How to identify if your child has psychomotor retardation

It fills us with emotion the day our baby smiles, sits, crawls or stops. In the first 5 years of life, children reach different indicators of development. If they are not achieved within the time foreseen, the parents come to the pediatrician anxiously to identify if their child has any psychomotor delay.

It is important not to be overly alarmed. The fact that a child presents problems in the way he plays, learns, speaks and acts can be a natural delay in the pace of development. Each child has its own rhythm of growth.

Only a neuropaediatrician can interpret these signals as indicators of psychomotor retardation. After doing the corresponding studies you can give the diagnosis and establish the therapy that the child needs to develop their fundamental skills and abilities.

What causes a psychomotor delay?

Thanks to prenatal screening or heel testing, there are increasingly fewer babies with psychomotor delay caused by congenital diseases. This simple blood test allows early detection and treatment of these diseases before the brain, physical and locomotor development of the child is affected.

The heel test is done a few days after birth. Through a puncture in the heel a few drops of blood are extracted to detect the metabolic problems that the baby may have and start treatment as soon as possible to avoid damage to the baby’s development.

Even so, there are cases in which there is a psychomotor delay. The causes can be genetic alterations or problems acquired in the uterus or during childbirth that affect the cognitive and motor development.

There is no scientific accuracy in what causes the delay. Only the careful study and follow-up of the case can determine if the psychomotor delay is caused or is the first phase of a major problem:

• Chronic extraneurological diseases, such as celiac disease, malnutrition, frequent and prolonged hospitalizations, heart disease
  congenital, etc.
• The effect of an isolated sensory deficit, such as sensorineural deafness.
• A future light or severe mental deficiency.
• Cerebral palsy in children with its various clinical forms.
• Disorder of the development of coordination, frequently associated with Attention Deficit and Hyperactivity Disorder (ADHD).
• Disorder of the autistic range.

How to identify psychomotor retardation?

A child who in his first 3 years of life has a slow or notoriously altered sequence in the achievement of development milestones may have a diagnosis of psychomotor retardation. This delay can be global, affecting not only the motor skills but also the skills to communicate, play or in social interaction. At other times, it becomes evident only in a specific area.

There are also children who show the first milestones of psychomotor development with relative normality. After the second year is when it becomes evident a delay in the language and a relative poverty in the way he plays.

The specialist is the one who can compare the evolution of the child with instruments such as development tables or tests that allow you to assess if there is any abnormality. However, there is no medical test (such as an analytical or imaging technique) that allows you to confirm the diagnosis.

What can we parents do?

First of all, you have to stay calm, well the child needs our support to overcome. The specialist will be who determines what should be done in each case. However, we can be attentive to the following signs:

At 2 months

• The baby does not respond to loud noises.
• It does not follow with the view to the things that move.
• It does not smile at people.
• When he is face down and pushes his head up, he can not hold his head up.
• He does not put his hands to his mouth.

At 4 months

• It does not follow with the sight to the things that move.
• It does not smile at people.
• He has difficulty holding his head firmly.
• It does not take things to the mouth.
• It does not chirp or make sounds with the mouth.
• He has difficulty moving one or both eyes in all directions.
• Do not push with your feet when they rest on a hard surface.

At 6 months

• The baby does not try to grab things that are within reach.
• He does not show affection for those who care for him.
• It does not react to the sounds around.
• He has difficulty taking things to his mouth.
• He does not laugh or make sounds when he feels pleasure.
• It does not roll in any direction to turn around.
• He looks rigid and tense muscles or, on the contrary, he looks without strength and flaccid.
• It does not emit vowel sounds (a, e, o).

At 9 months

• The baby does not sit with help.
• Does not hold on legs with support.
• Does not babble (mom, dad, dad).
• Playing in turns, like “first it’s my turn, now it’s your turn” is something he can not do.
• He does not respond when they call him by his name.
• He does not seem to recognize nearby people.
• He points out, but he does not direct his gaze to where he is doing it.
• Do not pass toys from one hand to the other.

At 12 months

• The baby does not crawl.
• He can not stand with help.
• It does not look for the things that it sees when they are hidden.
• There are gestures such as shaking hands or moving the head that does not learn.
• It does not point things.
• It does not say simple words like “mom” or “dad”.

At 18 months

• He has difficulty walking.
• It does not point out things to show other people.
• He does not know what are the things that are commonly used in his care or at home.
• Their behavior does not include imitating or copying what other people do.
• Does not learn new words or does not know at least 6 words.
• He does not realize or does not seem to care if the person who cares for him goes to or returns.

At 2 years

• Do not use two-word phrases. For example: give me water.
• Do not copy actions or words.
• He is unable to use common objects, such as a toothbrush, telephone, fork or spoon.
• You can not follow simple instructions.
• Also, walk with little stability.

3 years

• He falls a lot or has problems going up and down stairs.
• Do not look people in the eyes.
• He finds it difficult to play with simple toys, such as pieces to fit pieces, simple puzzles or turn a handle.
• He does not use sentences to speak.
• He does not understand simple instructions.
• Imagination does not appear in its games nor does it imitate.
• He does not want to play with other children or with toys.
• Drool or you do not understand when he speaks.

At 4 years old

• You can not jump in the same place.
• He has difficulty scribbling.
• Does not show interest in interactive games or imagination.
• Ignores other children or does not respond to people who are not family members.
• Refuses to dress, sleep and use the bathroom.
• He can not tell his favorite story.
• Does not follow instructions of 3 parts.
• Speak with little clarity.
• He does not understand what is meant by “equal” and “different”.
• He does not know how to correctly use the words “I” and “you”.

At 5 years old

• He can not say his first and last name.
• It does not express a great variety of emotions.
• It has extreme behaviors. For example: too much fear, aggression, shyness or sadness.
• He gets distracted easily, has trouble concentrating on an activity for more than 5 minutes.
• Does not respond to people or does it only superficially.
• He can not distinguish fantasy from reality.
• He is too withdrawn and passive.
• It does not play a variety of games and activities.
• He does not talk about his activities or daily experiences.
• He finds it impossible to brush his teeth, wash and dry his hands or undress without help.
• It does not draw.

To end

From the first year of life, if the child loses skills or abilities that he had already acquired, should be considered as a warning signal that deserves the immediate attention of the pediatrician or neuropediatrician.

When a specialist points out that there is psychomotor retardation, it is a provisional diagnosis, since we must wait for the evolution of the child. If the delay is persistent in the first years of life it can be the prelude to a future diagnosis of mental retardation.

It is up to parents to stay calm and support early stimulation of our son. You have to avoid blaming yourself. Whatever the reason for our child’s psychomotor retardation, we must learn to live with him and seek the best development of his skills and potential.