Early Intervention for Special Needs Is Critical
When my son was 10 months old, I noticed he was not babbling and cooing like my daughter had done at that age. His pediatrician encouraged me to wait a few months to see if he would catch up, but as his mother I knew that something was not right.
After weeks of worrying, I called the North Carolina Early Intervention (EI) program. His evaluation re-vealed a significant speech delay, and as a result he was enrolled in the infant-toddler speech program. He was eventually diagnosed with apraxia, a speech disorder, and we’ve since been told he would not have caught up without the early speech therapy he received.
Don’t ignore “red flags”
While no parents want to hear that their child may be facing an obstacle to typical development, experts agree that the earlier a delay or other condition is diagnosed and treatment begins, the better the outcome is likely to be. Catching a problem in the infant or toddler years provides therapy teams with crucial extra time to work with the child and his family.
“We really believe in looking at any sign of developmental delay as early as possible because we know that children’s brain development in the first three years is so important,” says Deborah Carroll, Ph.D., branch head for Early Intervention in the state Division of Public Health.
When assessing your child’s development, Carroll recommends noting if she seems to be able to hear, if her speech is on target for her age, and how she interacts with her family and caregivers. You can compare your child’s progress to a developmental milestones chart, such as the one on the Centers for Disease Control and Prevention “Act Early” website, www.cdc.gov/actearly.
If you are still concerned about your child’s development, talk first to your pediatrician. Your pediatrician may refer your child to the state’s EI program, which provides testing and services for children birth to age 3 who have developmental delays or a diagnosed condition, such as hearing loss or Down syndrome, that may affect development.
You may request a free evaluation even without your pediatrician’s referral. “Parents know their children best,” Carroll says.
She encourages parents to locate the Children’s Developmental Service Agency (CDSA) for their county by calling 919-707-5520 or visiting www.ncei.org. Caregivers, including grandparents and teachers, may also request an evaluation. Testing looks for developmental delays in five areas: cognitive, physical, communication, socio-emotional and adaptive. “We get a whole picture of the child and see if there is a developmental delay,” Carroll says.
The evaluation and service coordination is provided at no cost to the families. Any recommended therapies are billed to the family on a sliding scale based on income. Carroll says that most families in the program do not pay out of pocket for services.
What to expect from early intervention
If your child is enrolled in the EI program, you will be assigned a service coordinator to develop a plan for interventions and to help you navigate the system. Common therapies for infants and toddlers with delays include developmental, speech, occupational and physical therapies. Many of the therapies involve promoting development in daily routines.
“Therapists help parents recognize what learning opportu-nities exist in their child’s everyday life so they can help their child engage in skills that are important to their development,” says Sam Odom, Ph.D., director of the Frank Porter Graham Child Development Institute at UNC-Chapel Hill.
Julie Simmons of Cary was introduced to the EI program at WakeMed Health & Hospital’s neonatal intensive care unit when her son Woody was born 11 years ago. To treat his physical and cognitive disabilities, he received feeding, vision, occupational and physical therapies through the program.
“Woody’s therapists taught me how to teach my son how to do things that he never would have learned himself, such as sucking his finger and swallowing,” Simmons says. “Through Early Intervention, I met wonderful people whose life work is to help people like me show my child how to succeed. I am so appreciative that these therapists were there.”
Private and community resources
Other options exist as well. Raleigh mother Claudia Tyer encourages parents to explore private therapy if they feel their child’s needs are not being met adequately through state programs. Tyer pursued private therapy for her son Christopher, now 8. “If you fear your child is not developing like he should, do not wait,” she says. “Don’t make that mistake, because early diagnosis and intervention is crucial.
Always check with your insurance company to determine what evaluations and services are covered, as recent health care reform and other legislation may bring about changes. For information on autism legislation in North Carolina, visit www.autismsociety-nc.org.
In addition to the state’s EI program, there are many community-based resources available for children with developmental delays or related concerns.
In Wake County, Project Enlightenment provides screening and services for children who are 2 years and 10 months old through kindergarten. (Younger children are handled directly through the EI program.)
The Frank Porter Graham Child Development Institute in Chapel Hill, The Tammy Lynn Center for Developmental Disabilities in Raleigh, the Lucy Daniels Center for Early Childhood in Cary and TEACCH in Chapel Hill also provide early intervention services for young children.
As you go through the process, be sure to ask questions and advocate for your child. “Trust your gut as a parent, but be willing to listen. It is important to be informed and to use that information to make a decision and be an advocate for your child,” Odom says.
Jennifer Gregory lives in the Triangle with her husband, two kids and three dogs.
What is a developmental delay?
According to the Centers for Disease Control and Prevention, “Skills such as taking a first step, smiling for the first time, and waving ‘bye bye’ are called developmental milestones. Children reach milestones in playing, learning, speaking, behaving and moving (crawling, walking, etc.) A developmental delay is when your child does not reach these milestones at the same time as other children the same age.”
If you have concerns about your child’s development, talk to your pediatrician or local Children’s Developmental Service Agency about setting up an evaluation. Most of the time, a developmental problem is not something your child will “grow out of” on his own.
To learn more about developmental milestones and delays, visit The Centers for Disease Control and Prevention at www.cdc.gov/actearly or the North Carolina
Department of Health and Human Services at www.ncei.org.