Every parent is eager for her child to crawl, walk, babble, talk, and make his first friend. That's why it can be concerning, if not painful, to see these milestones pass your child by. Is he just a late bloomer, or is he developmentally delayed? And if your child is diagnosed with a delay, how do you navigate the early intervention system to get the best help available? To better understand the diagnosis and treatment for your child, we spoke with Laurie LeComer, M.Ed., author of A Parent's Guide to Developmental Delays. Her best advice: Be your child's biggest cheerleader, and show him that you notice and appreciate his good deeds, no matter what.
Parent & Child: What are the areas to watch in terms of delays?
Laurie LeComer: Developmental concerns fall into one of the following five categories. First there's cognition, which involves thinking and reasoning, as well as retaining and applying new information. Second is speech and language. Speech is the physical process of forming sounds and words; language is the ability to understand and communicate. Third is social and emotional development, which involves skills in relating to others. Fourth is motor development, both gross motor (the use of large muscles for rolling over, crawling, walking, and running), and fine motor (the use of small muscles in the hands and wrists for grasping, using utensils, and writing). Fifth is sensory processing, which involves using bodily and environmental information to make appropriate judgments and movements. Think of this last one as a child's ability to orient himself in space, among other things. Children may have delays in one or more of these areas.
P&C: How can parents distinguish normal development from a delay that requires intervention?
LeComer: It's very difficult sometimes. The truth is, children do have spurts of growth or development, and can lag behind in one area and move forward in others, then catch up later on their own. There are also times when a delay doesn't have a developmental cause, but is instead the result of environmental factors, such as a lack of experience or practice with certain skills. A colleague was extremely worried about her 1-year-old son because he was not cruising or walking yet. It turned out that, at his daycare, he spent a lot of time in a stationary walker and wasn't getting the kind of exercise he needed to work on his gross motor development. As soon as she changed daycare settings, he started moving around more and quickly caught up to the other toddlers in his age group.
P&C: Why is it important to identify the problem early?
LeComer: Because if there is a problem, early intervention is key to helping your child catch up. Most parents do have an instinct that something is amiss, and they should certainly act on it. Parents frequently hear such catchphrases as "children develop at their own rate," or "he'll grow out of it." It's certainly what many of us want to hear, as worried parents, but still, you should treat your own concern as a red flag, and not second-guess yourself. It is still estimated that only half of developmental problems are caught and treated before a child enters school. When parents don't seek help early, there is a much greater chance of the child being labeled as having a disability when entering school if he or she is still lagging behind peers.
P&C: What's the first step parents should take if they think their child is delayed?
LeComer: Make an appointment with your pediatrician. Even if you suspect your doctor will brush off your concerns, it's essential that your child be checked for possible medical issues that could be causing a problem. Undiagnosed hearing loss, for example, could cause speech delay. You can also call your school district office and ask for the contact information for early intervention specialists. Children can be evaluated for free in most cases. Or you can pay to have an evaluation done by a private child professional or by a major university or hospital.
P&C: Once your child has been evaluated and diagnosed, and is receiving therapeutic services, how can you be sure he's getting the right kind of help?
LeComer: You should have a feeling of confidence and feel in the loop. The therapist or other professionals should be working with you to set out goals and objectives and explain them so they make sense to you. You have a part in this, too — so take notes about a typical day with your child, including behaviors, language, and habits. Or videotape your child so that you have a visual record of where your child is, developmentally. Ask the professionals who work with your child to take some baseline data on her skills as a basis for comparison later. You should look for progress in three months, and again at six months.
P&C: What if, after following these suggestions, you're not satisfied with the help your child is getting?
LeComer: Don't be afraid to approach the professionals working with your child to express your concerns. Asking questions or kindly stating your unhappiness with the level or type of services your child is receiving is absolutely warranted. Make sure, though, that your expectations are reasonable. Talk to other parents and professionals and educate yourself about your child's specific difficulties. This will help you discuss treatment more confidently. It's helpful to ask for a meeting in which all who work with your child can hear and discuss your concerns. Try to make a positive difference by being honest and helpful. But don't feel stuck in a situation that you believe is not going anywhere. You know your child best, and you're within your legal rights to make a change if you truly feel it's warranted.
P&C: How can parents help their child's self-esteem remain intact when there is a delay?
LeComer: Examine your own attitude when in your child's presence. What does your body language and tone of voice convey to your child? Try to be your child's biggest cheerleader, and show him that you notice and appreciate his good deeds, his hard work, or his doing one more drill or task or test when he really didn't want to. Ask your child if you can be of assistance in some way. Don't make his therapy the focus of your family's daily life. It should be a component that will help your child participate more in the family, not the one thing your whole lives revolve around. Involve your child in your own interests and hobbies, and maybe help him find a hobby of his own.
P&C: How can parents help themselves through this challenge?
LeComer: The doubt, frustration, and worry involved in having a child with developmental delays can affect your relationship with your spouse, your parenting skills, your patience, and your time with your other children. Parent groups, both in person and online, are great ways to meet other mothers and fathers, whether just to vent your concerns or to share tips on how to cope with the daily reality of your family's situation.