How do I know if my child is growing ‘normally’?

Becoming a parent is kind of like a roller-coaster ride – there are ups and downs, and you never quite know what’s round the bend. It’s hard enough coping with a baby’s needs, but at times there is a further complication when your baby does not grow in the ‘right’ way – that is to say, the way that most other children of his/her age do. You might have noticed the difference yourselves or maybe an elder or a friend of the family observed it.

It helps, at such times, to have information on the so-called normal development pattern for a baby. The first thing you need to know, in such a situation, is that normal development covers a wide range of behaviours that can be learnt over a broad period of time. So, how do you decide whether your baby is within this range or not?

The first three to four years of life are responsible for a phenomenal amount of growth and changes – the baby learns to balance her head, crawl, walk and masters the simple rudiments of language and social behaviour, like smiling and greeting… to name just a few. These, as mentioned earlier can happen at any point on a continuum of possible time. So, for example, a baby learns to smile on seeing someone anytime between the first and fourth month, stands with help from furniture between 7 ½ months to a year, and would be able to say simple, one-word communications like ‘mama’ between 10 months to 1 ½ years.

So, as you see, there is a lot of time where some kids may pick up certain things earlier, while others do so later, but still within the acceptable limit. Your paediatrician would be the first person to notice and alert you if things are not going according to this schedule, if you’ve been regular with your visits.
Some warning signs that you need to look out for in a child between 1 and 6 years of age:

  • A significant delay in basic milestones, like smiling in response to someone, walking, talking and/or indicating basic needs like hunger, thirst, pain, and toilet-training. By significant, we mean more than 2-3 months above the normal variation (you can check with your paediatrician on the limits for individual milestones).
  • Less interest in the surroundings and in interacting with others – it may be harder to gain the attention of your baby or engage him/her with toys or with your voice and facial expressions.
  • Slowness in picking up word sounds, or in using them with others as a means of conveying his/her needs. The child may also be unable to recognise names of family members without the use of pointing or may be unable to carry out simple instructions like “Come here” or “Put that on the table”.
  • Difficulty in pronouncing words or being understood by non-family members, either because of their pronunciation or because they speak with an inconsistent, fast tone.
  • The absence of single words (like Mama, bye, hello) by the age of 2 years, or of two-word phrases like “want water”, “come here”, etc. by the age of 3 years.
  • Unusual clumsiness or uncoordinated movements – although s/he may be able to walk/ run, s/he may be prone to more accidents because of poor balance, and may have learnt how to walk, dress, etc. later than most children, and may require your assistance even then.
  • A dislike of being touched or cuddled, or a baby who prefers to lie in the cradle and watch a mobile rather than the mother’s face.
  • No sign of recognition of family members, or interest in other children – this is something common in very young babies (younger than 6 months), but should change beyond that age.
  • The baby may not look at you directly, or may address his/her needs by moving your arm or leg as if it were a separate object.
  • Repetition of certain actions or words without meaning; like spinning around for minutes on end without it being part of a play activity. The child may also repeat things that you say without any sense of its meaning. For example, s/he may respond to “What is your name?” with “What is your name?” and regard that as an answer.
  • An excessive need for things to be exactly the same in the house. For example, a young child may have a prolonged tantrum because a window that used to be kept open in summer was shut for the monsoons.
  • The presence of any kind of fits or seizures – this could range from the baby’s loss of control over limbs, frothing at the mouth, incontinence, or just a brief period of non-responsiveness to you, followed by normal behaviour.
  • Some children have great difficulty in remaining in one place or in continuing an activity till it is completed. They may also keep moving around or jumping about and may not be able to stop themselves from doing something, even if it is not appropriate for the situation. E.g., a boy might press the doorbell repeatedly even though he knows he has been heard, simply because it is in front of him.

The behaviours described above are some of the characteristics of disorders that begin at birth and affect the child’s development, like Autism, Mental Retardation, Attention Deficit Hyperactive Disorder (ADHD), Epilepsy and Speech and Language Disorders. It is not necessary that all these behaviours would be present in the same child. At the same time, it often happens that a child may have more than one syndrome or illness.

If you pick up certain signs of your child’s behaviour being markedly different from others of his/her age, you need to consult a clinical psychologist or a child psychologist at the earliest, because often, early intervention can go a long way in reducing the extent or nature of the problem. Therefore, if you feel that your pre-schooler has shown any one or more of the signs given above, it is essential that you get a screening done by a mental health professional. It would be wonderful if there were nothing the matter; but in case there is, the expert would be able to guide you about what to expect further, what steps you can take at home to help your child, and what kind of options are available for further intervention. Also, in order to be able to care for the child in the best possible way, you may need some support and a space to share your feelings and thoughts as well. TalkItOver can help you with the assessment of these disorders and with their interventions.

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About Gayatri Swaminathan

Gayatri Swaminathan is a clinical psychologist with 7 years of practical experience in the field. She has worked as a trauma counsellor, a qualitative market researcher, lecturer and private practioner. She has an M. Phil in Clinical Psychology and M.A. in Applied Psychology from Delhi University and B.A. (Psychology, Sociology, English Literature) from Bangalore University. She is trained primarily in the cognitive-behavioural approach, but also incorporates other schools of therapy and techniques as and when needed. She works with individual adults, couples, children and adolescents and their families.