Recognizing Typical Developmental Hurdles in Children with Special Needs

While working in a group home as an undergraduate student, one of my clients was a young man with severe cerebral palsy and moderate developmental delay. He enjoyed engaging in verbal play and acting, such as describing being a firefighter: driving the truck, arriving at the scene and rushing into the building to put out the fire and save lives.

Later in my studies, I came to understand that he was using his imagination to work through a typical teenage behavior of trying on new identities.

It’s one phase in a series of emotional hurdles that all people face. From the terrible twos to adulthood, these phases occur at generally the same age in everybody, and there’s no escaping them.

However, for children with special needs, these hurdles can get lost in the shuffle, leaving the child to deal with them alone. Here are five important developmental phases and thoughts for addressing them with your child.

Infants
The first emotional milestone is early development of trust and self-soothing in babies. It’s characterized by an ability to be comforted by familiar adults, and it comes from simply being held, loved and cared for. But the process can be disrupted in babies born with physical issues that involve pain or frequent medical procedures.

Parents often feel guilt as they hand over their child to a doctor for necessary procedures that will cause short-term pain or trauma, and they feel inadequate when they can’t even soothe their own baby afterward.

Understanding this developmental phase may help those feelings, while helping parents to be intentional about providing physical touch, consistency and predictability in as many ways as possible — even when faced with hospitalizations.

Toddlers
Between 12 and 36 months, children begin to take control of their bodies — doing things like dressing themselves, brushing their own teeth and feeding themselves.

In this “me do it” phase, the child’s mind just won’t settle any longer for being a passive participant in his or her own care. Even if a child has physical limitations that get in the way of self-care, the urge is still there and a child who can’t satisfy it may get frustrated or angry.

Recognizing this, parents and caregivers can look for strategies that give the child a feeling of control. Perhaps it’s letting the child take the top off the toothpaste tube, and pick out his or her outfit — with talk that recognizes the child’s desire and acknowledges even small successes.  

Preschool
By age 4, a child is becoming aware of his or her own identity as an individual, and is noticing differences between one person and another.

All of this can make preschool uncomfortable or scary for children with learning issues or physical differences. They notice when they aren’t able to do things other kids can do. They may feel harshly judged as other children, also noticing differences, ask about their disabilities.

If a child isn’t enjoying school, parents can work with the teacher to develop strategies that acknowledge the child’s social development, and help create feelings of success. Focusing on small things that make a child unique and special can help bolster self-esteem at this stage. Celebrating small victories in big ways builds an inner confidence that will help carry the child through the next steps in development.

Elementary School
Through age 10, children feel pride in learning, and the complexity of their learning blossoms. They gain the ability to transition from work to play and back again. Academics become more rigorous, and their games are increasingly structured and complex.

A child with special needs will recognize where he or she is struggling to keep up — socially, physically or academically. Often, parents avoid talking about it with the child because they don’t want to bring up sad thoughts — but you can be sure the child already recognizes it, and parents can help the child feel like there’s a reason to keep trying.

Helping at this stage starts with being proud and reminding them why they should be proud of themselves. It’s important to recognize the reality of a child’s special needs. But at this age, children also are able to understand that it is only a part of who a person is, and that there are many ways to measure success.

Adolescence
From age 11 or 12 to at least 19 years old, adolescence is about identity formation. It’s an exploration in which children struggle to answer, “Who am I on my own, without my parents?” and “What does my future hold?”

Children with special needs will watch their peers begin things like driving and dating. They want to be independent, too.

This phase may require allowing the child to take some measured risks that he or she is more ready for than you are. Just as a toddler feels a need to dress themselves, an adolescent feels a need to strike out on their own, even if it’s in the company of a trusted aide, or attending a carefully selected overnight camp.

When considering the future, the adolescent should be included in the conversation, and any fears he or she has about the next phase of independence can be worked with slowly — as with any child.

Kimberly Bell, Ph.D., is clinical director at Hanna Perkins Center for Child Development, and the John A. Hadden Professor in Psychoanalytic Development at Case Western Reserve University School of Medicine. Hanna Perkins Center is a non-profit agency offering a range of services that support healthy emotional development in all children.