Basic concepts

Development of a baby into a toddler, school-aged child, teenager, and adult is a complex and dynamic process that evolves over time. The timeline is not gradual – it goes through growth spurts, plateaus, setbacks, and more growth spurts.

Growth spurts, plateaus, and regression

A growth spurt is a time of rapid growth or development in a particular area. It is not uncommon to find that growth in one area is accompanied by regression or plateauing in another, as if the child could only handle one advance at a time.

A plateau is when things seem to be at a stand-still. Not to worry, this period is only temporary. It is often marked by a growth spurt in a different area. For instance, a child working on his language skills may show little progress in walking ability. He’ll catch up later.

Regression or setback is the apparent loss of acquired skills, a feeling of “going backwards”. This can happen at times of stressful or life-changing experiences; for example, the birth of a little brother or sister, start of daycare, moving to a new home. Once the child has adapted, things will get better again.

These phases are temporary and all children go through them.

Developmental dissociation, deviance, and delay

While all children undergo setbacks at one time or another, it is important to make a note of delays, dissociations, or deviance from the norm that get gradually worse. These behaviours are often associated or preceded by red flags, which we will talk about later.

Delay is said to occur when developmental milestones in one or more areas are reached later than in most children of the same corrected age. The order of events is the same, however. For example, a 2-year-old may function as a 15-month-old overall.

Dissociation refers to a marked delay in one area as compared to other developmental goalposts. For instance, a 2-year-old child with cerebral palsy may not be able to walk but can combine words into sentences and express himself well.

Deviance occurs when milestones are reached out of sequence. For example, a 4-year-old with autism spectrum disorder may clearly repeat complete sentences, but seemingly without understanding them.