Occupational Therapy: Children’s developmental milestones

By Verah Mugambi

Children are a blessing, not an inconvenience. They are a gift from God. Every child is unique and develops at their own pace, however, most children pass through specific changes at approximately the same time as they age.

A child’s development milestone refers to specific stage and growth children are expected to pass through at a certain age. Experts divide developmental stages into five periods from birth to 18 years old. At each stage, healthcare providers hope children meet certain developmental milestones.

According to Mr. Evans Okong’o, KNH Occupational Therapist at the Pediatric Unit, experts use several parameters depending on the child’s age to gauge whether there is delayed development or if it is on the right track.

Mr. Evans Okong’o - Occupational Therapist at the Pediatric Unit, KNH

PHOTO | STEVE ARWA

“We usually have a rough estimate stage whereby we expect a child to achieve certain milestones. For example, a three months old child is expected to be able to hold their head, but if you realize it has taken more than 8 or 9 months, that will be an alarm for a delayed milestone,” Mr. Evans told Newsline as we started the interview.

If children don’t meet expected milestones, a healthcare provider can evaluate them for developmental delays. While there is no cure for developmental delays, certain types of therapy can help your child thrive.

Examples of developmental milestones in a baby’s first year of life may include: smiling intentionally, sitting without support, waving goodbye, moving objects from one hand to the other, and transitioning from crawling to taking steps, among others.

“We manage the condition, not treat. We get children as young as one week old. Most of these have been diagnosed with hypoxia (lack of insufficient oxygen to the brain). It’s a rehabilitation where we help the child fit in, efficiently do their daily activities, and achieve certain milestones.

At birth, when they don’t cry or take long to cry, it means there is inadequate oxygen flow to the brain, and doctors suspect the child might develop a complication in the future. So better start early intervention and management,” Mr. Evans explained. “So early intervention and management is advised.”

What are developmental delays?

Developmental delays refer to areas where children have not gained the skills that experts expect children their age to have. You may notice delays in any developmental areas, including ones that affect: Cognitive skills, such as problem-solving, communication skills, fine motor skills, social skills, and speech and language.

Identifying and knowing the cause of any delays can help provide appropriate support. A delayed milestone is not a diagnosis of its own; it’s a secondary thing to something; it is a symptom. Some conditions lead to that.

Healthcare Experts (WHO) divide child growth and development into four areas:

• Physical development; refers to the strength and physical skills.

• Cognitive development; involves thinking and problem-solving.

• Language development; relates to communication and understanding.

• Social-emotional development; affects how children interact with others and process feelings.

How can one measure child development?

A child undergoing Occupational Therapy

PHOTO| RUSH

Mr. Evans: Delayed milestones can be noted immediately after birth. The first sign is suckling. This should be an automatic reflex immediately after the baby is born. If the baby takes one or two weeks to suckle, that indicates that the child is delayed.

“I always advocate for early intervention. In my years of practice, I have noticed that those who come early for intervention have shown more outstanding outcomes compared to the child who is 3 or 4 years because of complications. These interventions help your child succeed in school, connect socially and learn to communicate,” Mr. Evans expounded.

What are the signs of developmental delays?

Signs of developmental delays can vary significantly. Sometimes, you may notice signs of delay during infancy, or symptoms may not appear until a child is school-age. Some of the most common signs of developmental delays can include:

• Rolling over, crawling, or walking much later than expected.

• Difficulty communicating, talking, or fitting in socially.

• Problems with connecting actions to consequences.

• Inability to perform everyday tasks without help, such as getting dressed or using the bathroom.

• Trouble remembering instructions.

“Here at Kenyatta National Hospital, some of my colleagues in Occupational Therapy (OT) do rounds at the labor wards, and you will be surprised at how we spot these milestone delays at an early stage. It’s straightforward to detect at that age and talk to the mother about the child’s condition.

Unfortunately, most mothers/ parents come to us without knowing what’s happening to their kids. I wish all centers could have OT’s around before discharging the babies to do a thorough screening and detect these conditions as early as possible so we can manage it at that moment,” Mr. Evans concluded the interview.

“I always advocate for early intervention. In my years of practice, I have noticed that those who come early for intervention have shown more outstanding outcomes compared to the child who is 3 or 4 years because of complications

If you notice developmental delays, speaking with your child’s pediatrician is advisable. The pediatrician may recommend a developmental evaluation. This evaluation can involve specialists such as a Child psychologist, a Developmental pediatrician (a doctor specializing in child development), an Occupational therapist, a speech-language pathologist, or even a Physical therapist.