Global development delay (GDD) adanya penundaan yang signifikan pada dua/lebih domain perkembangan antara lain : personal sosial, gross motor (motorik kasar), fine motor (motorik halus), bahasa, kognitif dan aktivitas sehari-hari. Global development delay menjadi faktor utama dari sebagian besar neurodevelopmental disorder. Umumnya GDD terjadi dalam rentang usia 0 – 18 tahun. 1-3% anak di dunia rata-rata mengalami GDD dan mengakibatkan gangguan tumbuh kembang.
Evaluasi dan investigasi pada anak dengan global development delay mengungkapkan penyebab 50-70% dari kasus ini. Pada kasus ini dapat meninggalkan minoritas yang besar, jika dibandingkan dengan anak seusianya. Mulai dari terlambatnya kemampuan fungsionalnya hingga retardasi mental. Anak dengan global development delay bisa saja mengalami retardasi mental selain dari keterlambatan pada fungsionalnya, tapi tidak semua anak dengan GDD mengalaminya. Semua tergantung pada penyebab yang membuat kondisi anak mengalami keterbelakangan mental (Walters, 2010)
Apa, sih, penyebab dari GDD bisa jadi karena gangguan genetik atau kromosom seperti down syndrome. Bisa pula terjadi karena gangguan atau infeksi susunan saraf seperti cerebral palsy, sindrom Rubella atau spina bifida. Bayi yang lahir prematur, bayi berat lahir rendah, hingga yang mengalami sakit berat di awal kelahirannya dan membutuhkan perawatan intensif .tanda atau gejala yang bisa kita waspadai:
Perkembangan bahasa ekspresif
Anak yang mengalami GDD biasanya kurang memiliki kemampuan menunjuk untuk memperlihatkan ketertarikan terhadap suatu benda. Ini bisa terlihat pada usia 20 bulan. Orangtua juga harus waspada ketika setelah usia 24 bulan anak tidak mampu membuat frase yang bermakna. Dan ketika ia mencapai usia 30 bulan, orang tua masih tidak mengerti perkataan si kecil.
Perkembangan bahasa reseptif
Waspadai jika anak tidak merespon secara konsisten suara atau bunyi, misalnya tidak merespon ketika dipanggil. Di usia 20 bulan anak tidak mampu berbagi perhatian dan seringkali tidak menunjukkan ketertarikan pada orang lain. Setelah usia 30 bulan umumnya anak lebih suka mengulang atau membeo perkataan orang lain daripada membuat kalimat atau frase sendiri.
Perkembangan motorik kasar
Gerakan yang dibuat anak tidak seimbang, misalnya antara anggota tubuh bagian kiri dan kanan tidak bisa selaras. Dan ketika bayi berusia lebih dari 6 bulan, refleks primitif (refleks yang muncul saat bayi) menetap. Umumnya juga anak memiliki gangguan refleks tubuh dan muncul gerakan yang tidak terkontrol.
Perkembangan motorik halus
Bayi yang mengalami GDD umumnya masih memiliki refleks menggenggam setelah usia 4 bulan. Dan di usia 1 tahun biasanya hanya 1 tangan yang mendominasi. Seringkali juga eksplorasi oral (memasukkan barang ke dalam mulut) masih sangat dominan setelah usia 14 bulan.
Perkembangan kognitif
Kita juga bisa mewaspadai adanya GDD ketika bayi di usia 4 bulan matanya sulit mengikuti gerak benda. Sementara ketika ia berusia 6 bulan, ia belum merespon sumber suara. Perhatikan juga ketika di usia 9 bulan bayi belum bisa babbling, dan belum dapat merangkai 3 kata di usia 36 bulan.
Perkembangan keterampilan sosial dan emosional
Gejala anak yang mengalami GDD juga bisa ditunjukkan ketika ia berusia 6 bulan jarang sekali tersenyum dan menunjukkan ekspresi senang lainnya. Ia pun jarang bersuara ketika mencapai usia 9 bulan, dan tidak merespon ketika namanya dipanggil saat mencapai usia 12 bulan. Anak yang mengalami GDD juga tidak menunjukkan tanda-tanda ketertarikan berinteraksi dengan orang-orang di sekitarnya.
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