Developmental disorders in children and teenagers

Developmental disorders can occur in the following three areas:

• Speech
• Motor skills
• Learning ability (reading, writing and math)

Children can also have problems in more than one of these areas.

Children with these types of developmental disorder are just as intelligent as other children. Usually, they only have difficulties in one area – like math, for instance.

Developmental disorders are mainly linked to problems in the development of certain parts of the brain. Genes play a key role in the development of a child’s nervous system. Complications during pregnancy or birth (premature birth, for example) can sometimes increase the risk of developmental disorders, but they’re rarely a factor.

A developmental disorder isn’t a mental disability, nor is it a sign of a mental illness or nervous system disorder. Environmental factors such as a lack of support at home or poor teaching at school don't have any influence, either. However, the child’s family, kindergarten and school can influence how the disorder develops and how much the child suffers as a result of their impairments.

Difficult social or family circumstances don’t cause these types of disorder either. Children who grow up in stable environments can have them too. So the fact that they occur doesn’t mean the parents have done anything fundamentally wrong.

It’s estimated that roughly 5 to 8% of children have a developmental disorder. They are more common in boys than in girls.

Development disorders usually start from around the age of two years. However, the point at which they become noticeable depends on the type of disorder. Speech problems often become evident at age two or three. Initial signs of motor skill problems can show up between the ages of three and five but a diagnosis shouldn’t be made before the child turns five. Problems with reading, writing and math tend to become apparent in the first few months at school and they’re often diagnosed in second grade.

Developmental problems in small children often disappear after a while because some children simply develop a little more slowly than others. If a child over the age of three still has a speech disorder or a child over the age of five still has motor skill problems, they’re likely to become long-term issues. Some deficiencies can still make life difficult even in adulthood despite treatment. However, the problems can be reduced during infancy and adolescence with the help of special support.

The effects of a development disorder depend greatly on the type of disorder and how severe it is. For instance, a minor motor skills disorder has significantly fewer consequences than a full-blown reading and writing deficiency.

Developmental disorders can affect a child’s self-esteem. The child senses there are certain things they can’t do as well as other children and sometimes feels overwhelmed. Other children or the child’s own parents might also make them feel there’s something wrong with them. Often, the parents also feel overwhelmed.

Some children with development disorders are more irritable and restless than others and have more trouble concentrating. Often, they’re also more impulsive and have more behavioral issues. They also give up more easily or avoid doing things they find hard. Many have difficulty making friends with other children and maintaining those friendships, especially if they’re teased or excluded from certain activities. Developmental disorders can also increase the risk of mental health problems such as anxiety or depression.

Some young people have problems getting a school-leaving qualification or finding their feet at work later on. Their qualifications don’t always reflect their actual abilities.

It is not always easy to determine whether a child actually has a development disorder or is just developing more slowly or differently in certain areas than other children.

On the other hand, it’s important to detect any real problems and take them seriously. So a thorough examination is essential if there’s reason to suspect that a child has a developmental disorder. This type of examination can be done at:

• a specialized pediatric practice,
• a special practice for speech and voice disorders or hearing disorders in children or a speech therapy practice,
• a psychiatry or psychotherapy practice specialized in treating children and teenagers,
• a center for social pediatrics (sozialpädiatrisches Zentrum, SPZ).

As well as looking at the specific problem the child has, these doctors and health care specialists check his or her overall physical and mental development. They also use special speech, motor skills, reading or writing tests as a diagnostic aid. In addition, they perform various neurological and psychological tests and a sight and hearing test to rule out the possibility of development being delayed due to physical or mental illness.

The parents, and sometimes teachers or other people close to the child, are included in the diagnostic process. Another important aspect is the extent to which the child’s difficulties cause problems in his/her day-to-day life and family life and how much he/she is suffering personally.

Performance-based tests and psychological examinations are never totally accurate. This is especially true with children because the test results can depend on how they were feeling, how well they cooperated or whether they felt under pressure. So it’s even more important that they’re performed by experienced experts and in a suitable environment. There are usually no major problems then.

As a general rule, a child should only be diagnosed with a developmental disorder if certain abilities are significantly less developed than expected for his/her age and if the problems can’t be resolved quickly with a little more support. In addition, the child should have had the problems for some time.

The child development check-ups carried out by pediatricians and family doctors in Germany can reveal possible developmental disorders and their effects at an early stage. They are also intended to track the child’s overall development. The “U1” to “U9” check-ups are for children up to the age of six. There is also a check-up for teenagers between the ages of 12 and 14 (“J1”). Some health insurers also pay for the J2 check-up, which is for young people between the ages of 16 and 17.

Many pediatricians also offer additional development check-ups for children aged between 7 and 10 (“U10” and “U11”). These are intended to detect any persistent learning difficulties. Most health insurers pay for these check-ups but sometimes you have to pay yourself.

Developmental disorders can also be revealed in the medical check done when a child starts school in Germany.

If developmental problems become apparent at home, kindergarten or school, it makes sense to consult your pediatrician or ask the kindergarten or school for advice.

The form of treatment that makes most sense depends on the precise difficulties the child has, how severe they are and the extent to which they have a negative impact on the child’s life. If they’re only having a minor impact, support from the parents is often enough to help. This can take the form of playing sports together or helping the child train certain abilities through suitable games, arts and crafts or by reading aloud.

However, if the problems persist and are having a major detrimental impact on the child, additional support is necessary. It is important to get detailed advice, looking at questions such as: How can the family ensure a good atmosphere at home? How can the parents support the child in day-to-day life? How can they and other people close to them boost the child’s self-esteem? What can they expect the child to do and what can they insist on?

Support and treatment for children with motor, speech or learning development disorders can take the following forms:

• Speech therapy
• Occupational therapy
• Physiotherapy
• Special education interventions (“Heilpädagogik”)
• Psychological/psychotherapeutic interventions
• Specialized support that combines psychological, educational and physical interventions (“Motopädie”)
• Exercises to improve fine motor skills (handwriting skills)
• Reading, writing and math training

The important thing is to ensure the treatment goals are realistic and don’t overwhelm the child. Treatment should provide the support the child needs, in small doses and without creating additional stress. Expectations that are pitched too high can result in disappointment and conflict.

Treatment can often last months or even several years. Although it can’t guarantee all the problems will disappear, it can improve the child’s chances of being able to compensate for any deficiencies or at least lessen their impact.

Some treatments and forms of support are covered by the statutory health insurers but sometimes you’ll have to pay for them. The local youth welfare service (“Jugendamt”) can pay for some types of intervention, such as learning therapy.

At school, it’s also possible to have the child’s learning impairments taken into account in any academic assessments or examinations. Further information on the types of support available can be obtained from the Federal Centre for Health Education (BZgA).

When people are ill or need medical advice, they usually go to see their family doctor or pediatrician first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.