Is My Child Developing Well?

What is typical development for a preschooler?

A preschooler enjoys exploring the world through jumping, running, and playing. They learn to do many tasks independently, such as feeding and dressing themselves, and may prefer to use the toilet alone. In terms of speech and language, they progress from speaking in short phrases to forming longer, more detailed sentences. Socially, they become more aware of their environment and learn to interact with others, building relationships with family members and peers. 

How to support your child's development?

• Ensure your child's safety while they explore the world around them.
• Provide a well-balanced diet, sufficient sleep and regular physical activity.
• Use screen time only with supervision and active engagement.
• Involve your child in household chores.
• Set clear and consistent boundaries, using non-hurtful discipline when needed.
• Support your child in forming and maintaining friendships.
• Encourage sharing and taking turns.
• Help your child discover their strengths and interests.

What Is a Developmental Delay?

The term "developmental delay" refers to a child who is slower in achieving developmental milestones compared to other children of the same age.

What Is a Developmental Disability?

According to the Centers for Disease Control and Prevention (CDC), developmental disabilities are a group of conditions caused by impairments in physical, learning, language, or behavioural abilities. These conditions typically emerge in early childhood and can affect movement, communication, thinking, learning, and behaviour throughout life.

Common development disabilities in children include:

• Autism spectrum disorder (ASD)
• Attention deficit hyperactivity disorder (ADHD)
• Dyslexia

It is important for parents to understand typical child development and recognise any concerns early. Early intervention can help maximise a child’s potential and improve long-term outcomes. 

Autism Spectrum Disorder (ASD)

Children with autism spectrum disorder (ASD) have difficulties in social communication and have repetitive patterns of behaviour. They may also have unusual interests and may process sensory information (e.g. how things look, smell, taste, sound, feel etc) differently.

Here are some red flags, which may suggest ASD:

Reference: http://www.cdc.gov/ncbddd/autism/signs.html

If you have any concerns that your child may have ASD, discuss these with your child's doctor as early intervention is crucial for your child's optimal development.  

Attention Deficit Hyperactivity Disorder (ADHD)

Children with attention deficit hyperactivity disorder may struggle with paying attention, controlling their impulses, or may be overly active compared to other children of the same age.

A child with ADHD may:

• Have difficulty focusing on task
• Seem forgetful
• Be unable to sit through games, stories, and circle time in school
• Constantly ask questions but rush off before receiving an answer
• Struggle to wait for their turn and interrupt others during conversations
• Be constantly on the go, stopping only to collapse from exhaustion 
• Knock into objects and people or climb and jump off furniture
• Have frequent injuries
• Fail to meet academic and social expectations in school 
• Have difficulty verbalising organised and focused responses to the teacher's questions
•  Frequently misplace their belongings

Excessive screen time exposure and insufficient sleep can lead in poor attention, difficulty controlling impulses, and hyperactivity. These symptoms may resemble those seen in ADHD. For more information, refer to our Healthhub resources on sleep and screen time exposure in children.

If despite ensuring healthy screen time exposure and sufficient sleep, your child continues to show these behavioural concerns, consult with your child's doctor.

Dyslexia

Dyslexia, or specific learning disorder with impairment in reading, is a language-based learning disability. Children with dyslexia have difficulties in reading, spelling and writing. There is an unexpected gap between a child's potential for learning and his or her academic achievement. It is not caused by vision problems or intellectual disability.

Common symptoms of dyslexia include:

• Difficulties in acquiring and using language
• Difficulties in reading, spelling
• Writing letters in the wrong order
• Difficulty learning the names of letters or sounds in the alphabet
• Difficulty in identifying and/or discriminating sounds in words
• Confusion with similar letters such as "b" and "d", "p" and "q"
• Confusion of words that look alike such as "on" and "no", "was" and "saw", "there" and "three"
• Confusion with concepts relating to directions such as "left" and "right", "before" and "after"
• Difficulty organising spoken and written language

If you are concerned that your child may have some symptoms suggestive of dyslexia or other learning difficulties, discuss these concerns with your child's doctor. While a formal dyslexia assessment can only be done after a child is 6-7 years old, younger at-risk children can receive appropriate intervention without the formal diagnosis. 

How to Seek Help

You are encouraged to bring your child to your family doctor, doctor at the polyclinic or your child's paediatrician for a developmental assessment.

It will be helpful to speak to your child's other caregivers (if any) and preschool teachers (if your child attends school), to understand your child's behaviours, learning and function in different settings.

The doctor may refer your child to one of the following for further evaluation:

For children who are not yet in primary school

• Child Development Unit, National University Hospital (NUH)
• Department of Child Development, KKH 
• Private paediatricians/ child psychiatrists/ psychologists

For children in primary school

• Child Guidance Clinic 
• Department of Psychological Medicine, NUH
• Private paediatricians/ child psychiatrists/ psychologists

Disclaimer: The information provided in this article is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any treatment or if you have any questions related to your health, physical fitness or medical condition.