Global Developmental Delay (GDD)

Global developmental delay (GDD) is defined as a significant delay in two or more developmental domains (gross motor/fine motor, cognitive, speech/language, personal/social, activities of daily living) in children less than 5 years old. Global developmental delay (GDD) affects 1%–3% of the population of children under 5 years of age.

Feeding and Nutrition: What You Need to Know 

Feeding problems are associated with developmental delays because both might be contributed by underlying neurological problems.

A child with GDD may

• Drool
• Cough when eating or drinking
• Have difficulty chewing solids 
• Reject certain food tastes or textures 
• Hold food in mouth
• Have insufficient weight gain 

Ways to support challenges with mealtimes and nutrition include 

• Adjusting and/or supporting the posture during mealtimes  
• Modifying food textures and/or fluid consistency 
• Pacing feeding 
• Speech therapy to improve and develop oral motor skills
• Diet modification to optimise nutrition 

 

Speech therapists can support your child’s chewing and feeding development and reduce risks of choking. A dietitian can help optimise your child’s nutrition.

How Global Developmental Delay (GDD) Affects Speech Development 

Speech and language delay is often one of the first few signs in a child with GDD. Children with GDD present with co-occurring delays in other areas (e.g. in cognition, social skills), adding further potential challenges to their learning. 

A child with GDD may present with

• Late talking
• Fewer words compared to peers of similar age
• Difficulty understanding spoken language 
• Unclear speech 

Ways to support speech and language development in children with GDD include

• Explicit teaching of language (e.g. vocabulary, sentence structure, grammar) to improve your child’s understanding and expression
• Speech therapy to target pronunciation of specific sounds that your child is having difficulties with
• Introduction of Augmentative and Alternative Communication (AAC) (e.g. use of pictures, objects, signs, speech generating devices) to give your child a mode of communication

A speech therapist can provide direct therapy and work with you to support your child’s speech and language development. 

Movement and Motor Skill Challenges 

Many children with GDD have delays in their motor development.

A child with GDD may present with

• Late sitting, crawling, and/or walking
• Abnormal muscle tone (e.g. too stiff, or too floppy) 

• Difficulty with balance and coordination 

• Decreased strength 

• Difficulty with manipulating objects

Ways to support the motor development of children with GDD include

• Exercises to target improvement of strength, balance and coordination
• Use of assistive/adaptive devices such as walkers, braces, splints, specialized feeding utensils, and pencil grips to support daily activities 

Physiotherapy and occupational therapy can benefit children with GDD, in supporting their motor development.

Supporting Your Child’s Development 

GDD refers to general delays that cannot be more specifically identified due to the child’s age. A child with GDD should be reassessed as they become older to obtain a more specific diagnosis.

To support your child’s communication at home, you can 

• Talk at your child’s eye level  
• Talk about your child’s interest 
• Give your child time to talk 
• Talk slowly to help your child imitate your speech more clearly 

 

To support your child’s motor development at home, you can 

• Provide safe spaces to practise (e.g. crawling, standing, etc)
• Engage in activities that are useful for developing fine motor skills, such as play-doh, squeezing clothes pegs, slotting coins into a piggy bank.  
• Create opportunities for your child to practise self-help skills, such as self-feeding, dressing and undressing, toothbrushing 

 

To support your child’s feeding at home, you can 

• Create positive mealtime experiences, e.g. eating as a family 
• Reduce distractions during mealtimes, e.g. removing screentime  
• Expose your child to a variety of tastes and textures (while being mindful of what your child can cope with without choking) 

Reference

Choo YY, Agarwal P, How CH, Yeleswarapu SP. Developmental delay: identification and management at primary care level. Singapore Med J. 2019 Mar;60(3):119-123. doi: 10.11622/smedj.2019025. PMID: 30997518; PMCID: PMC6441684.

Putnick DL, Bell EM, Ghassabian A, Robinson SL, Sundaram R, Yeung E. Feeding Problems as an Indicator of Developmental Delay in Early Childhood. J Pediatr. 2022 Mar;242:184-191.e5. doi: 10.1016/j.jpeds.2021.11.010. Epub 2021 Nov 11. PMID: 34774577; PMCID: PMC8882156.