31274712.

* Morris CA. Williams Syndrome: What Pediatricians Need to Know. Curr Probl Pediatr Adolesc Health Care. 2017 Jul;47(7):191-197. doi: 10.1016/j.cppeds.2017.06.002. Epub 2017 Jun 24. PMID: 28732688.

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Q.

Worried About Delays? Fragile X Syndrome Signs & Medical Next Steps

A.

There are several factors to consider: ongoing delays in speech, learning, behavior, or social skills with poor eye contact, sensory sensitivities, repetitive movements, and sometimes subtle physical traits can suggest fragile X, the most common inherited cause of intellectual disability and a known genetic cause of autism. Next steps include documenting concerns and seeing a pediatrician to discuss an FMR1 blood test, developmental evaluation, and early therapy services, with urgent care for seizures or sudden regression; see below for important details that can affect which actions you take.

References:

* Loesch DZ, Kukuruzinska MA, Humenny Z. Fragile X syndrome: a review of the literature. Curr Opin Pediatr. 2018 Dec;30(6):797-802. doi: 10.1097/MOP.0000000000000693. PMID: 30045269.

* Kidd SA, Lachiewicz AM, Finucane B, Wittenberg DF, Barone B, Corrigan NL, de Vries BBA, Field M, Hessl D, Kooy RF, Miller RM, Simon-Cereijido G, Tassone F, Hagerman RJ. Current management of fragile X syndrome. J Med Genet. 2021 Nov;58(11):721-729. doi: 10.1136/jmedgenet-2020-107386. PMID: 34215918.

* Monaghan KG, Lemoine L, Scharff ML, De Witte M, El-Hattab AW, Kooy RF, Mefford HC, Redin C, Reardon R, Schaaf CP, Stover J, Tassone F, Working Group Members. Genetic testing for Fragile X Syndrome: an updated clinical practice guideline. Genet Med. 2023 Nov;25(11):100936. doi: 10.1016/j.gim.2023.100936. PMID: 37639148.

* Hersh JH, Saul RA; American Academy of Pediatrics Council on Genetics. Clinical Guidelines for the Management of Fragile X Syndrome and Premutation Conditions. Genet Med. 2019 Jan;21(1):151-158. doi: 10.1038/s41436-018-0010-0. PMID: 29420658.

* Budimirovic DB, Pedapati EV, Berry-Kravis E, Tassone F, Hagerman RJ. Fragile X syndrome: neurodevelopmental challenges and treatment avenues. Curr Opin Pediatr. 2023 Apr 1;35(2):162-171. doi: 10.1097/MOP.0000000000001229. PMID: 36979644.

See more on Doctor's Note

Q.

Is it Williams Syndrome? The Reality & Medically Approved Next Steps

A.

Williams syndrome signs, diagnosis, and next steps: it is a rare genetic condition that can include developmental delays, distinctive facial features, a very social personality, and heart or blood vessel problems, and it is confirmed only by genetic testing after a medical evaluation, often with an echocardiogram to check for vessel narrowing. There are several factors to consider, and some signs overlap with other conditions. Medically approved next steps include seeing your pediatrician, asking about genetic testing and a heart evaluation, starting early intervention if delays are present, and seeking urgent care for chest pain, fainting, trouble breathing, or extreme fatigue; see the complete details below to understand key signs, look‑alike conditions, and how to navigate care.

References:

* Pettee C, Al-Khatib SM, El-Hattab AW. Williams syndrome: clinical features, diagnosis, and management. GeneReviews(®). 2020 Jul 16. pubmed.ncbi.nlm.nih.gov/32669466/

* Martens MA, Hoeft F, Reiss AL. Williams syndrome: A comprehensive review of the phenotypic, genetic, and molecular features. J Clin Invest. 2018 Nov 1;128(11):4725-4734. doi: 10.1172/JCI124823. Epub 2018 Oct 18. PMID: 29997193; PMCID: PMC6205366. pubmed.ncbi.nlm.nih.gov/29997193/

* Ng P, Mervis CB. Williams Syndrome: An Overview for the Pediatrician. Pediatr Ann. 2018 Aug 1;47(8):e323-e328. doi: 10.3928/19382359-20180724-01. PMID: 30104616; PMCID: PMC6119859. pubmed.ncbi.nlm.nih.gov/30104616/

* Del-Moral-Murat G, Gámez-Rodríguez S, Galera-Martínez E, Valdés-Cañedo F, Cruz-Campos I, Sánchez-Medina T, Serrano-Delgado S, Sánchez-González M. Cardiovascular and renal abnormalities in Williams syndrome: A comprehensive review. World J Cardiol. 2021 Mar 26;13(3):121-131. doi: 10.4330/wjc.v13.i3.121. PMID: 33772242; PMCID: PMC8003649. pubmed.ncbi.nlm.nih.gov/33772242/

* Mervis CB, Ng P. Neurodevelopmental and Behavioral Profile of Williams Syndrome: Review and Practical Implications. Pediatr Ann. 2018 Aug 1;47(8):e318-e322. doi: 10.3928/19382359-20180724-02. PMID: 30104615; PMCID: PMC6119866. pubmed.ncbi.nlm.nih.gov/30104615/

See more on Doctor's Note

Q.

Is it Down Syndrome? Why Trisomy 21 Occurs and Your Medically Approved Next Steps

A.

Down syndrome, or Trisomy 21, happens when there is an extra copy of chromosome 21, most often from random nondisjunction, with less common translocation or mosaic forms; risk rises with maternal age and signs can include characteristic facial features and developmental delays. Medically approved next steps are to confirm with diagnostic genetic testing after screening by working with your obstetrician or pediatrician and a genetic counselor, and to start early intervention if diagnosed; there are several factors to consider, including associated heart, thyroid, hearing, vision, and feeding or breathing issues that can be urgent, so see the complete guidance below.

References:

* Siciliano, J. C., & D'Armiento, F. (2021). Genetic and Epigenetic Mechanisms Underlying Down Syndrome Pathogenesis. *Cells*, *10*(11), 3123.

* Greger, V., Witsch, M., Schlecht, S., & Benda, N. (2020). Prenatal screening and diagnosis of chromosomal aneuploidies: A review of the current landscape. *Genes*, *11*(11), 1278.

* Bull, M. J., & Committee on Genetics. (2022). Health Supervision for Children and Adolescents With Down Syndrome. *Pediatrics*, *150*(5), e2022059341.

* Antonarakis, S. E., Skotko, B. G., & Reeves, R. H. (2022). Down Syndrome: Clinical Review and Updates. *The New England Journal of Medicine*, *387*(14), 1310-1321.

* Maltby, C., Tanti, S. J., & Farrell, R. M. (2023). Communicating a prenatal diagnosis of Down syndrome: an updated narrative review of approaches and their impact. *Human Reproduction Update*, *29*(5), 654-670.

See more on Doctor's Note

Q.

Why is the Genetic Blueprint Unique? Down Syndrome & Medically Approved Next Steps

A.

There are several factors to consider. The genetic blueprint is unique in Down syndrome because an extra copy of chromosome 21 changes gene dosage from conception, shaping development and raising the likelihood of certain health conditions; it is not caused by anything a parent did. Medically approved next steps include confirming the diagnosis with a karyotype, scheduling heart, hearing, vision, and thyroid evaluations, and starting early intervention therapies. For key details on ongoing monitoring, education plans, urgent red flags, and the long-term outlook, see below.

References:

* Lek M, et al. The landscape of human genetic variation. Nature. 2016 Aug 18;536(7616):308-14.

* Antonarakis SE, et al. Down syndrome: from aetiology to therapeutic targets. Nat Rev Genet. 2020 Jan;21(1):15-31.

* Bull MJ; COUNCIL ON GENETICS. Health Supervision for Children and Adolescents With Down Syndrome. Pediatrics. 2022 Jul 1;150(1):e2022057010.

* Dierssen M, et al. Down Syndrome in the Age of Genomic Medicine: Research Opportunities. JAMA Neurol. 2021 Mar 1;78(3):263-265.

* Pinter G, et al. Pharmacological interventions in Down syndrome: A systematic review and meta-analysis. Eur J Paediatr Neurol. 2022 Mar;37:25-41.

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References