Is My Child's Development on Track? Milestones Across Every Area and When to Seek Assessment
"Is this normal?" is the single most common question underneath every worry a parent has about development, and the honest answer is that the range of normal is wider than most baby apps and milestone charts suggest. Children reach milestones in moving, playing, speaking, thinking and relating to others at genuinely different rates, and being a little behind in one specific area, on its own, is frequently not a sign of anything beyond ordinary variation. What actually matters far more than any single milestone is the pattern across several areas together, and whether a delay is isolated or affecting more than one domain at once.
Developmental delay is described as isolated when it affects a single area, for instance motor skills alone, and as global developmental delay when a significant delay is present across two or more areas, motor, language, cognitive, or social and emotional development, together. This distinction genuinely changes the assessment and the likely path forward, because an isolated delay in one area is approached very differently from a delay spanning several. At The Online GP your child's development is assessed across all these domains together, not in isolation, and referral to the right specialist, paediatric developmental assessment, child psychology or educational psychology, is made based on the actual pattern found. In-person consultation from £125. Fees appear further down this page.
Get your child properly assessed on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
The four areas doctors actually look at together
Gross motor skills cover the large movements, rolling, sitting, crawling, walking and running, and most children sit unsupported by around 6 to 9 months and take their first independent steps somewhere between 10 and 18 months, a genuinely wide window. Fine motor skills cover smaller, more precise movements, the pincer grip used to pick up small objects, stacking blocks, and later holding a pencil, and these develop somewhat independently from gross motor skills.
Speech, language and communication covers understanding, expression and social use of language, and is detailed further in our separate article on speech and language delay specifically. Social, emotional and play development covers eye contact, interest in other people, responding to their name, imaginative and interactive play, and sharing enjoyment or interest with a caregiver, pointing at something exciting and checking that you saw it too. This last area is often the one parents find hardest to describe but doctors find most informative, because social communication patterns show up early and reliably across a wide range of developmental conditions.
When to book an assessment rather than wait
Book an assessment if your child is not sitting unsupported by 9 months, not walking independently by 18 months, or shows a clear loss of a skill they previously had, at any age, since regression of an established skill is always worth assessing properly regardless of how minor it seems. Also book if you notice a delay affecting more than one area at once, for example speech alongside motor skills, or social interaction alongside play, since a pattern across domains points toward a different and broader assessment than an isolated concern in one area.
Persistent difficulty with eye contact, very limited interest in other children or in showing you things, unusual or repetitive movements, or an intense, narrow focus on a small number of interests that seems to interfere with other activities are all worth raising directly rather than waiting to see if they resolve, since these are the kinds of social communication patterns that benefit most from earlier rather than later assessment. And, as with every area of a child's health, a persistent parental instinct that something is different is a legitimate reason to book, independent of whether it matches a specific item on a checklist.
Ask what to raise on WhatsApp or email team@thewellnesslondon.com.
Isolated delay versus global developmental delay
An isolated delay, where one specific area is behind while everything else is developing typically, is common, is frequently temporary, and often resolves with time, encouragement, and sometimes a specific, targeted intervention such as physiotherapy for a gross motor delay or occupational therapy for a fine motor one. Prematurity is worth factoring in specifically here, since a baby born early is generally assessed against their corrected age, adjusted for how early they arrived, rather than their actual birth date, for the first couple of years, and what looks like a delay against the calendar date is often entirely appropriate against the corrected one.
Global developmental delay, a significant delay affecting two or more areas together, is a different and broader picture, and it usually prompts a wider assessment to look for an underlying cause, which can include a range of genetic, neurological or other medical conditions, though in a meaningful proportion of cases a specific single cause is never identified even after thorough assessment, and the focus moves to supporting the child's development directly regardless of cause. This broader pattern is one of the clearest signals that the right next step is a comprehensive paediatric developmental assessment rather than a single-discipline referral.
What actually happens in the assessment
A structured history across all four developmental areas, alongside direct observation of your child during the appointment, forms the basis of the assessment, rather than relying on a parent's account alone, useful as that account is. A general physical examination looks for anything relevant, including growth, muscle tone, and reflexes, since physical findings sometimes point toward a specific explanation for a motor delay in particular.
Where hearing or vision has not already been checked, this is arranged as standard, since problems in either can masquerade as a developmental delay in several areas at once. Where the pattern is isolated to one area, direct referral to the relevant specialist, physiotherapy, occupational therapy, or speech and language therapy, is the usual next step. Where the pattern is global, affects social communication specifically, or the picture is genuinely unclear, referral to a consultant paediatrician for a comprehensive developmental assessment, sometimes alongside a child psychologist or educational psychologist depending on your child's age and the specific concerns, is arranged directly.
What if the assessment is reassuring
This is a common outcome, and it deserves to be treated as good news rather than a brush-off. Where development across all four areas is within the wide range of normal variation, even if slightly behind in one specific skill, the sensible plan is often watchful waiting with a specific review date, rather than either dismissing the concern entirely or over-investigating a pattern that most likely reflects ordinary variation.
Where a genuine isolated delay is found and a targeted referral made, most children make good progress with the right, specific support, and a defined review point lets you and your doctor confirm that progress is actually happening rather than assuming it in the background. developmental milestones and concerns checklist
Bring this to your appointment, it turns "I think something might be off" into something a doctor can properly work through with you.
developmental milestones and concerns checklist
developmental milestones and concerns checklist
Bring this to your appointment, it turns "I think something might be off" into something a doctor can properly work through with you.
Motor
Sitting unsupported by 9 months
Walking independently by 18 months
Using a pincer grip to pick up small objects by around 12 months
Social and play
Responds consistently to their name
Makes eye contact and shares enjoyment with you, for example pointing to show you something
Shows interest in other children by around 2 to 3 years
Engages in pretend or imaginative play by around 2 to 3 years
Any age, raise regardless of milestone charts
Loss of a previously established skill
Delay affecting more than one area at once
Unusual or repetitive movements
A persistent feeling that something is different
Remember: if your child was born prematurely, their progress is generally assessed against their corrected age, not their actual birth date, for the first couple of years.
Send us your checklist on WhatsApp or call 020 3951 3429.
What does the assessment cost privately in London
A private consultant paediatrician appointment for a general developmental concern in the Harley Street district commonly runs £250 to £450 before any further specialist assessment. A comprehensive private developmental assessment, once referred, involving occupational therapy, speech and language therapy or psychology input together, typically runs into several hundred to low thousands of pounds depending on scope, confirmed directly by the specialist team once a referral is made.
At The Online GP:
First consultation, 45 min, full developmental assessment across all areas, growth plotted, written plan — £395 in person / £350 by video
Follow-up, 30 min — £340 in person / £295 by video
Referral for hearing/vision, physiotherapy, OT, SALT, or comprehensive paediatric/psychology assessment — arranged directly
Same-day and next-day appointments at 10 Portman Square, Marylebone, 3 minutes from Baker Street.
Why choose The Online GP
Because development is assessed across all four areas together, not one milestone in isolation, and the difference between an isolated delay and a genuinely global pattern is exactly what determines whether your child needs a single, targeted referral or a broader specialist assessment.
Because prematurity, hearing, and vision are actively factored in before a delay is assumed to be developmental in origin, protecting against a correctable or explainable cause being missed underneath a broader label.
And because whichever pathway fits, physiotherapy, speech and language therapy, or a comprehensive paediatric developmental assessment, the referral happens directly from this appointment, with your child's full history already documented rather than starting again from scratch.
Book an assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
How do I know if my child's development is genuinely delayed or just different from other kids
Normal variation in the age children reach milestones is genuinely wide, and being slightly behind in one isolated area is often not a sign of anything beyond that variation. What warrants assessment is a delay affecting more than one area at once, a clear loss of a previously established skill, or milestones significantly outside the typical range, for example not walking by 18 months.
What is global developmental delay
It describes a significant delay affecting two or more areas of development together, for example motor skills and language, rather than a single isolated area. It usually prompts a broader assessment, sometimes looking for an underlying cause, though a specific cause is not always found even after thorough assessment.
Does being born premature affect developmental assessment
Yes. A baby born early is generally assessed against their corrected age, adjusted for how early they were born, rather than their actual birth date, for the first couple of years. What looks delayed against the calendar date is often appropriate against the corrected one.
What happens if the developmental assessment finds a genuine delay
Referral is made to the specialist that fits the pattern found, physiotherapy or occupational therapy for an isolated motor delay, speech and language therapy for an isolated communication delay, or a comprehensive paediatric developmental assessment, sometimes alongside psychology input, where the pattern is broader.
Should I wait and see or book an assessment now
If you have a persistent feeling that something is different, that alone is a legitimate reason to book, independent of whether it matches a specific milestone on a chart. An assessment either confirms your child is within normal variation, which is reassuring, or identifies something worth acting on early.
The Online GP is a private GP service providing GMC-registered doctors from our Marylebone clinic and by video across the UK. Referral for physiotherapy, occupational therapy, speech and language therapy, and paediatric developmental, child psychology or educational psychology assessment is arranged with named specialists. This article is general information and not a substitute for medical advice about your child's development.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
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