The earliest years of childhood are a period rapid development unlike any other time in our lives. It is a period punctuated with many firsts that parents will always remember: first smile, first word, first steps. These enormous leaps are the product of a myriad of complex processes that integrate development across five domains: fine motor, gross motor, communication, social/emotional, and cognitive. Development tends to happen in a predictable sequence which provides parents with a schedule of growth in children – we know that a baby will babble before she speaks and crawl before she walks. What we do not always know is when it will happen for individual children. Children change and grow according to their own individual developmental track and most arrive at their developmental destination within the expected age-range. According to the CDC, however, 1 in 6 children do not reach their particular milestones within the normal time limit and have a developmental delay.
A developmental delay is simply that – a delay in a child’s development – and the best course of action is early intervention. Because development builds upon itself and multiple domains are involved in the culmination of milestones, a delay in one domain can have a cascading effect that interferes with development in other domains. A motor delay – or a difficulty coordinating muscle groups – can contribute to a speech delay if a child can’t move his tongue to form certain sounds. Intervention, such as physical therapy or speech therapy, can help to alleviate the root delay, as well as stem subsequent delays. Early intervention is especially important because of the unparalleled brain development that occurs in early childhood. During this critical period, the neural circuitry that supports learning is at its most flexible and, therefore, most open the change. By taking advantage of this window of opportunity, early intervention can change the developmental trajectory for a child.
Your pediatrician performs developmental checks during your child’s Well Check appointments. If you happen to have a Well Check appointment coming up, you can use the Bright Futures checklist as a point of reference for measuring your child’s development. These are questionnaires were developed by the American Academy of Pediatrics specifically for Well Check appointments. If you are feeling uneasy about your child’s development or a loss of developmental gains and you do not have an upcoming visit with your pediatrician, schedule one right away and let your doctor know you would like to discuss your child’s development. Prior to your appointment, you can check your child’s development against a developmental milestone checklist that covers a wider range of skills than the Bright Futures questionnaire. Checklists available through the CDC and and the Department of Early Learning may help you identify areas where you are concerned. It also helps if you write down a few concrete examples to illustrate your concerns to your doctor. Observations from caregivers and/or preschool teachers are also useful. Your doctor should gather information from you and your child to determine if an evaluation is warranted. If your doctor urges you to “wait and see,” ask for clear guidelines as to just how long you should wait before coming back. If you aren’t satisfied with your doctor’s response or can’t ignore that voice in the back of your head, there are several things you can do that do not require a doctor’s referral.
The Early Intervention Program for Infants and Toddlers With Disabilities, or Part C of the Individuals With Disabilities Education Act (IDEA), is a federal grant program that offers statewide program of services and supports for children birth through 2 years old with developmental delays. In King County, WithinReach facilitates evaluation and early intervention services for children 3 and under. You can get started by calling their Family Health Hotline at 1-800-322-2588. They also offer a free online developmental assessment for children under 5 ½ years old called the Ages and Stages Questionnaire. It will be expertly scored and results returned to you within a week with recommendations. If you child is between the ages of 3-5, you can request a screening through the Child Find program sponsored by Seattle Public Schools. Call 206-252-0805 to set up a screening. Lastly, the Modified Checklist for Autism in Toddlers (M-CHAT) is a screening tool for toddlers between 16 and 30 months of age to help identify children who may benefit from a more thorough developmental and autism evaluation.
Speaking from personal experience, it can feel frightening to first consider that your child might be delayed, followed by a rush of emotions when your concerns are confirmed. We all know that parenting is not for the faint of heart. It takes courage to acknowledge the tug of parental instinct that refuses to be ignored. As Mark Twain said, “Courage is resistance to fear; mastery of fear – not the absence of fear.” So we must master our fear so that our children can master their potential.
Your Parent Educators and Children’s Teachers are here to support you. Please don’t hesitate to reach out if you have concerns about your child’s development.