Late bloomers: when to worry

Posted on 28 October 2016

How can you tell if your child is a late bloomer and whether you should be concerned about a possible medical problem? Dr Jonda Kerner, a paediatrician at Panorama Mediclinic, advises on the steps to take if a baby or toddler is showing signs of late talking or walking. 

When can one call it late talking or walking?

For parents, the age their child starts walking or talking can invite nail-biting comparisons with their friends’ children. There is some merit to this concern. Late talking and walking can be a result of one of many medical problems. But this is only true if the child is indeed a late bloomer: a 17-month-old who just started walking or a 2-year-old who begins to put words together is still falling into the normal range.

Here are the main milestones to determine whether your child is a late bloomer:

• Eye contact by 6 weeks: By this age, your baby should start looking at you and following you with their eyes.
• Sitting by 8 months: Babies should be able to sit unsupported between 6 and 8 months of age.
• Walking by 18 months: However, many children walk at around a year.
• Talking (single words) by 18 months: Again, many children start saying words by the age of one.
• Talking (two-word sentences): By the age of two, most children are talking in two-word sentences.
• Clear talking: By the age of three, a stranger should be able to understand what your child is saying. Unclear talking could be a sign of a hearing problem.

Other causes for concern

Clumsy walking: It is hard for parents to differentiate between the clumsy walking of learning and clumsiness caused by an underlying condition. Dr Kerner says while you can accept a certain amount of clumsiness in the beginning when your child is learning to walk, you shouldn’t be ignoring clumsiness when they’ve already been walking for a few months.

Regression: The only time that children should regress or move backwards in their development is in a very mild form when they have a new sibling in the house. As soon as children stop speaking or start having trouble walking, it could be a sign that the brain isn’t developing typically (for example as a result of autism, another cognitive disorder or brain trauma) or it could indicate a number of diseases.

Shyness: Shyness is a factor that parents may think has an impact on the age a child starts talking, but Dr Kerner says shyness is easy to spot. ‘If a child is shy, it means they will speak normally at home or in front of their family but won’t talk in front of strangers. If your child isn’t speaking to you or other family members by the age of two, you should investigate the reasons.’

When children don’t hit their milestones

Not talking: Dr Kerner advises you to consult a paediatrician. ‘The first thing we do is to make sure their hearing is normal. We will then follow a further set of steps if they pass this test. ‘If a child’s speaking is unclear, the paediatrician will refer you to a number of other sub-specialists depending on their diagnosis, including speech therapists or audiologists.’

Not walking: ‘The question is why is the child not walking?’ says Dr Kerner. ‘Paediatricians have to go through a whole host of possible disorders before making a diagnosis. For walking problems, the next step would be to send you and your child to a specialised physiotherapist to help the child perform to the best of their ability. The physiotherapist may then recommend surgery or other therapies depending on the specific condition.’

Don’t delay

Dr Kerner advises parents to have any concerns checked out sooner rather than later. Treatment is proven to be more effective for conditions such as autism or cerebral palsy when started at a young age.

‘You don’t want a child to get to Grade 1 and have to learn how to speak while the other children are already learning to read and write. Speech therapy, for example, could have fixed this problem much earlier on’.

The  most common disorders for late talking and walking usually present on a broad spectrum, so healthcare professionals will determine the severity of the condition. They will then advise on whether the child can be mainstreamed, with the right support, or whether they need to attend a dedicated school and receive more support at home.

Dr Kerner emphasises that the right medical support can positively change the course of a child’s life, giving them opportunities to function to the best of their abilities.