Diagnosis and Interventions for Developmental Disorders

This disorder is usually first noticed when a child has difficulty producing speech sounds expected for their age. Parents and teachers may observe that the child:

• Has unclear or hard-to-understand speech.
• Leaves out, substitutes, or distorts sounds.
• Struggles more than peers in being understood, even though they hear normally and understand language.

A child suspected of having a speech disorder is referred to a trained professional—such as a pediatrician, developmental pediatrician, neurologist, psychologists, and speech and language therapist (SLT). The process involves:

• Taking a detailed history from parents about development and communication.
• Observing the child's speech during play and conversation.
• Testing how the child produces sounds and words.
• Using standardized assessment tools where available.
• Reports from teachers and caregivers about functioning in daily life.
• Ruling out hearing problems or broader developmental conditions.

• Speech therapy: Children benefit from regular therapy sessions that use play, repetition, and structured exercises to improve sound production.
• Parent involvement: Parents are guided on how to practice speech at home through everyday activities (storytelling, songs, games).
• School support: Teachers can give extra time, encourage participation, and work with therapists to reinforce skills in class.
• Community awareness: Reducing stigma and encouraging early help- seeking ensures children get support as soon as possible.
• Medical Care: Some children may need medical treatment (e.g., for ADHD, epilepsy, or cerebral palsy), available in the bigger hospitals.

• Global Developmental Delay (GDD): When a young child (usually under 5 years) shows significant delays in two or more areas of development—such as speech, motor skills, learning, or social interaction.
• Intellectual Disability (ID): Diagnosed in older children when there are persistent difficulties with learning, problem-solving, and daily life skills, often measured through standardized assessments.

Parents, teachers, or health workers may notice that a child:

• Learns skills later than peers.
• Struggles with understanding, memory, or following instructions.
• Has difficulty with social interaction, communication, or independence.
• Needs extra help to do tasks that other children their age can manage.

• History and observation: Developmental history from parents, plus direct observation of how the child plays, communicates, and learns.
• Developmental checklists and screening tools: Used by health workers, teachers, or therapists to measure milestones.
• Formal developmental assessment: Conducted by pediatricians, developmental pediatricians, neurologists, psychologists, psychiatrists, and therapists, to evaluate cognitive, speech, motor, and adaptive skills.
• Medical investigations: Hearing and vision tests, or medical exams to check for the underlying conditions are needed.

• Family support: Parents are trained in using routines, play, and daily activities to encourage development.
• Early intervention: Therapy services (speech, occupational, physiotherapy) help children build daily living and communication skills.
• School-Based support: Placement in inclusive or special education settings with individualized learning plans.
• Medical and social services: Treatment of associated health conditions, disability registration, and linkage to social support (e.g., cash transfer programs in Kenya).
• Community inclusion: Parent support groups, NGOs, and faith-based organizations provide advocacy and resources to reduce stigma and promote acceptance.

ASD is a condition that affects how children learn, communicate, and relate with others. Children with autism may develop differently from their peers - they might:

• Find it harder to talk or understand language.
• Prefer routines and repeat certain behaviors.
• Enjoy playing in their own way, sometimes differently from other children.

Every child with autism is unique - some may have mild challenges, while others may need more support. With early intervention, family involvement, and understanding, children with autism can learn, build on their strengths, and thrive at home, in school, and in the community.

Early identification of autism typically relies on:

• Caregiver concerns
• Teacher observations
• Standardized developmental checklists.
• ADOS-2 and ADIR-R are autism specific standardized assessments that can be done by trained professional only.
• In low-resource contexts, community health workers and educators may also play a critical role in recognizing these children due to the limited number of specialists.

Diagnosis of Autism is made primarily through clinical assessment, involving:

• Developmental history and caregiver interviews,
• Structured behavioral observations: - can be done by specialists such as pediatricians, developmental pediatricians, neurologists, psychiatrists, psychologists and aligned professionals.
• Where access to these multidisciplinary teams is limited, trained clinicians adapt existing diagnostic frameworks (such as DSM-5 or ICD-11) to the local context, often with input from parents and teachers.
• ADOS-2 and ADIR-R are autism specific standardized assessments that can be done by trained professional only.

Management focuses on evidence-based, cost-effective interventions. Strategies include:

• Parent-mediated interventions that equip families to support communication, social interaction, and daily living skills at home.
• Early intervention services, include occupational therapy, speech therapy, behavioral therapy, physiotherapy, and nutrition support as needed.
• Task-shifting approaches, where community workers and teachers are trained to deliver structured play, communication, and behavior support activities.
• School-based inclusion, through teacher training and adapted learning environments.
• Community support systems, including parent support groups and NGO partnerships, to reduce stigma and enhance access to resources.

ADHD is a condition that affects how a child pays attention, controls energy levels, and manages impulses. A child with ADHD may:

• Have trouble focusing or finishing tasks.
• Be very active or restless.
• Act quickly without thinking.

These behaviors are not the child's fault - they come from differences in how the brain develops and works. With guidance, support at home and school, and sometimes medical care, children with ADHD can learn strategies to manage their energy, focus better, and succeed in daily life.

Children are often first flagged for possible ADHD when parents or teachers notice persistent challenges with attention, hyperactivity, or impulsivity. Simple screening tools such as checklists and questionnaires (e.g., adapted versions of the Vanderbilt or Conners scales) are used in schools, clinics, or by community health workers. Teacher and caregiver reports are especially important where specialist access is limited.

Formal assessment is usually carried out by a pediatricians, developmental pediatricians, neurologists, psychiatrist, psychologist, or trained clinicians. This process includes:

• A detailed developmental and medical history.
• Observation of the child's behavior in different settings (home and school).
• Input from teachers and parents using standardized rating scales.
• Exclusion of other medical, neurological, or learning conditions that may mimic ADHD.

Management often focuses on practical, community-based strategies, including:

• Parent and teacher training on behavior management techniques, structured routines, and positive reinforcement.
• Early intervention services, include occupational therapy, speech therapy, behavioral therapy, physiotherapy, and nutrition support as needed.
• School support through individualized learning strategies and classroom adjustments.
• Community and peer support groups to reduce stigma and provide guidance to families.
• Medication (such as stimulants or non-stimulants) is available in urban centers under specialist supervision, though access remains limited in rural areas.

Learning difficulties are challenges a child may face in acquiring basic academic skills such as reading, writing, spelling, or mathematics. They are not caused by low intelligence, poor teaching, or lack of opportunity, but by differences in the way the brain processes information. Children with ADHD may face learning difficulties. A child with a learning disorder may:

• Struggle to read fluently (dyslexia).
• Find writing or spelling very hard (dysgraphia).
• Have difficulty with numbers and calculations (dyscalculia).

With the right teaching methods, patience, and support at home and school, children with learning disorders can succeed and reach their full potential.

• Observation and screening: Teachers and parents often notice children struggling with literacy or numeracy compared to peers.
• Educational assessments: Done by the Kenya institute of Special education, Special Needs Education teachers, and Education Assessment and Resource Centres (EARCs) conduct structured assessments to identify specific difficulties.
• Clinical Assessments: Psychologists or educational specialists may use standardized tests (where available) to evaluate reading, writing, and cognitive skills.
• Multi-source information: Diagnosis relies on combining reports from parents, clinical assessment to rule out vision, hearing, emotional issues, or coexisting developmental disorders, the teachers' assessments.

• Classroom support: Teachers can provide individualized learning plans, extra time, simplified instructions, and the use of teaching aids.
• Remedial education: Focused support sessions targeting reading, writing, or math using structured, multi-sensory methods.
• Family involvement: Parents are guided on how to support learning at home through reading, play, and practice in daily activities.
• Therapy services: Speech-language therapists and educational psychologists (where available) provide specialized interventions.
• Inclusive education: The Competency-Based Curriculum (CBC) in Kenya emphasizes adaptations to accommodate children with diverse learning needs.
• Community and NGO programs: Organizations often provide teacher training, low-cost learning resources, and peer-support for families.