Tuesday, August 23rd, 2011
Many parents of young children grew up during an era when the “wait and see” approach to developmental delay was the primary philosophy. Today, it is highly recommended that parents follow the principles of “Learn The Signs. Act Early.” As my fellow blogger Jill Cordes pointed out to me last month (in response to one of my blog posts on early screening for autism), this emphasis on developmental screening is not only important for detecting problems in the earliest stages – but also for determining when delay does not warrant intervention and “wait and see” is appropriate.
Take the case of two-year-olds who are “late talkers.” If a comprehensive developmental screening does not reveal any issues beyond the lag in expressive language (measured in terms of number of words spoken), it may indeed be the case that delay is just reflecting normal variation and intervention is not necessary. Furthermore, a new study suggests that, contrary to early speculations in the literature, “late talkers” – defined as being at or below the 15the percentile (gender referenced) in terms of expressive language at two years of age AND not showing any other signs of developmental delay – do not show evidence of behavioral and emotional problems through seventeen years of age (a longitudinal design was used to conduct follow-up evaluations at 5, 8, 10, 14, and 17 years of age).
This study is important because the toddlers with delay at age 2 did, at that time, demonstrate elevated levels of behavioral and emotional problems. These problems, however, were shown to decline over time, presumably in concert with catch-up in language skills. The researchers speculate that for these toddlers the behavioral and emotional issues were a reaction to the frustrations of the delay, and were not attributable to other underlying causes.
To be clear, the take-home message of this research is that developmental screening is an important tool for evaluating the big picture when babies and toddlers show delays. It can help resolve when specific isolated delays may not signal the need for intervention. And of course it can guide clinicians and parents to seek out further evaluation and if necessary early intervention when appropriate. It can bring some clarity to what used to be a much fuzzier issue (it’s not a perfect science, but it is continuously improving in accuracy). These are the reasons that “Learn the Signs. Act Early” is the philosophy of choice for parents.