Soon after birth, your child will show off her personality and develop skills such as briefly gazing at objects, communicating that she wants to be held, and fussing to be fed. Although children develop at their own pace, most achieve certain milestones – crawling, walking, saying first words – at around the same age. When children are not reaching expected milestones and are showing significantly delayed development, parents may worry. Suspecting a "delay" is scary, but there may not always be a problem.
If there is a problem, early intervention (EI) services are available to help a child who may have trouble reaching certain milestones. Early intervention means using "therapy services to enhance a child's ability to interact with others and the environment; these everyday experiences and interactions are essential for optimal child development," says Anne Zachry, Ph.D., assistant professor of occupational therapy at The University of Tennessee Health Science Center and author of Retro Baby. In 1986 the U.S. Congress mandated an Early Intervention Program (EIP) under the Individuals with Disabilities Education Act (IDEA) to support children's development with funding for all 50 states. EIP services are usually free and available for children under 3 years old who are suspected of having developmental (physical, cognitive, language) delays, disabilities, or special needs. A pediatrician will usually recommend an evaluation.
Many families receive EI services after birth when a genetic or chromosomal disability (for example, Down syndrome) is identified, but other early red flags include sensory sensitivities, refusing to be held, fearing movement, or have feeding difficulties. "Milestones for biting, chewing and swallowing a variety of foods are typically accomplished by age three," says Melanie Potock, a speech and language pathologist in Longmont, Colorado, and author of Happy Mealtimes with Happy Kids. If you notice that your child is not developing significant skills around the same age as her peers or older siblings, visit the First Signs website, which lists the average ages that children typically reach specific milestones. Definitely consult your physician if your child is not:
Waving, pointing, or imitating gestures by 12 months
Walking by 18 months
Manipulating ring stacks, form boards, and nesting cups by 18 months
Saying and understanding at least 50 words by 24 months
RELATED: 12 Milestones You Shouldn't Overlook
Early intervention begins with a team evaluation to identify a child's needs. "Research reveals that early intervention services can considerably mitigate the effects of developmental delays. Physical, occupational, and speech therapy services may be necessary in order to promote motor skills, speech, and language development," Dr. Zachry says. Early intervention services may include counseling, social work, therapies (occupational, physical, and speech), psychological services, audiology, and vision services. These services can be as simple as recommending hearing aids for a baby who has a diagnosed hearing loss or eyeglasses for a toddler who does not look at pictures, or they can be as complicated as involving a team of professionals who help a child with cerebral palsy sit in a chair to feed herself.
"Professionals will team together to boost coordination, strength, and stability while supporting a child's sensory needs and address goals to help a child thrive at preschool, on the playground, and at mealtimes," Potok says. EI services are provided at an EI center or at home during in-person visits, and the earlier these services are utilized, the better.
Occupational therapy helps promote the cognitive, visual, sensory, and motor skills to grasp and manipulate objects. Occupational therapy can help develop concepts such as size and shape discrimination (so that kids can fit smaller objects inside larger ones), hand-eye coordination to use a spoon, and sensory skills to scribble on a tray covered with shaving cream.
Speech and Language Therapy
Speech and language therapy is also referred to as speech language pathology (SLP), which helps promote receptive and expressive communication and the oral motor skills to speak and swallow. Speech therapy may include using speech, pictures, gestures, and electronic devices.
Physical therapy helps promote stability during sitting or standing and mobility to crawl and walk. Physical therapy also helps address kids' needs for any adaptive devices such as walkers and wheelchairs.
Early Childhood Special Education
Early childhood educators help provide developmentally appropriate learning environments and activities to promote cognitive and social skills, such as singing finger-play songs and asking for more bubbles to pop.
Social Work Services
Social work services assess the social and emotional needs of a child and his family and provide help with counseling or parent training.
All kids with developmental delays who live in the U.S. are entitled to free early intervention services through age 3 and free special education from age 3 through 21, thanks to the Individuals With Disabilities Education Act. The first step is to get an evaluation through your state’s education department. To schedule an appointment, ask your child’s doctor for a referral or Google “early intervention” and your state for contact info.
Eligible families will then get a personalized plan—called an Individualized Family Service Plan for infants and toddlers and an Individualized Education Program for preschoolers. These explain which services would be helpful for the child and how to sign up for them. EI therapists can come to your home or even to your child’s daycare or preschool, where they’ll work with the teachers to find an appropriate place and time for the sessions.
Every state has its own guidelines, but children with issues such as cognitive disabilities, vision or hearing problems, gross motor delays, feeding problems, speech delays, and more may all be eligible for services.