The pace of your child's development may be due to factors such as his/her personality or the home environment.

ADHD, dyslexia, autism and other developmental delays

Every child develops at a different pace. Some children learn things earlier, others need more time. The rate of your child's development may be due to factors such as his personality or the home environment.

At some point, you might ask, “How do I know if my child is developing normally?” and you may compare your child’s physical, intellectual and behavioural development to that of your relative or neighbour’s child of the same age.

What is normal development for a pre-schooler?

A pre-schooler likes to explore the world around him by jumping, running and playing. He learns to do many things on his own, like feeding and dressing himself, and may prefer to use the toilet alone. Speech-wise, he progresses from single words to complete sentences. Socially, he will be more aware of his environment and learn how to interact with people and establish relationships with family members and peers.

How to support your child's development?

  • Ensure your child is safe while he is exploring the world around him

  • Ensure a well-balanced diet, sufficient sleep and physical activity

  • Use screen time only with supervision and interaction with you

  • Involve your child in household chores

  • Set clear and consistent boundaries and use non-hurtful discipline when your child misbehaves

  • Support your child as he forms and maintains friendships

  • Encourage your child to share and take turns

  • Help your child discover her strengths and interests

    What is a developmental delay?

    The term “developmental delay” is used to describe a child who is slower to reach developmental milestones than other children in the way he moves, communicates, thinks, learns and behaves. Developmental delays can be temporary or permanent.

    What is a developmental disability?

    Developmental disability is a term that refers to a permanent mental and/or physical impairment that occurs in the early years of life. This disability usually results in the child being affected in the way he moves, communicates, thinks, learns and behaves. Common developmental disabilities that affect children are Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia.

    It is important for parents to be aware of and detect developmental delays and developmental disabilities early, so that the child can receive help on time and maximise his potential in the long run.

    Autism Spectrum Disorder (ASD)

    Children with
    Autism Spectrum Disorder (ASD) have difficulties in communication and have repetitive patterns of behaviour. They may also have unusual interests and may process sensory information (e.g. how things look, smell, taste, sound, feel etc) differently.

    Here are some red flags, which may suggest ASD:



    By 12 months

    Does not respond to name

    By 14 months

    Does not point at objects to show interest

    By 18 months

    Does not pretend play


    • Speech and language delay

    • Avoids eye contact

    • Prefers to be alone

    • Has trouble understanding other people's feelings

    • Has trouble talking about own feelings

    • Repeats words or phrases over and over

    • Gives unrelated answers to questions

    • Gets upset by minor changes

    • Has obsessive interests

    • Makes repetitive movements, eg. flapping hands, rocking, spinning in circles

    • Has unusual reactions to the way things sound, smell, taste, look or feel

    Reference: http://www.cdc.gov/ncbddd/autism/signs.html

If you have any concerns that your child may have ASD, discuss these with your child's doctor as early intervention is crucial for your child's optimal development.

Red flags for attention deficit hyperactivity disorder (ADHD)

Children with 
Attention Deficit Hyperactivity Disorder (ADHD) are over-active and display impulsive and inattentive behaviour. This behaviour is generally more frequent and intense than in other children of the same age.

A child with ADHD may

  • be unable to sit through games, stories, and circle time. He/she may roll around on the floor or crawl under tables

  • constantly asks questions but races off before the answer is given

  • be constantly on the go, stopping only to collapse from exhaustion

  • bang into objects and people, or climb and jump off furniture

  • have frequent injuries often requiring hospitalisation (head injuries, fractures)

  • be seemingly unaware of preschool routines, rules and expectations, even after several months in school

  • fail to meet academic and social expectations at the school

  • has a weak memory

  • has difficulties controlling his/her behaviour

  • has problems understanding the instructional language used in the classroom

  • has problems verbalising organised and focused responses to the teacher’s questions.

Excessive screen time exposure in children and insufficient sleep can result in poor attention, difficulties in controlling impulses and hyperactivity. These symptoms may be similar to those seen in ADHD.

If despite ensuring healthy screen time exposure and sufficient sleep, your child continues to have above behavioural concerns, discuss these concerns with your child's doctor.


Dyslexia is a specific learning disorder with impairment in reading, is a language-based learning disability. Children with dyslexia have difficulties in reading, spelling and writing. There is an unexpected gap between a child's potential for learning and his or her academic achievement. It is not caused by vision problems or intellectual disability. 

Common symptoms of dyslexia include:

• Difficulties in acquiring and using language

• Difficulties in reading, spelling

• Writing letters in the wrong order

• Difficulty learning the names of letters or sounds in the alphabet

• Difficulty in identifying and/or discriminating sounds in words

• Confusion with similar letters such as "b" and "d", "p" and "q"

• Confusion of words that look alike such as "on" and "no", "was" and "saw", "there" and "three"

• Confusion with concepts relating to directions such as "left" and "right", "before" and "after"

• Difficulty organising spoken and written language

If you are concerned that your child may have some symptoms suggestive of dyslexia or other learning difficulties, discuss these concerns with your child's doctor. While a formal dyslexia assessment can only be done after a child is 6-7 years old, younger at-risk children can receive appropriate intervention without the formal diagnosis.

How to seek help

You may wish to speak to your child’s caregivers and preschool teachers to check your observations against different settings.

You might want to find out about your child’s behaviour and learning during lessons, and how your child gets along with his/her classmates.

You are encouraged to bring your child to the family doctor, doctor at the polyclinic or paediatrician for a Developmental Screening Assessment.

The doctor may refer your child to one of the following for further evaluation and follow-up: 

  • Department of Child Development, KKH

  • Child Development Unit, NUH

  • Child Guidance Clinic 

  • Private paediatricians/ child psychiatrists/ psychologists.    

Speaking of Children II: Dr Kenneth Poon on Tips for Managing Children with Developmental Needs

If you notice some anomalies in your child’s development or behaviour and are considering seeking professional help, Dr Kenneth Poon has some useful advice for you. He shares more about the signs to look out for, when early interventions should be carried out and the positive actions you can take to support and guide your little one through.

Speaking of Children II: Dr Kenneth Poon on Self-Care for Parents of Children with Developmental & Special Needs

As you take care of your child with developmental or special needs, it’s just as important that you and your spouse find the space in your day to practise self-care too! Watch on for some self-care tips from Dr Kenneth Poon.

Contributed by:
Health Promotion Board's Parent Hub