Children
Child development
For concerns about speech, social skills and parenting
with a medical interpreter
24 hours a day, 365 days a year
OK to consult together
payment information
About
About Child development
You can consult us in Japanese about your child's language and social development and any parenting concerns. We're here to support you with the worries of raising children abroad.
Why it happens
Children's development varies widely, and every child grows in language, movement and social skills at their own pace. Developmental differences aren't a result of the child's effort or parenting; they are thought to come from the individual way each brain processes information from birth. Abroad, children also have to adapt to multiple languages and education styles that differ from Japan's, which can make it harder to tell a developmental delay from a temporary effect of the environment.
What's happening in the body
Development is a process that builds up step by step. Motor development (holding up the head, sitting, walking) and language development (making sounds, saying meaningful words, forming sentences) each progress in stages. But the pace varies greatly between children. It's natural for children of the same age in months to be able to do different things. When assessing development, we don't just look at what a child can do at a certain age; we look at whether they are progressing through the stages in their own way and how balanced the different areas are. In a multilingual environment, time spent with each language is divided, so vocabulary in one language may look smaller than that of a child who speaks only one language. In this case, the languages need to be assessed together. When something concerns you, we think together about whether it's within normal variation or whether support would help.
Main symptoms
- Not talking, vocabulary not growing, or not yet using two-word phrases
- Little response when called, or difficulty making eye contact
- Little interaction with children of the same age, or difficulty with group activities
- Strong fixation on particular things, difficulty switching activities
- Restless, unable to sit still
- Over- or under-sensitive to sound, light or touch
- Not wanting to go to nursery or school, or difficulties at school
- Severe tantrums or difficulty moving on from strong emotions
When you can wait and see
What you can do yourself
- Focus on and note what your child can do rather than what they can't
- Keep instructions short and specific, and add visual cues
- Keep a regular daily routine
- Make sure you, as a parent, get rest and have someone to talk to
- Share information with the nursery or school, and don't carry it all yourself
Please consult us
If any of the following apply
- You're concerned about delayed speech or development
- You're worried about how your child is doing in group settings
- You want to talk to someone about parenting
Seek care right away
If any of the following apply
- Losing words or skills your child could do before
- Repeated seizures
- Repeatedly hurting themselves or others
- Not eating or sleeping, and not gaining weight or losing weight
Don't wait for a Cotovia consultation; call the emergency number in your country.
See the emergency guide for each countryIf you're not sure, ask us on LINE
Differential
Telling it apart from similar conditions
Symptoms that look the same may need different care depending on the cause. Use this as a guide to find what's closest to your situation.
Within normal variation
Progressing slowly but steadily through the stages, with other areas appropriate for age
We watch how things develop and suggest ways to interact with your child
Effects of a multilingual environment
Looks limited in one language but is appropriate for age when languages are combined
The languages need to be assessed together
Hearing problems
Little response when called, and not startled by loud noises
A hearing assessment is recommended. Repeated middle ear infections may be behind it
Developmental differences
Difficulty making eye contact, strong fixations or sensory sensitivities
Understanding and support from an early stage make life easier later on
A reaction to a change in environment
Temporarily losing skills after a move or starting nursery
It usually settles as the child gets used to the environment
Motor delay
Clearly late in motor milestones such as holding up the head, rolling over or walking
A physical assessment is recommended
* This is not a complete list. If you're not sure, please consult us.
When it might be something else
Course
Typical course
This is the general course. Actual progress varies from person to person.
- When you first become concerned
You're often told to wait and see at this stage
Writing down what concerned you and when helps when you consult us
- Consultation and assessment
We hear how things have developed and how your child is doing now
It helps if you bring your Maternal and Child Health Handbook and any videos
- Monitoring period
We check for changes over several months
We take our time and follow your child's own pace
- If support is needed
We refer you to specialist services as needed
We go over both the support available locally and the options in Japan
Local Insight
For people living in Southeast Asia
The climate, healthcare and access to medication differ from Japan. Here are points specific to this region.
Abroad, there are fewer chances to notice concerns
In Japan
- Checkup at 1 and a half years
- Checkup at 3 years
- Schools have advice services
Abroad
- Public developmental checks aren't offered in the same way
- Support in Japanese is hard to get at international and local schools
- Only a few Japanese schools have special needs support in place
Abroad, the public developmental checks available in Japan, such as the checkups at 1 and a half and 3 years old, often aren't offered in the same form, so concerns can be noticed later. It's important to make a conscious effort to seek advice.
International schools and local schools rarely offer support in Japanese, and only a small number of Japanese schools have systems in place for special needs support. It's reassuring to know your schooling options early.
In a multilingual environment, speech can develop more slowly for a while, but rather than assuming it's because your child is bilingual, it's best to assess development as a whole.
Procedures for school enrollment and support when returning to Japan differ by municipality, so it helps to start gathering information while you're still abroad.
Care
What Cotovia can do
- A careful consultation in which we listen to you
- Developmental assessment and advice
- Referral to specialist services as needed
Tests you may have
Not knowing what will happen can make people hesitate to seek care, so here's what actually takes place.
Time to talk
Understanding how things have developed, how your child is doing now and how you interact at home
Developmental assessment
Checking each area, such as movement, language and social skills
Hearing check
Checking whether a hearing problem is behind it
Physical examination
Checking growth charts and physical health
Treatment options
Ways of interacting
Working out what you can do at home
Rather than one-size-fits-all advice, we work out together what suits your child
Follow-up
Looking at changes over time
It's important not to decide on a single assessment but to watch progress through the stages
Referral to specialist services
Connects you with the support you need
We tell you about both the support available locally and the options in Japan
Support for families
Eases the burden on parents
Not carrying your worries alone is also an important part of your child's environment
* Tests, procedures and prescriptions are decided by the doctor after a consultation. Services may vary by country and location.
Preparation
Before your visit
When seeing a doctor abroad, simply organizing what you need to say makes a big difference.
What to bring
- Passport or residence card
- Insurance card and your insurer's contact details
- Maternal and Child Health Handbook
- Results of any checkups in Japan
- Any videos showing what concerns you
What to tell us
- Roughly when you became concerned and what concerns you
- Which languages are used at home, and in what proportion
- How your child is doing at nursery or school
- Changes since you were in Japan
- What your child has learned to do, and when
Self Care
What you can do yourself
Along with seeing a doctor, here are things to keep in mind in daily life.
Prevention
- Have regular checkups and developmental checks (make a conscious effort, as there are fewer opportunities abroad)
- Make sure your child has plenty of everyday interaction in both Japanese and the local language
- Consulting early can give you more options
- Make sure parents don't become isolated
How to Consult
How to be seen
Choose from 3 ways to be seen, depending on your symptoms and schedule. If you're not sure, we'll guide you on LINE.
Online consultations
See a doctor by video call from home or the office. Medication delivered or from a pharmacy.
Available for this symptom
In-person care
In-person consultations at our clinics and partner hospitals, including tests and procedures.
Available for this symptom
Cotovia Counter
Support with an interpreter for visits to general hospitals.
Available for this symptom
If an online consultation finds that tests or procedures are needed, we'll guide you to in-person care or Cotovia Counter.
From consultation to receiving medication
Add us on LINE and consult
Tell us your symptoms, and we'll recommend the right way to be seen.
Book and be seen
See a doctor online or at the nearest location, with an interpreter present.
Receive your medication
Have it delivered or pick it up at a pharmacy or the clinic (varies by country).
Follow-up
You can also consult us on LINE about how you're doing afterward.
Special Care
People who need extra care
Families planning to return to Japan
Organizing your records from abroad makes it easier to connect with support in Japan
Parents who are anxious about communicating with the nursery or school
We can also help you work out how to explain things
Parents and guardians
Your own tiredness and worries matter too. Please don't keep them to yourself; talk to us
Children with possible hearing problems
If a child has repeated middle ear infections, their hearing may affect language development
FAQ
FAQ
Common questions before a visit, and common assumptions that lead people to judge for themselves.
QCan I get advice on development while living abroad?
Yes. You can consult us in Japanese. We can also refer you to specialist services locally or in Japan as needed.
QIs my child's speech delayed because they hear both English and Japanese?
A multilingual environment can have an effect, but it may not explain everything. It's important to also check development in areas other than language.
QCan you give a diagnosis?
A definite diagnosis often requires a specialist assessment. We start by hearing how things have developed and refer you to a suitable service as needed.
QCan parents consult without the child?
Yes. Parents or guardians can consult on their own. We can start by going over how your child is doing and the difficulties you have at home.
Common misconceptions
Myth Speech delay is only natural in a multilingual environment
Fact The environment has an effect, but it may not explain everything. The languages need to be assessed together
Myth If you wait, your child will catch up eventually
Fact Many children do catch up, but when support helps, starting early gives you more options
Myth If you ask for advice, your child will be labeled as disabled
Fact A consultation is a chance to understand your child's situation. It doesn't assume there will be a diagnosis
Myth There's nowhere to get advice when you live abroad
Fact Consultations in Japanese are available, and we can go over options both locally and in Japan
Myth It's caused by the way the parents raised the child
Fact Developmental differences are not caused by parenting
Feel free to ask us on LINE first
It's fine to contact us even if you're not sure you need to see a doctor. We're available in Japanese 24 hours a day, 365 days a year.
- Symptoms
- When it started
- Your country of residence
- How you'd like to be seen
Sending these 4 things helps us respond faster. It's fine if you don't have them all.
Ask us on LINE