Early intervention for developmental delays in children

As most parents quickly learn, babies develop skills at very different rates. Some babies do everything early, from language acquisition to gross motor skills to fine motor development, while others are slower in one area or another. I do not like to use the word “lag” unless the skill is quite delayed, as there is such a wide range in what is normal in terms of when children develop certain skills.

Normal delays

It is hard for parents to accept a delay in any area of development, especially when faced with another child who runs circles around your child on the playground or at the birthday party. If a child truly seems delayed in a particular area, I usually work with parents to try to figure out a reason the delay might be occurring. For example, if a family is bilingual, their baby may be delayed in generating speech, although the child usually understands most everything in both languages. Although studies have suggested that multilingual children are not delayed in speech, my experience suggests otherwise. Another possible reason for language delay is the fact that not enough people are speaking or reading to the child. If the babysitter is on her cell phone most of the day or the family does not spend time reading together, it is possible the child is not hearing enough words spoken clearly to her. Or she may get what she wants by whining and pointing, or siblings may serve as interpreters—both of which give the child no incentive to learn to use real words.

Some children are carted around from bouncy chair to car seat to sling and do not get enough “floor time” to learn to use their bodies to move and make things happen. This happens frequently when there is a large family with lots of siblings or in households where a parent may be afraid to put the baby down on the floor because of “germs.”

Fine motor skills are also acquired by doing, which sometimes means allowing the baby to make a mess. For example, if a mother insists on feeding the baby to ensure adequate nutrition, the baby never learns to master the spoon. And putting toys that the baby wants just out of his reach can give incentive for the baby to figure out how to get to the toy—in other words to move!

Early intervention

Nevertheless, some babies are delayed in development in a more serious way, or may be temporarily behind and just need a boost to get where they need to be. That is where early intervention comes in. In most states, early intervention is offered free of charge to children under age three if they meet certain criteria.

If you call your state’s early intervention program, you will get an appointment for an evaluation to see if your child meets criteria for services. If so, speech therapy, physical therapy, occupational therapy, or all of the above may be offered to him. This is a wonderful opportunity for the child. Even if the delay is marginal, what baby wouldn’t benefit from some one-on-one attention from a professional? However, I find many parents reluctant to seek extra help, as they don’t want their child to be “labeled.” This is an understandable concern in our competitive society, but if your pediatrician agrees that your child has a weakness in one or more areas, get him off to a good start and avail yourselves of the, free extra help. Obviously, these services should only be for children who really need them.

Once a child is enrolled in early intervention, he will be re-evaluated periodically to see if services are still needed. Many times therapies are needed for just a short time. There may be simple exercises that a parent can learn to do with the child at home.

After three years, many children still need extra help. These services are not provided by early intervention programs, and so families may have to pay, depending on their insurance provider.

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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