When one thinks about childhood, we often think of it as the golden age. While that is true, it is also the time of life when the human brain is most active, and neuroplasticity is at its peak. There is a normal expected range of time for achieving each milestone for a baby and these are divided into 4 domains, gross motor milestones (those pertaining to attaining control of the body such as sitting, standing and walking), those pertaining to fine motor skills which also involves vision and co-ordination, those pertaining to speech, which in turn references cognition as well as hearing and finally, the social domain which is often lastly placed but is very crucial. The overall aim is also to maintain the sequence of developmental progression. 

Any abnormal delay in these milestones should be a cause for concern, to see if course correction to help the child with early interventions is possible. A good example is a child of two years of age who is very physically agile and thought to be naughty and full of energy, but unable to have meaningful social interactions with peers and those around them. This could be an early sign of being at risk for a social communication disorder such as autism. 

Why is it important to identify these developmental delays or deviations early? Because we can introduce early interventions, harness the brain’s neuroplasticity and even normalise the child in most situations. In all cases, one would be able to improve the child, if we intervened earlier. But this requires increased awareness among all of us caring for young children and watching out for signs such as: Does the infant have adequate eye contact? Is the child too friendly and without any sense of reserve with strangers? Does the child get distressed by new situations and challenges and how does he or she deal with such challenges? Do they react with melt downs because of sensory overload? These are a cry of help from our children and if we pick them up early, they can often be averted and managed well. These children would often require further analysis to look for underlying conditions by trained paediatric neurologists whilst side by side they also need requisite assessments to discover their functional capabilities by a trained developmental paediatrician and their team of early interventionists. This will then help us determine the child’s strengths overcome their weaknesses. This requires the working together of multiple specialists, but the result is always gratifying and satisfactory. Hence any deviations from the normal schedule of development, especially its trajectory should always be taken seriously as there is always an underlying cause for this. A simple symptom like toe walking in a child is never isolated and often means either a sensory symptom which is the harbinger of social communication issues or is suggestive of a neuromuscular condition. Hence a delay or change in the pattern of development always requires referral to a specialist. Another example is sudden poor academic performance or worsening academic performance in a previously otherwise well child. This often means that there is an underlying cause such as either a condition that affected the cognitive functioning of the brain of the child such as subclinical seizures or in certain cases, emotional issues with the child that might have gone undetected till then.