Give kids time to play; it is important for their development. — Photos: KAMARUL ARIFFIN/TheStar
THE Covid-19 pandemic may be over but unfortunately, some children are still reeling from its after-effects.
Doctors are seeing an increasing number of kids with developmental delays in their practices, and while this can be attributed to many factors, the pandemic, along with its restrictions on movement and socialisation, seems to have played a major role.
Consultant general and developmental paediatrician Associate Professor Dr Norazlin Kamal Nor says while the country doesn’t have data on autism and general developmental delay (GDD) prevalence, she is seeing more patients in her practice with those conditions.
While a greater awareness in autism and GDD has seen many more parents look for medical opinions earlier, Dr Norazlin says living situations during the pandemic could have exacerbated developmental delays in children.
Her opinion is echoed by The Institutes for Public Health (under the Health Ministry’s National Institutes of Health) which noted an increase in the prevalence of social delay among children in Malaysia, rising from 1.2% in 2016 to 4.2% in 2022. This, it says, “warrants serious attention from relevant stakeholders and authorities.”
It adds that social delay was found to be higher among boys; and by age group, it is more prevalent among children aged 24 months and below.
“Social isolation is a risk factor in developmental delay and between 2020 and 2022, kids were not going to playgrounds or kindergartens, where important age-appropriate lessons like playing with friends and interacting with teachers take place. And when it comes to these developmental milestones, some kids are still catching up,” Dr Norazlin says.
Dr Norazlin says excessive screen time takes away the time kids should be playing and going outdoors, at an age when their brains are rapidly developing. — Photos: SIA HONG KIAU/The Star
With kids cooped up at home during that period, screen time increased exponentially as parents themselves grappled with new living conditions and the need to balance childcare and working from home.
“More than issues about content, excessive screen time takes away the time kids should be playing and going outdoors, at an age when their brains are rapidly developing. This includes engaging in conversations with their parents, playing by themselves and exploring the world around them,” she says.
Some parents, she adds, allow their child screen time as it can be educational as they choose good, age-appropriate content but Dr Norazlin asserts that this is still a “one-way communication with no reciprocity.”
“It’s not the same as having a back-and-forth conversation with a responsive adult,” she says.
Meanwhile, Dr Nik Raihan Mohammed who runs Klinik Kenit, a social enterprise which provides underprivileged families with subsidies to help kids with developmental delay, says on top of parental stress and excessive screen time, climate change also is a factor for this condition.
“This is something discussed by doctors now. When it’s very hot or when the Air Pollution Index (API) reading is high, like during the haze season, kids don’t go out to the playgrounds and over time, this could hamper their brain development, which is fragile and experience-dependent,” she adds.
Dr Nik Raihan, who also does volunteer work, says that in 2021, after the massive floods in Shah Alam had subsided, she set up a play area there to occupy the affected children while their parents were busy cleaning their homes.
“What I saw shocked me. They were not talking and they couldn’t play. Some were just rocking their bodies back and forth, trying, in their own ways to make sense of what was going on. The three-day natural disaster was traumatic for them. Now, imagine if they live with continuous stress, whether it’s air pollution or parental neglect,” she adds.
Dr Nik Raihan says some parents don’t play with their kids because they think it’s a waste of time; but playing is one of the best things they can do for their child’s development.
Missing out on the golden years
According to the Harvard University’s Center of the Developing Child, while the basic architecture of the brain is constructed before birth and continues into adulthood, a child’s early experiences will establish “either a sturdy or a fragile foundation for all of the learning, health and behaviours that follow.”
In the first few years of life, some one million new neural connections are formed every second. After this period of rapid proliferation (between zero and five years old), these connections are reduced so that brain circuits become more efficient.
Sensory pathways for basic vision and hearing are the first to develop, followed by early language skills and higher cognitive functions. “Connections proliferate and prune in a prescribed order, with later, more complex brain circuits built upon earlier, simpler circuits,” it says.
These connections are important because they are the building blocks of a child’s future. If the blocks aren’t fully constructed within that period, development can be seriously affected, leading to developmental delay, and unfortunately, this is sometimes irreversible.
And each child has only one shot at this, making this phase a critical period for the child.
Dr Cheah says the brain blooms between the ages of one and five and kids learn the best during this time.
Human anatomy expert and Universiti Putra Malaysia senior lecturer Associate Professor Dr Cheah Pike See, who has done research on the human brain says the brain “blooms between the ages of one and five and kids learn the best during this time.”
“After that, the brain undergoes ‘pruning’, where the weaker connections are removed and the stronger ones stay,” she adds.
Dr Norazlin and Cheah were speaking at the launch of the Comel (which stands for Cognitive, Optic, Motor, Emotion and Language) Developmental Milestones Checklist last month. The checklist can help parents keep track of their children’s development between the ages of one and seven years old.
Dr Norazlin says doctors are seeing these developmental delay cases now because when these kids enter kindergarten or Year One, teachers notice that they are not well-developed in social skills, cognitive and function, as they should for their age.
