Diagnosis Process for Developmental Delays

The Frustrating Reality of the Diagnosis Process for Developmental Delays in South Africa

For parents of children with developmental delays, the journey to obtain a diagnosis can be a daunting and disheartening one. They often face a multitude of challenges and financial limitations, not knowing where to seek help or who to turn to.


Unfortunately, the diagnostic process in South Africa is deeply flawed, resulting in significant delays for families in need of support for their children. Accessing services or receiving assistance often requires a formal diagnosis, which can take an agonizingly long time to obtain.

In this article, I will explore the reasons why the autism diagnosis process in South Africa is riddled with flaws.

One of the primary issues lies in the pervasive lack of awareness in society. Many parents and even educators struggle to recognize the signs of developmental delays, sometimes dismissing them as part of a child’s (individual) pace of development.

Another critical factor is the scarcity of specialists available. The shortage of these professionals leads to extensive waiting times for evaluations and further contributes to the significant delays in obtaining accurate diagnoses.

Furthermore, the diagnostic consultations themselves present additional challenges. Evaluating a child’s development is a complex task that should encompass various aspects, including:

  • Observations of behaviour in different settings and situations.
  • Assessment of cognitive abilities, such as problem-solving skills, memory, and attention span, in diverse contexts.
  • Evaluation of speech and language skills, covering receptive language, expressive language, speech clarity, vocabulary, and comprehension of nonverbal communication cues. These assessments should be conducted in a range of settings and situations.
  • Assessment of social and emotional development, including social interactions and emotional regulation across various environments.
  • Observations or assessment sessions that capture a child’s performance in group settings, one-on-one interactions, during transitional phases, and in response to different sensory stimuli.
  • Evaluation of general interactions with others in different social settings over an extended period.
  • Assessment of motor planning skills, encompassing fine motor development, hand-eye coordination, handwriting, as well as gross motor skills involving coordination, control, and strength.
  • Evaluation of adaptive skills, which relate to a child’s daily living abilities and basic problem-solving skills.
  • Sensory processing assessment to understand how a child processes sensory information and responds to various sensory stimuli in group settings.
  • Assessment of play skills, including engagement in class or group settings, interactive play, general play skills, imaginative play, and pretend play.
  • Evaluation of academic or pre-academic skills at an age-appropriate level.

Unfortunately, when diagnosing very young children or toddlers with developmental delays, medical professionals in South Africa often heavily rely on information provided solely by parents during consultations. However, this approach is flawed because parents may lack the necessary understanding of their child’s development or the ability to recognize potential delays.

As a result, relying solely on parental information can lead to misdiagnosis or delays in identifying developmental issues. It is crucial to implement a comprehensive approach to the diagnostic process, involving collaboration among professionals, observations in diverse settings, and thorough assessments conducted by trained specialists.

By acknowledging and addressing the flaws in the current diagnostic process, we can work towards improving awareness, increasing access to specialists, and adopting a more accurate and holistic approach to diagnosing developmental delays in children.

Through collective efforts, specialists can ensure that families receive timely support and interventions, enabling their children to reach their full potential.

Ilse Kilian-Ross

Ilse Kilian-Ross is the owner of Amazing K, a registered ECD and Partial Care Facility in Johannesburg. Amazing K is a private adhd school, autism school and therapy centre for children from age 2 - 6 years where learners receive the best of both the schooling and therapy world. The autism school offers Individualized Education Programs, Speech- and Augmentive Alternative Communication (AAC) therapy as well as a full and adapted Academic Curriculum.