Lessons learned: A critical reflection on child- and contextual variables related to the development of children with a significant cognitive and motor developmental delay.

The authors looked back at their own project on babies and toddlers with severe cognitive and motor delays. They wrote a lessons-learned list instead of running a new experiment.

They warn that tiny sample sizes, missed visits, and shaky data are normal when you study this group. Flexibility beats rigid protocols every time.

The team found no tidy numbers. Instead they found chaos: kids who slept through tests, equipment that failed, and scores that swung wildly week to week.

The big message is expect mess. Single time-point assessments can mislead you because development in these children is jumpy, not smooth.

Eussen et al. (2016) tracked very preterm infants for five years and saw the same wild swings in motor scores. Their data support the warning: one snapshot is not enough.

Dumont et al. (2014) showed that parental ID raises developmental risk, but poverty explains more than half of that risk. Ines et al. agree context matters and urge you to model it before you blame the delay on the child.

Gagliardi et al. (2015) ran a single-case cognitive rehab with a preschooler who had Joubert Syndrome. They could only describe trends, not prove the rehab worked. Ines et al. say that is the best you can hope for with such rare, severe cases.

Next time you assess a child with severe delays, plan for short, flexible sessions. Collect data across multiple days and settings. Drop the probe if the child is sick or sleepy. Share messy raw trends with families instead of hiding the noise. This honest picture keeps expectations real and guards against bad decisions based on one lucky or unlucky test day.