Having worked as a Speech-Language Pathologist for many years, I have come across my fair share of parents who have been instinctively concerned about their child’s development, however upon asking trusted parties in their lives – including doctors, educators, parents etc., have been advised that it is just a phase and that one needn’t worry until the child is older.
“His dad didn’t speak till he was 3 years old and he turned out fine” –Parent. Based on real facts.
“Your child is not even 18 months old. You don’t need to worry about his language development. You’re being an over-anxious parent.” – ENT (to me a Speech-Language Pathologist!). Really Happened.
“Listen to your doctor he’s not worried about the fluid in Arman (my son)’s ears” – My mom. Really Happened.
“He seems to be getting along fine in class. He’s following what the other children do so it seems as if he understands the directions.” – Teacher. Based on real facts.
And maybe they’re right and maybe they’re not…but we can’t afford to play the maybe game when it comes to our children.
Therefore – arm yourself with the correct knowledge and professionals to help you make the correct decisions.
I say all of this to emphasize the point that you must choose the sources you trust based on their believability. This is a term by Ray Dalio, the American billionaire investor, hedge fund manager, and philanthropist, and it basically has you question the following: What are the credentials of the people I am asking? Are they experts in the topic of discussion? Are they the best people to advise me on the concerns I have?
Is your mom a specialist? If not, listen but confirm with a professional.
If you’re concerned about movement development, yes your doctor has basic understanding and can make the correct referrals, but (depending on the situation), a Pediatric Physical Therapist or Occupational Therapist has more in-depth knowledge and information that can supplement the doctor’s knowledge and information and provide a more complete picture.
What if you had a team of believable people who could give you the best holistic advice for your child? Wouldn’t this be IDEAL?
Speaking of IDEAL, The Individuals with Disabilities Act (IDEA) in the U.S is a law and within it, is Clause C for Early Intervention, providing services to newborns from 0-3 years with delays in the areas of: Special education, physical, speech and language, vision, hearing, nursing, health services, assisted communication. And in these earliest years, it is a family centered approach that includes a plan called an IFSP – Individual Family Service Plan so that professionals can work with families and create goals that are relevant to environmental, social, and cultural needs. It also includes information about the child’s milestones and goals for parent training.
If tax money is being utilized for these programs to be implemented, they must be rooted in evidence and necessity, with the potential of reducing the financial burden at a later stage in a child’s life.
So why is Early Intervention part of the public system in the U.S.?
Research has shown that half a person’s intelligence potential is developed by age 4 years. Early childhood is the most rapid period of development in the lifespan of an individual. Birth to 8 years is vital to the emotional, physical, cognitive growth of children.
Early childhood is when the role of a child’s environment is critical in determining how the brain grows and develops. Environmental factors can affect the number of brain cells, number of connections, and the way they are wired, based on a child’s sensory experience in the outside world. Scientists say that if the brain does not receive the appropriate stimulation during this critical window, it is more difficult for the brain to re-wire itself at a later time. That being said, it is important to note that the brain is “plastic” i.e., it can change based on input and experiences no matter what the age of the individual. The brain is however more “ripe” during the early years.
The Center on the Developing Child at Harvard University has summarized this research:
Neural circuits are most flexible (plastic) in the first three years of life.
Stable relationships with caring and responsive adults, supportive environments, and nutrition are important
Early social/emotional development and physical health provide the foundation upon which cognitive and language skills develop.
Addressing the Taboos:
Early Intervention is all about getting in early. Why? Because we don’t play the maybe game – especially when it comes to the development of our children. And we know too much now about the brain and how it develops to ignore early signs.
Where I work at The Developing Child Center (TDCC) in Dubai, we use the terminology – Skill Development. For my former role, we had changed my title from Director of Therapy to Director of Skill Development because that’s what it’s all about. We care about the symptoms and the pain points so we know what skills need to be taught to maximize the potential and confidence of the child we are working with. Diagnoses are helpful and have their place in giving an overall picture of what to expect, but symptoms are what guide the necessary, individually-focused skill development areas required in intervention. And the key is to identify the symptoms early so that intervention can begin and your child has a higher likelihood of success in developing the skill sets to improve his/her functionality, and thereby his/her confidence.
A mother that I guided to begin intervention early has the following to say:
"Early intervention (EI) is nothing short of a miracle. I had, for many years, read and heard about the importance of EI. It was not until my husband and I went on our own journey with our son that I truly understood the magnitude of recognizing and addressing developmental delays as early as possible. If you have any doubts regarding the development of your child, just take action. EI takes a lot of hard work and patience, but the results are beyond belief."
Another one of my clients’ mom’s e-mailed me recently. She had been over-anxious about her child who was 2.5 years old and still not talking. With Early Intervention and correct environmental nudging, he scored solidly in the average range on his language skills one year later.
It makes a difference.
Steps to ensure that you catch a skill development need early:
1. Be an informed parent (the purpose of my blog is to inform you!)
2. Document basic milestones and areas of concern
Speech and Language: When did your child babble, say his first words, start stringing words together? Please refer to this link to gauge your child’s speech and language milestones: http://bit.ly/2sOd4O2
Motor: When did the child roll, sit, crawl, stand, walk? Be aware that there are ranges of normal development. Some children will walk at 9 months, some at 14 months. Please refer to this link for motor milestone ranges: http://bit.ly/2Ju4RZP
Document what has been worrying you more than normal – your child is a picky eater, your child is not putting on weight, your child is very sensitive to loud sounds, your child does not look at you etc., It is important to know the milestone ranges so you don’t become overly anxious but so that you’re sure when to seek assistance from a professional.
3. Be preventative where you can be e.g., if you read my other posts, you will see recommendations from an audiologist and an ophthalmic surgeon on when you should take your children for general screenings of their ears and eyes.
4. Seek advice from “believable” professionals – not just people you trust because you’re supposed to trust them or because you trust them about other subject matter. But really identifying who are the professionals that are the experts in the aspect of development that you are concerned about.
5. Trust your instinct and if your child does need to start intervention, the best thing to do is to take action now. Many parents blame themselves and focus on answering the “Why did this happened to my child?” question. As difficult as it is, it’s important to start focusing your energy on finding the right professionals to help your child maximize their potential through action. It’s hard work but it’s worth every penny and every tear.
The action plan is:
What are the symptoms I am noticing in my child?
How does my child’s development compare to other children in the particular category I’m concerned about.
Maybe you haven’t noticed anything, but your teacher has brought something to your attention.
Identify the professionals that can best guide your journey. A Clinical Psychologist or a Developmental Pediatrician can help to Case Manage your child for you and guide you to the right professionals.
Check credentials and experience, go by recommendations
If you need to see multiple professionals, it is important that they are all connected to form a “team.” There must be collaboration. And it is important to have 1 person case manage all the professionals for you – someone who can see the whole picture (as mentioned in line 4).
You, as parents, are an integral part of the team. Your active participation in the treatment of your child is what can really make a huge difference – refer to the Individual Family Service Plan above. You are critical in creating the right environment of growth for your child.
Intervening early is easy to say but it may not always be easy to do. As a parent this is going to be hard. You may be stressed, nervous, anxious. But know that you are doing the best you can. It is very critical to take care of yourself, to be kind to yourself, to take time for yourself and to do what you need to be a good parent, including seeing a psychologist or counselor to help you along the way if you need to.
For some of you, this may be a quick journey. And for some, it may be a marathon. Pace yourselves.
Tomasello, Nicole M et al. Family Centered Early Intervention for Infants and Toddlers with Disabilities. 18 Mar 2010. Journal of Family Social Work. https://www.tandfonline.com/doi/full/10.1080/10522150903503010?scroll=top&needAccess=true
Center on the Developing Child at Harvard University (2008). InBrief: The science of early childhood development. Retrieved from http://developingchild.harvard.edu/download_file/- /view/64/
Center on the Developing Child at Harvard University. (2010).
The foundations of lifelong health are built in early childhood. Retrieved from http://developingchild.harvard.edu/library/reports_and_wor king_papers/foundations-of-lifelong-health/