Developmental Domains

There are five areas of development that are looked at during a multidisciplinary evaluation.  These are communication, cognitive, physical, social-emotional, and adaptive development. Below are the NYS Early Intervention Program's descriptions of each:

Communication Development

Communication development involves the overall developmental progress in young children in acquiring the ability to comprehend and produce messages that allow them to understand and interact with the social world. Communication development typically progresses from the development of gestural and social pre-linguistic communication to the onset of first words and production and use of language. Children who experience delays in the acquisition of speech and language skills usually follow a typical pattern of development but at a slower rate than children who are not delayed. Marked regression or loss of language can be a sign of a serious underlying medical or neurological problem and may indicate the need for a comprehensive medical, psychological, and audiologic evaluation.

Communication disorders are impairments in the ability to receive, send, process, and comprehend concepts or verbal, non-verbal, and graphic messages. A disorder may be evident in the processes of hearing, language, and/or speech. Individuals may demonstrate one or any combination of these three aspects of communication disorders. Communication disorders in children may be the primary disability or may be secondary to other disabilities.⁶³

Physical Development

Physical development, including hearing and vision, refers to physical changes in childhood, including alterations in body structures and functions. Aspects of physical development include gross and fine motor skills, the degree or quality of the child's motor and sensory development, health status, and physical skills or limitations. In addition, physical development interacts with psychological, behavioral, and social aspects of the developing child. Physical development is typically measured through the use of growth charts and physical indicators (such as height for weight and head circumference); assessment of sensory functioning, including hearing and vision; and, assessment of motor development.

Motor development, as with other areas of development, occurs in an orderly, predictable sequence of events for most children, although the rate and age of motor skill attainment varies from child to child. The process of motor development depends on the maturation of the central nervous system and muscular system. As these systems develop, a child's ability to move progresses. Motor milestones are defined as the major developmental tasks of a period that depend on movement by the muscles. Gross motor development involves skills that require coordination of the large muscle groups (e.g., sitting, walking, rolling, standing, etc.). Fine motor development is concerned with the coordination of smaller muscles of the body, including the hands and face. Fine motor skills use the small muscles of both the hands and the eyes for performance.

Developmental motor disorders are manifested by mild to severe abnormalities of muscle tone, movement, and motor skill acquisition. These include global developmental delays, hypotonia, hypertonia, and mild neuromotor dysfunction. Delays in motor development and clinical indicators of motor disorders or a diagnosis of motor disorders may be associated with delays or impairments in cognitive development.

Cognitive Development

Cognitive development refers to the changes over time in children's thinking, reasoning, use of language, problem solving, and learning, and children's approaches to interaction with their physical and social environments. Components of cognition include intelligence; arousal, orientation, attention, and executive function; memory (short and long term); information processing functions (such as pattern recognition, facial-emotional content, imitation, cause-and-effect associations, processing multiple sources of information simultaneously); representational thought; and reasoning and concept formation (problem solving, language, perspective-taking, social context and rules).

For children age birth through two, cognitive development involves learning to coordinate sensory input with emerging motor skills, development of object permanence, differentiation of self from others, and emergence of representational thought and symbolic play. Cognitive development is often assessed using standardized tests to derive a developmental quotient, mental index, or intelligence quotient. For children under age three, cognitive development is measured using a developmental or mental index. Children who score significantly below average using a standardized test would be considered to have substantial limitations in cognitive functioning.

Cognitive impairments in very young infants and toddlers are generally associated with a diagnosed physical or mental condition with a high probability of resulting in developmental delay (e.g., central nervous system abnormalities, syndromes or conditions, etc.) and include deficits in one or more components of cognition.

Social-Emotional Development

Social-emotional development involves progressive change in the way that children relate to their social world and their ability to differentiate and express emotions and perceive emotional states of other individuals. Social development refers to relating to others; the degree and quality of the child's relationships with parents and caregivers; feelings about self; and, social adjustment to a variety of interactions over time. Emotions reflect an individual's attempt or readiness to establish, maintain, or change the relation between him or herself and his or her environment (e.g., a child who overcomes an obstacle to a goal is likely to experience happiness); emotions become more differentiated as infants develop (e.g., crying behavior differs depending on whether the infant is hungry or angry); and, infants' strategies for regulating their emotions change over time (e.g., responses to distress develop from gaze aversion to self-soothing behaviors).

Children who are experiencing disorders or impairment in social-emotional development may exhibit patterns such as inability to form attachment relationships with caregivers, failure to develop joint-attention skills, perseverative behaviors, etc. Examples of disorders in this area of development may be found in Appendix B, which lists and describes psychiatric disorders that can affect young children. Diagnosed conditions such as those in Appendix B are characterized by qualitative and extreme problems and variations in child behavior and emotional development, in comparison with the "testing" or "trying" behaviors typical of most children in the two-to-three-year-old age group.

Adaptive Development

Adaptive development refers to the development of behaviors and self-help skills that assist children in coping with the natural and social demands of the environment, including sleeping, feeding, mobility, toileting, dressing, and higher-level social interactions. A child who is experiencing delays in adaptive development has difficulty in learning and acquiring these behaviors and skills. Delays in adaptive development may be associated with delays or impairments in other areas of development, including fine and gross motor skills, oral-motor functioning, cognitive development, communication development, and social-emotional development.

For more information please visit the NYS Department of Health's Bureau of Early Intervention's website