Written by the Inclusive Developmental and Therapy Center therapy team · medically reviewed by Dr Muhammad Suffyan, MB BS (GMC 8023727) · Last reviewed July 2026
Global developmental delay (GDD) means a child under five is noticeably behind expected milestones in two or more areas of development at the same time — movement, speech and understanding, thinking and play, social skills, or everyday self-care like feeding and dressing. It is not an illness, and it is not an explanation of what caused it. It is a description, and a signal that your child’s development needs a proper look.
Most parents notice it in ordinary moments rather than in a clinic. He isn’t sitting yet, when his cousin was. She has a handful of words at two, while other children her age are joining words together. In Urdu families it usually comes out as نشوونما میں تاخیر — or simply, bacha der se chal raha hai, abhi theek se bolta nahi. One late milestone on its own is often nothing at all. It is the pattern — several areas behind together — that is worth checking.
At our centre on MPS Road in Model Town, Multan, that check starts with a developmental assessment: a gentle, play-based session that maps which areas are on track and which need help, and sends you home with a plan rather than a label. You don’t need a doctor’s referral or a diagnosis to book one.
Timing matters more here than in almost anything else in childhood. The brain builds connections fastest in the earliest years, so the same amount of therapy usually goes further at two than it does at five. Starting early isn’t about panicking. It is about giving your child the easiest possible version of the work.
Which signs of developmental delay should I look for?
- Movement: not sitting without support by around 9 months, or not walking alone by around 18 months
- Hands: not reaching for or holding objects, and still no scribbling or spoon-holding well past the usual age
- Talking: no babbling by around 12 months, no single words by 18 months, or no two-word phrases by around two and a half
- Understanding: doesn’t turn to their name, or can’t follow a simple instruction like “give me the cup”
- Play: very little pretend play, or playing in a simple, repetitive way for their age
- Social: slow to make eye contact, smile back, point at things, or copy what you do
- Everyday skills: real difficulty with feeding, drinking from a cup, or helping to dress
- Muscle tone that feels floppy or unusually stiff, or movement that looks very clumsy
- Several areas behind at once, rather than one late milestone on its own
- Skills your child once had that have faded or stopped — this one always needs a doctor’s opinion, not a wait-and-see
How do we help children with developmental delay in Multan?
- A developmental assessment first, so we map all five areas instead of guessing at one
- Hearing ruled out early — glue ear and mild hearing loss quietly hold language back and are easy to miss
- Speech and language therapy for understanding first, then talking, led by our founder Mahnoor Baloch, a Speech & Language Therapist and special educator
- Motor, play and daily-living skill work — sitting and walking practice, spoon and cup, dressing, pencil grip — delivered by our special education and ABA team
- Special education with an individualised plan when learning is the area furthest behind
- One coordinated plan across every area, rather than three separate efforts that never meet
- Short home activities you can fit into an ordinary Multan evening, because most of the practice happens with you
- Regular review, so the plan keeps pace with your child instead of the calendar
A delay is not a ceiling. Many children with global developmental delay make large gains, and where there is an underlying condition, finding it early means we plan around it rather than being caught out by it. And if we ever see something that belongs with a doctor — skills fading, unusual stiffness or floppiness, staring spells — we will say so plainly and point you to a paediatrician, even though that means sending you elsewhere.
Picture a two-year-old who is behind on several fronts at once: walking only recently, a handful of words, playing in a simple and repetitive way. Instead of another six months of waiting, an assessment maps all five areas and one plan is built — language work, motor and daily-living practice, and short daily activities his parents do at home. In children like this, the changes tend to arrive in a familiar order: understanding first, then attention, then words, then independence.
An illustrative, general example — not a real child. Every child is unique; the only way to know what yours needs is a proper assessment.What the research tells us
Everything we do is grounded in published research, not just opinion. Here are a few findings from trusted, independent sources:
A 2025 review of early rehabilitation for global developmental delay concluded that early identification and intervention have shown substantial effects on motor skills, cognition, language and socio-emotional skills — and that therapy works best when it is multidisciplinary and family-centred, shaped around the individual child and their circumstances.
— Early rehabilitation interventions for global developmental delay in children: a narrative review, Frontiers in Pediatrics (2025). View sourceA cluster-randomised trial in Pakistan added early child development counselling for mothers — play and stimulation, nutrition and maternal mental health — to routine visits at private clinics in poor urban areas. At twelve months, significantly fewer children in the intervention group had delays in two or more developmental domains than in the control group.
— Is integrated private-clinic based early child development care effective? A clustered randomised trial in Pakistan. BJGP Open (2018). View source
Other areas we help with
Developmental Delay: questions parents ask
Will my child grow out of it, or should we start now?
Some children with global developmental delay do catch up, and some catch up a great deal — but there is no reliable way to tell in advance which children those will be. The earliest years are when the brain learns fastest, so waiting spends exactly the time that helps most. An assessment costs you one visit and tells you whether to act or to relax. Here is why early intervention matters.
Is global developmental delay the same as autism or intellectual disability?
No. Global developmental delay describes what you can see — a child under five who is behind in two or more areas. It does not name a cause. Some children with delay turn out to be autistic, some are later found to have an intellectual disability, and many have neither and simply need a boost. Because it is a description rather than a cause, GDD is normally looked at again around age five, when a clearer picture has emerged.
What causes global developmental delay?
Often no single cause is ever found, and that is a normal result rather than a failed search. Known causes include being born very early or very small, difficulties around birth, hearing loss, genetic conditions such as Down syndrome, and differences in how the brain developed. Your paediatrician is the person who investigates causes; our job is to assess the areas and build the skills. Hearing is always worth ruling out first — see the signs of a hearing problem.
My child was born premature. Do I count from her birthday or her due date?
Use her corrected age until around two years old: subtract the weeks she arrived early from her actual age, and compare her against that. A baby born ten weeks early who is twelve months old is developmentally closer to nine and a half months, and the checklists should be read that way. After about two years, most children are compared on actual age. Our milestone checklists by age work either way.
We speak Urdu and English at home. Is that why he is behind?
No. Growing up with two or three languages does not cause developmental delay and does not slow a child down. The common mistake is counting only the English words. Count everything he says in Urdu, Saraiki, Punjabi and English together — that combined total is his vocabulary. If the combined total is still small, and other areas are behind too, that is the moment to have him checked. More on raising a child in a bilingual home.
What is the first step, and what actually happens at the assessment?
A developmental assessment. It looks like play rather than a test: we watch how your child moves, listens, communicates, solves small problems and manages everyday tasks, and we ask you a lot about home. You leave with a plain-language picture of all five areas, which ones need work, and what to do first. If you would rather start smaller, our free 2-minute milestone check is a good place to begin.
What can I do at home while we wait for an appointment?
A great deal, and it counts. Get down to your child’s eye level and play face to face. Name what he is already doing instead of quizzing him with questions. Leave a clear beat of silence after you speak — most of us fill it far too quickly. Practise one everyday skill a day: spoon, cup, shoes. Our free home support program for developmental delay lays this out week by week.
How soon will we see progress, and what usually changes first?
Understanding tends to move before talking, and attention before either. In the early weeks, parents most often notice their child turning to their name, following a one-step instruction, or staying with an activity a little longer — small things that make the whole day easier. Bigger gains in speech and independence build over months rather than weeks, and we review the plan regularly so it keeps pace with your child.
Worried about your child? Let’s talk.
A short, friendly conversation is the best first step. Call, text or WhatsApp us — we’ll listen and guide you, with no pressure.
MPS Road, Block A Model Town, Multan (near Bloomfield Hall School, Street No. 2) · Mon–Sat, 10 AM – 7 PM