As a child psychologist for almost twenty years I have interviewed hundreds of parents when I am in the process of conducting psychological evaluations of their children. Most them have told me that they had a concern or gut feeling that their child was not developing normally when the child was one or two years old, sometimes younger. When they discussed these concerns with their pediatrician they were often told “Don’t worry. Every child develops differently” or “Your child will catch up.” Occasionally, they were ridiculed by the pediatrician and told that they worry too much. In fact, many parents have shared comments from their pediatricians that made it clear that the doctor did not have an accurate understanding of normal child development. For example, when child was 2 years old and only saying “mama” and “dada”, but not learning any more words, the pediatrician said, “let’s wait until he is 3 and then we can see if he starts talking.” This child required years of speech therapy in elementary school. Another child was 15 months old and not crawling or walking. The parents were concerned, because the older siblings were all walking before their first birthdays. The pediatrician informed them, “Your child is lazy. Stop carrying him and he will start walking.” A pediatric orthopedist later diagnosed the child with a muscular disorder. Another child, aged 3, was always clumsy. She would fall, walk into things and drop or knock things over frequently. When the pediatrician was asked about this by the concerne parent, he responded, “Maybe your child is just poorly coordinated. Put her in sports when she is older and she will be fine.” This child had very poor vision, and after getting glasses her coordination improved. Finally, another parent that I recently worked with told me that her younger son had some odd obsessive behaviors beginning when he was about a year old. He would follow family members around the house and close every door they opened-including the refrigerator door. When she discussed this with the pediatrician, the mother was told, “Everyone has a little OCD (obsessive-compulsive disorder)”. This child was later diagnosed with Autism.
Why is it important to identify developmental problems early, rather than “wait and see”? Don’t all children eventually catch up if they are slower in developing basic skills such as walking, talking and socializing? The answers to these questions are found in the field of early intervention. In 1986 Congress established a program of early intervention for infants and toddlers with disabilities (birth to age 3). This was an addition to the original Public Law 94-142 passed in 1975, that established and funded special education services for all school aged children with disabilities. By the 1980’s it was very clear that children who were at risk for developmental delays (due to prematurity, genetic factors, birth injury or other prenatal complications), benefited greatly from early intervention services. These children who received speech therapy, occupational therapy, physical therapy, social skills and other early intervention services often caught up to same-aged peers by age 3. Some required additional services until they entered kindergarten, but their delays tended to be mild, when compared to the children with delays who did not receive early intervention. In fact, the children who were not identified as infants or toddlers and only began receiving help in elementary school often required many years of services. For example, some children with speech and language delays who did not receive early intervention were later diagnosed with Learning Disabilities (e.g., Dyslexia) in reading and spelling. Therefore, identifying children early and giving them intervention before they entered preschool or elementary school lead to better outcomes for these children. And yet, many pediatricians still want to take a “wait and see” approach, because they do not understand or see the value of early intervention.
If you are concerned about your child’s development and your instincts tell you that something is wrong, trust your instincts. No one knows your child better than you do. If you have older children or spend time with friends and relatives who have children and notice that your child seems be weaker or slower in some skill, first talk to your pediatrician or family physician. If you don’t feel like the doctor is listening or taking you seriously then seek another opinion. Of course, there are some pediatricians who will acknowledge that they are not experts in every field and refer to other specialists in early child development. You can also contact a child psychologist like myself to get a developmental assessment. Or you can search for a speech therapist, occupational therapist or physical therapist through your insurance. If your child attends preschool or is involved in a Mommy & Me class, ask the teacher if they can refer you to one of these specialists. If your child is under age 3, then contact the Regional Center in your area and ask for a free evaluation for the Early Start program. This is the federal and state funded early intervention program established back in 1986 with the federal law. Keep searching until you find someone who will listen and assess your child. It could be that your child’s skills are a little slow to develop and with a few months of intervention they will be fine. However, if your child has a more serious developmental disability, such as a speech and language delay, Autism Spectrum Disorder, vision problem or a motor coordination delay, the earlier you can identify the problem and get help for your child the more likely he or she will catch up with peers before they enter elementary school. If you “wait and see” (like the pediatrician recommended), then you might be one of the parents I often see in my office with 8 or 10 or 12-year-old children who are struggling in learning, speaking, socializing or behavior. When I ask them specific questions about their child’s development or when they first started being concerned, most of these parents tell me “I had a gut feeling something was wrong when my child was young by the pediatrician told me not to worry. I should have trusted my instincts.”