Missing early language milestones is one of the first observable signs leading to parent concern about their child’s development. Parents are often comforted by well-intentioned friends, family and (unfortunately,) healthcare professionals to “wait and see if they grow out of it.” There will always be a story, intended to ease parental nerves, of a neighbor’s cousin’s friend’s son who didn’t speak a word “until they were 4” and now is totally fine! He never needed speech therapy or anything special, so I’m sure your child won’t either.
As a parent, trust your gut. Know the signs, and push for a referral from your pediatrician, even if your concerns are being dismissed. One study from the University of Oregon found that a simple 15-minute parent questionnaire submitted before or after a doctor's appointment resulted in a 224-percent increase in referrals of one-year-old and two-year-old children with mild developmental delays in a yearlong study. This means that without parent input, 53 of 78 referrals would not have been made by the pediatrician’s observations alone. The study also indicated that physicians had a greater difficulty identifying delays at 12 months compared to 24 months. Neural circuits in the brain, which create the foundation for learning, behavior and health, are most flexible (or able to be molded,) during the first 3 years of life. Missed signs between 12 and 24 months equates to 1 whole year (excluding any potential wait lists,) without early intervention services, which over 40 years of research has shown to be crucial to short and long term gains.
The bottom line is, always air on the side of caution and ask for a referral, regardless of the opinion of others… even your pediatrician. You are the expert on your child!
Here are a few myths associated with Early Intervention (EI):
Therapy is too expensive: From birth to three years old, your child qualifies for free early intervention evaluations and services, in every state in the U.S. Here is a list of early intervention providers by state. You don’t need to wait for a referral from your doctor for an evaluation with EI- go ahead and call today! EI can be provided in-home or in an outpatient center, depending on your location. You may choose to add additional private therapy depending on your child’s needs.
My child is over 3 years old, it’s too late: For children who have not received EI by 3 years old, contact the Child Find program through your local public school system (google “Child Find“ and your state). Children ages 3-21 with suspected delays are entitled to free evaluations and services through the school system. You may choose to add additional private therapy depending on your child’s needs. You can find local speech therapists in your area using the American Speech-Language Hearing Association (ASHA)’s ProFind Tool: www.asha.org/profind/
My child attends private school; they don’t have therapists there: Even if your child attends a private school, they are still entitled to a free evaluation and services through Child Find. A speech-language pathologist from the public school system where your child’s private school is located can push-in to your child’s school to deliver services. You may choose to add additional private therapy depending on your child’s needs (See above for links for a previous post on school/private services and to find local therapists)
I have concerns for Autism; EI or Child Find is enough: Though EI and Child Find can assess for Autism through a multidisciplinary evaluation with a psychologist, an educational classification of Autism is not the same as a medical diagnosis. If your child is identified as having Autism through EI or Child Find, it will entitle them to services within school; it will not cover private services through your insurance company. The National Research Council has determined that a minimum of 25 hours per week of early, intensive intervention is best practice for children with Autism; this means that a combination of school and private services is usually the best bet for long term gains. If you have concerns regarding Autism, contact an Autism Center in your area for a multidisciplinary evaluation; because Autism is a large “spectrum,” disorder (meaning it presents in different ways, with varying degrees of severity,) it’s important to see specialists when determining an Autism diagnosis. If you’re unsure if you have concerns about Autism, check out the following resources:
Parent Questionnaire that assesses for level of concern for autism (M-CHAT)
Videos comparing typical play development in toddlers vs. toddlers with Autism
Additional developmental milestone information
The moral of the story is: you, as a parent, are your child’s best advocate. Pushing for referrals early on may feel overly cautious; however, research shows that the earlier the intervention, the greater the outcomes. In terms of your child’s development, it is always better to be safe than sorry. Trust your gut, know the signs, act early, and keep rocking parenthood!
Jackie