Evo Terra (Host): This is Children's Health Checkup, where we answer parents' most common questions about raising healthy and happy kids. I'm Evo Terra. Today's topic, recognizing the signs of developmental disability in children. I'm joined by Dr. Amber Gibson, psychologist at Children's Health and Assistant Professor at UT Southwestern for this conversation.

Understanding developmental disabilities can feel overwhelming, but early identification and support can make all the difference. In this episode, we'll cover the most common developmental disabilities, early warning signs to watch for, and what steps parents can take if they're concerned. Dr. Gibson, welcome to the show.

Amber Gibson, PhD: Thank you for having me.

Host: First, can I get you to share the most common developmental disabilities you see in children?

Amber Gibson, PhD: I would say that the most common developmental disabilities we see in clinic or just in general working with small children, even into that school age area, are global developmental delays. Also, autism is going to be one that we see pretty frequently, language disorders. And then, as we get more into that school age, we see a lot of that ADHD, whether it be hyperactive or inattentive or combined.

Host: You mentioned global developmental disabilities, I'm not sure I'm familiar with that term.

Amber Gibson, PhD: So, a global developmental delay is going to be a diagnosis that's typically given to children under age five, who have two or more areas of their development that are significantly behind what we would expect them to be. So, those areas of development are going to be their physical development, adaptive behavior, so like those skills you need for independence, communication, cognitive, and then lastly your social emotional skills.

Host: Thank you. Thank you very much, that's helpful. So from the caregiver side of things, parents or grandparents like myself, what are some early signs of developmental disabilities in young children that we should be watching for?

Amber Gibson, PhD: So, you're going to be looking at, are they meeting their milestones? So, going back to those areas that we talked about the different areas of development, that physical, adaptive behavior, communication, cognitive, and social emotional. Are the children meeting milestones as expected? So, for example, are they crawling and walking within the expected timeframe. Are they able to point at different things? Maybe they don't have their verbal communication yet, but are they able to point to direct your attention to something? Are they responsive when you smile at them? Do they recognize when someone new comes into the room? Things of that nature are going to be those areas that you want to make sure you're kind of keeping track of as they develop.

Host: And so, if we see things like that, obviously, we want to see our primary care physician right away and talk about things. But I'm wondering if this process of diagnosing developmental disabilities in children, obviously, we should not do that as caregivers, we need professionals to do that, but At what age can that be done? And talk to us about the process.

Amber Gibson, PhD: Absolutely. So if you're seeing as a parent, a caregiver some concerning delays or concerning behaviors, the first thing you're going to do is bring that up with your child's pediatrician. And then, going from there, the pediatrician will kind of assess sometimes, you know, as parents or caregivers, we may feel like that they're behind when really they're right on target. And that's kind of nice to be able to go to the pediatrician and they're like, "Actually, they're doing okay."

But then, sometimes on the other hand of things, we do have situations where the pediatrician says, "Okay, I see why you're concerned. Let's go ahead and get them referred over to a specialist for an evaluation." In the clinic I work in, we see children as early as 15 months. Typically when we're looking at things in that age range, that is on the earlier side of things, but we can see signs and symptoms of autism as early as that. Many times when we do interviews with parents, we'll ask them, "When did you first begin to have concerns?" And they'll say six months or seven months. And so, even at those ages, if you're reporting that to your pediatrician, now we have a line of data that we can follow. And then, when you come into our clinic at one and a half, two years old, now we're able to say, "Okay, this is not something new. This is something that there's been a history of this. And we're continuing to see these gaps in development." And so yeah, as early as one and a half, two years old, we're seeing kids come into our clinic.

Host: Yeah, that's a great advice about saying something early so that you have it on record, but also so that that shows that pattern. That's a very smart idea. I think this is changing, but you'll tell me if I'm right or wrong about that, but there are obviously some stigmas attached to developmental disabilities with Children that I'm sure every parent and caregiver would hope they never have to deal with. But nonetheless, those stigmas exist. Are there some ways around that? Are there common misconceptions about these issues in children?

Amber Gibson, PhD: Absolutely. That's a great, great question. There are stigmas related to any differences, whether they be with children, adults. Any type of diagnosis sometimes comes with a stigma. What I remind parents is that those are our things to deal with and not the child's things to deal with, right? And then, when we sit and talk about the misconceptions that people have, if a child has a developmental disability and we kind of look at those and say, okay, "Well, we've proven this wrong and proven that wrong," sometimes that lets parents kind of sit with that information a bit better. For example, a lot of times people think that if a child has a developmental disability, that means that they won't ever grow more than what they are already doing, and that's not true at all. Or they may feel as if their child may never have any type of independence or that their child will need a significant care for their whole life. And while for some children who then eventually grow into adults, that is true. For many more, that is not the case.

Our goal is to intervene early so we can equip them with the skills that they need to have as much independence as possible to reach their full potential and that will look differently for every child. But what I can say definitively is that every child has room to grow. So even if your child is a child that will need significant care for the remainder of their lives, that does not mean that they will not show any growth at all from the time that they're first diagnosed as they progress throughout their lifespan.

Host: An important thing to keep in mind for parents, certainly. I'm thinking about childhood development and clearly if we're not seeing any developmental issues, we're probably not going to rush them to a child psychologist, but I'm assuming at some point in time there's some routine and regular screenings that we should be doing in young kids to make sure there's not something that we're missing.

Amber Gibson, PhD: So if you're keeping up with your child's just typical, regularly scheduled pediatric appointments, your pediatrician is trained to make sure that they are asking the questions that they need to ask to see if there are any red flags that are going up. So, they're going to ask you about all those areas of development that we've talked about before. They're going to ask you, "Do you have any concerns?" And a lot of times, to your point, parents may not see anything as a concern because maybe they don't have other children to compare their child to, maybe this is their first child. Or maybe they think, "Oh, maybe this is a little different, but they'll grow out of it." The pediatrician is there to say, okay, either "They're doing well, they're on target, they're a little behind," or "I have some significant concerns." And then, the pediatrician will then make the referral to the appropriate entity to have any additional testing done.

Host: Let's talk about prevention for a moment. What can we do to reduce the risk of developmental disabilities in our children?

Amber Gibson, PhD: When we talk about prevention of developmental disabilities, first, we need to take a step back and talk about what causes developmental disabilities. And some things are outside of our control. Some things are genetic. And so, there may not be anything that you could do to change how things would lay out.

But then, when we look at the other side of things, we can say, "Okay, the same way that we would be intentional with a child that we didn't have any concerns about in their growth is the same way we want to be intentional with children who we do have concerns about in their growth." So, modeling language, using language that you want your child to then use. Modeling play, sharing, turn-taking, things of those natures. Giving children opportunities to practice these skills will help development as it goes along. So even if a child does have a developmental disability, doing these things and practicing these skills with these children in a way that they can understand can help them grow and continue to develop. And hopefully, goal is as much as possible to close any gaps between how the child is developing and how their same-age peers are developing.

Host: Dr. Gibson, this whole conversation has been good news piece. Anything else that you'd like to add or advice you want to give to a family who maybe is concerned that their child might have a developmental disability.

Amber Gibson, PhD: I would just say that early intervention is key. That is what we stress in our field because we understand that there is a critical window of time when children are younger, typically between that two and four-year-old age where they are able to absorb information in a way that is more difficult as we continue to age.

I always give the example to families of why it is easy to teach a three year old a new language and a 30-year-old could learn the same language, but it is a lot more difficult to teach them at 30 than it would be at three. And the reason is because of how the brain is designed and how it is still growing in those early stages of life.

And so, in order to not miss those critical windows, if you have any concerns, tell your doctor. No concern is too small. I also tell parents that you're taking a gamble if you say, "Hey, my kid will grow out of it" because they may, but then they may not. And if they missed that critical window, then we missed a time period where intervention could have been most effective, not saying that it won't be effective down the line, but we missed the window where it could have been the most effective.

And so, I would always err on the side of caution. If you have any concerns, bring it up. If you do receive a diagnosis and you receive recommendations for interventions, follow through with those interventions, and that is going to give your child the opportunity to have the best outcomes.

Host: Dr. Gibson, thank you very much for your time today.

Amber Gibson, PhD: Absolutely. It's been a pleasure.

Host: for more information on diagnosing and treating autism or developmental disabilities in kids please visit childrens.com/autism. Thank you for listening to Children's Health Checkup. If you found this episode of our podcast helpful, please rate and review the show, or share the episode with your friends. And please follow Children's Health on your social channels. Thanks for listening.