Kids with ‘developmental delay’ will be diverted from the NDIS. But how do you know if your child is delayed?
- Written by Elizabeth Hill, Speech Pathologist and Senior Lecturer, School of Allied Health, Curtin University
From mid-2027, the government will divert children with mild and moderate developmental delay and autism away from the NDIS and onto a program called Thriving Kids.
The government is also considering new Medicare items for allied health services when children need additional support. This may include occupational therapy, speech pathology and psychosocial (psychological and social) therapy.
But what exactly is a developmental delay?
Progressing more slowly than their peers
Developmental delay is a general label for a range of conditions. Developmental refers to something arising during development and delay means a child is progressing in the expected way, just more slowly.
Up to 24% of children are considered “developmentally vulnerable”. This means they haven’t met a key milestone and are at risk in one or more areas, including speech and language, motor skills, thinking and learning, social and emotional development, and everyday life skills.
A child might be delayed in their speech and not speak in sentences by the age of three.
A child might not crawl or walk by around 18 months or may have difficulty using their hands to play with toys or feed themselves.
Thinking skills such as memory and problem-solving may develop more slowly. Or a child might have more trouble controlling their emotions or interacting with parents or siblings than others their age.
Everyday tasks such as dressing, going to the toilet and brushing teeth can also be difficult for children with developmental delay.
It ranges in severity
When a child shows difficulty in one area, it’s called a specific delay.
When multiple areas are impacted, it’s called a global delay. Around 1–3% of children experience global developmental delay.
Developmental delays are usually identified as a result of parental concern, observations at daycare, or during routine milestone checkups by a family GP and/or child health nurse. They’re then confirmed by a GP, paediatrician, or allied health provider.
Delays are described as mild, moderate, or severe. Mild delays occur when a child is developing at less than about one-third of their actual age, moderate between one-third and two-thirds, and severe at less than two-thirds.
In reality, judging severity is complicated. Children’s abilities can vary from day to day. Assessment tools may not fully capture their strengths and needs, especially if the child is shy, tired, or unfamiliar with the environment.
This means severity labels don’t always fully reflect a child’s abilities or the support they require.
Do kids grow out of it?
Some children with developmental delays will “catch up” over time. A child who has had fewer opportunities to hear and use language, for example, may make progress with the right support. Early intervention can be highly effective.
However, a large proportion of children won’t grow out of their difficulties.
The term developmental delay is frequently criticised for failing to recognise that delayed development is often associated with long-term difficulties (not just a lag). And it can be difficult to identify which young children have delays that will improve over time.
Globally, around 15% of children are diagnosed with a developmental disorder: lifelong conditions that affect how they grow and participate in the world.
Developmental disorders include autism spectrum disorder, Down syndrome, intellectual disability, cerebral palsy, attention-deficit hyperactivity disorder (ADHD), specific learning disorders (for example, dyslexia), and developmental language disorder, which impacts a child’s ability to use and understand language.
If a child is still having difficulties by the time they are four or five, they may meet the criteria for a developmental disorder.
How should children be supported?
Whether a child has a developmental delay or disorder, research shows a strong link between early support and better outcomes. Support often comes from a team of specialists such as:
occupational therapists. They help children develop skills such as dressing, playing and managing emotions
speech pathologists. They help with feeding and support children to express their wants and needs, and to be understood clearly
physiotherapists. They focus on movement and physical skills, helping children improve their balance, coordination and strength for activities such as walking and playing
psychologists. They implement strategies to help children and families manage difficult behaviours and emotions, and improve daily functioning
audiologists. They assess and support hearing difficulties that can contribute to developmental delays in communication and social skills
specialist teachers in schools and early learning settings. They have extra training and experience in supporting children with additional needs.
Intervention should begin as soon as difficulties are noticed, rather than waiting to see what happens and should be tailored to the needs and preferences of each child and their family.
Therapists work directly with children individually or in small groups, either in clinics, at home, or at daycare or school, where they collaborate with teachers to embed strategies such as visual supports or play-based activities.
This can be combined with helping family members and other professionals (such as teachers) develop the skills to support the child. However, coaching others takes time and training to ensure success.
Therapists also provide advocacy and systems support, helping families navigate services, school and funding pathways to ensure children receive the right help at the right time.
The best outcomes for children with developmental differences, whether delay or disorder, are achieved by a combination of one-on-one as well as systems-level support. It’s important policymakers keep this in mind as they design the Thriving Kids program and new Medicare items.
Authors: Elizabeth Hill, Speech Pathologist and Senior Lecturer, School of Allied Health, Curtin University
