Early Intervention: What You Need to Know
Baby’s first smile, sitting up, waving bye-bye, crawling and baby’s first word are all milestones new parents look forward to and expect since most first-time parents start reading and learning about baby’s development during the pregnancy.
It’s important to understand that all babies develop and achieve skills at different times. But what if a baby seems delayed? What if an older sibling did things much earlier? What if parent intuition says something might not be quite right?
It might be time to consider an early intervention evaluation. Early intervention — a term that refers to the services and supports that are available to babies and young children with developmental delays and their families — is essential to helping children achieve their maximum potential.
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According to Dr. Leslie Rubin, a developmental pediatrician, empowering parents to follow their gut instincts regarding their child is of the utmost importance. “From my nearly 40 years of experience, if mom or dad think there’s a concern with their child, they are almost always right,” he says. “And, if they are wrong, at least they know there’s nothing to worry about.”
Janine Wiskind, an occupational therapist and founder of On Solid Ground Occupational Therapy based in Sandy Springs, agrees. By the time families make it to her, parents have usually been struggling with their gut instincts for a long time. “If you have the opportunity to help your kids thrive, why not take it?” explains mom of two from Cobb County Katherine Thomas. Thomas has seen this first-hand; her son Henry has come a long way in better managing his nervous system thanks to early intervention therapies and techniques. “He’s even considered advanced in language at this point,” she says.
“The earlier you start with therapies, the easier it is for children to adapt certain skills and habits,” says Jenny Bowen, MA, CCC-SLP and Founder of SpeechFamily located in Dunwoody. Normalizing neurodiversity can help parents in seeking early intervention for their child. “Families have such diverse backgrounds — culturally, financially, educationally — and these factors impact their reactions to concerns they may have,” says Bowen.
For some parents, having a diagnosis helps determine next steps and gives them peace of mind. “I work with the family to understand areas of need and strengths of the child,” explains Rubin. “Then, I can formulate a diagnosis and recommendations for therapies and interventions to help the child make as much progress as possible.”
For other families, a diagnosis can add tension to an already stressful situation. “I always tell parents, when you’re ready to explore, we have resources, and we are on this journey with you,” says Bowen. “We teach parents to better understand their child, which helps the entire family system, including siblings.”
“Babies are born with more brain cells than they will have later in life,” says Rubin. “It’s a physiological fact. The younger a child is, the more potential for learning and incorporating new skills into who they are exists.”
Progress through therapies occurs much more quickly, the younger a child is when therapy starts. Waiting to see what might happen, especially with motor development, can be a loss of valuable time. “If core steps of movement are missed, it’s harder to build upon during therapy,” explains Wiskind. Rubin notes that this is especially true for children with cerebral palsy who need assistance in moving the effected muscles before they become paralyzed or atrophied.
Children can exhibit signs of developmental delays in various ways. With sensory processing, children have to learn how to synthesize each of their senses and movement at the same time. If they have difficulty doing this, they may seem sensitive to sounds or lights. They might also have behavioral challenges. Some developmental delays are more obvious such as missing milestones like being able to sit up, walking, feeding themselves or speaking.
“In the first year of life, a baby learns to go from lying in whatever position you place them in to being able to walk and move independently,” says Rubin. “It’s a huge time for motor development and that process has certain milestones. What parents need to be aware of is when a child misses several milestones or if a delay persists.” The same pattern follows in the second year of life for speech and language skills. Rubin notes that one red flag is if a child stops speaking or regresses in their speech around 15-20 months of age.
Jill Lewis started to notice signs for her older son in behavioral issues. “He was biting a lot and acting out,” says the Brookhaven mom of two. “He really wasn’t listening and had a big reaction when Charlie (his younger brother) was born.” She saw a huge improvement in a short time following starting occupational therapy when he was a toddler. “Within weeks I saw a change and after seven months, he was like a new kid.”
The long-term benefits of early intervention can be truly life changing for children who experience developmental delays. “The biggest impact of my work as an OT is giving a child the ability to be their best self and helping parents find a balance between accepting their child and the expectations they have for them,” says Wiskind. “My goal is to create joy and confidence for kids, so that they feel proud of who they are.”
Developmental Delays 101
Developmental delays align with the areas of child development and connect with different parts of the brain. Some children can experience a delay in only one area; other children may have delays in multiple areas, which is referred to as global developmental delay.
The categories of developmental delays include:
- Cognitive skills: Cognitive or thinking skills include learning and understanding information, as well as problem solving and following multi-step directions.
- Social and emotional skills: This includes getting along with others and being able to express feelings and communicate needs. Those with social or emotional delays may struggle with understanding social cues, accepting changes to a routine, or having a conversation.
- Speech and language skills: Speech and language skills include speaking and comprehension. If a child can speak but does not understand what others are saying, this still constitutes a developmental delay in this area, and vice versa.
- Fine and gross motor skills: Motor delays are centered in the muscles and can deal with gross motor skills such as sitting up or walking or fine motor skills such as holding a crayon or bottle.
Common Conditions Connected to Developmental Delays
According to the Centers for Disease Control and Prevention (CDC), recent estimates in the United States show that about one in six, or about 17%, of children between the ages of 3 and 17 years have one or more developmental delay. While there are many factors at play, commonalities with certain conditions are evident, including:
- Autism Spectrum Disorder
- Cerebral Palsy
- Premature Birth
- In-utero Exposure to Drugs and Alcohol
- Genetic and Chromosomal Conditions