Baby's fourth month: delayed development
It may be reassuring to know that there is a very wide range in what is considered 'normal' in how babies and children grow and develop.
Your baby's doctor will be able to determine if your baby’s development is delayed by conducting ongoing measurements and noting deviations from this pattern. Many parents worry that their baby’s development may not be on track for averages but all babies are different. In most instances, babies reach each developmental milestones like rolling over, sitting, walking, and talking right around the expected time, and if they don't they catch up soon.
On the other hand, spotting potential problems sooner rather than later is important if your baby does have a genuine developmental delay, in one or more areas, such as gross and fine motor skills (such as sitting up and grasping and manipulating objects); communication and language skills (both "receptive," which relates to understanding, as well as "expressive," which relates to speaking); self-help skills (like toilet training and dressing); and social skills (such as making eye contact and playing with others). There is always a natural progression for skills whereby simpler skills need to be reached before the more complex skills can be learned, such as learning to crawl before walking.
Even if children have developmental problems, loving parenting, early treatment, and the right opportunities to learn, can make a huge difference to how they cope as they grow up.
By having an idea of the standard times that cognitive and physical skills are usually acquired, you will be able to notice when your baby is lagging. Some signs that your baby may not be meeting his normal motor milestones include not being able to bring his hands together by 4 months, not rolling over by 6 months, having head lag when pulled to a sitting position after 6 months, not sitting by himself without support by 8 months, not crawling by 12 months, and not walking by 15 months. If this is the case you should notify your doctor as soon as possible.
Premature babies will almost always take slightly longer to learn things and most doctors assess a pre-term child's development against the time he should have been born (his due date rather than his actual birth date) for this reason.
Sometimes delayed development has a medical cause, such as complications of a premature birth or a genetic condition like Down syndrome. Or it could be the result of a serious illness or accident. Speech and language delay might stem from a hearing impairment or a problem with the larynx, throat, or nasal or oral cavity. Difficulties with communicative intent might be related to a problem with the central nervous system. If a child is far behind other children in development, this may be called an intellectual disability. Sometimes doctors cannot find a cause though and further research needs to be done for better diagnosis.
It may be reassuring to know that there is a very wide range in what is considered 'normal' in how babies and children grow
and develop. At first children often have 'spurts' of learning, like growth spurts, where they seem to be learning something new every day. Then a period of 'marking time' can follow where they absorb their new skill and practice it. There can even be some minor regression if children are under some emotional stress or are unwell or are working hard at learning another new skill. This is why comparing your baby or child with another is not the best way to get answers.
Even if children have developmental problems, loving parenting, early treatment, and the right opportunities to learn, can make a huge difference to how they cope as they grow up. There are many early intervention resources and programs that cater to individual development problems such as assistive technology, audiology or hearing services, counselling, educational programs, nutrition services, occupational therapy, physical therapy, psychological services and speech pathology and language services.
If you have concerns discuss the issue in our Premature Babies forum, or our Babies & Children with Disabilities and Special Needs forum.