To round out my CEU courses for the year, I finished with Effective Early Intervention: Innovative Solutions to Build Motor, Balance, and Social-Emotional Skills to Improve Overall Development. While this lecture was geared towards therapists, there is still some great information that parents can use about child development and what early intervention provides.

Early Intervention

Early intervention describes any service or support that helps children from birth to three years of age reach their developmental milestones if they are behind. While some children immediately qualify for services (such as those born prematurely or with a genetic/neurological condition), for everyone else an evaluation must be done to determine eligibility. The areas of development examined are:

• Motor skills – rolling, sitting, reaching, crawling, walking
• Cognitive skills – learning, problem solving
• Communication skills – listening, gesturing, babbling, vocalizing
• Self-care skills – eating, dressing
• Social/emotional skills – playing, interacting with others

To qualify for early intervention, there must be at least a 25% delay in two or more of these areas or a 33% delay in one.

Evaluations are conducted by two or more specialists in an arena-style format. That means multiple people will observe, play, conduct standardized tests, and ask the caregiver questions while engaging with the child. On the eval team, there is a developmental interventionist who looks at the overall development, and another specialist based on the main areas of concern. This can be a/an:

• PT (physical therapist) to observe gross motor skills
• OT (occupational therapist) to look at sensory processing and fine motor skills
• SLP (speech-language pathologist) to discern language and communication skills
• Psychologist to look at behavior concerns
• Social worker to address family needs, such as sorting our financial help or applying for insurance

If a child qualifies for early intervention, a legal document called an IFSP (Individualized Family Service Plan) is written up, outlining the support and services needed to help them catch up to their peers on the developmental milestone roadmap.

The IFSP is a living, breathing document, meaning that it is constantly reviewed every six months and updated at least once a year. Updates and changes to the IFSP is a team effort. The team must involve:

• The family
• The service coordinator: your point person and liaison throughout the early intervention process
• The evaluation team
• Specialists who will provide services to the child and/or family

Good Observations

Aside from standardized developmental assessments and questionnaires about the child’s medical history, much of the evaluation involves observations to figure out what other limitations are affecting development. These can include:

• Retention of Reflexes

Primary (primitive) reflexes are innate, involuntary motor responses that provide a fundamental foundation for conscious actions later. As more neural connections develop in baby’s brain, these stereotyped movements diminish. However, if one or more of these reflexes do not integrate, it can hinder the baby’s body awareness as well as their coordination to effectively move and interact with their environment.

• Head Control

Head control is the foundation for many motor milestones, and babies eventually gain it by six months of age. But if it’s not well established, it impedes the baby’s ability to visually locate and observe what is going on around them from where they are.

• Visual Development

Newborns have horrible vision. They are near-sighted, can’t really see color (but can detect white, like the whites of teeth or eyes), and have poor visual coordination. But after five months, their visual system should be functional enough for them to fixate and attend to people/objects as well as track movement during play and exploration. The visual system also has a reciprocal relationship with movement and motor development. For instance, the presence of certain primary reflexes (ATNR, STNR, TLR) hinder visual skills.

• Gesturing

Around nine months, infants implicitly learn about two gestures a month. This means that they aren’t formally taught these non-verbal signals; they just pick it up from watching others. These include reaching, pointing, head shakes/nods, or holding up an object. Because gesturing is a predictor of language acquisition, concerns are raised when a child is not utilizing them to express their wants/needs. 

Red Flag Warning

If you notice any of these in your baby, do not hesitate to let your pediatrician know. The sooner we can identify a delay, the faster we can get them back on track.

My Personal Account

So much of a child’s brain development happens within those first few years and Early Intervention can be a huge help if developmental delays are spotted timely. Because a child’s brain is plastic, the earlier intervention starts, the greater the gains.

When my son was born at 29 weeks, he qualified for early intervention. Because I’m an OT and pediatrics is my area of focus, I left working in the clinic in order to treat to him for the next three years. He was playing a game of catch up in all areas of development in his first year, achieving milestones three months later than his peers. With consistent intervention and follow through, he was able to narrow the gap in his second year; and by three years of age, met all his milestones ON TIME. He is about to turn seven, and you would never know whether he was a preemie or he had delayed development.

I realize that my case is rather different and not many parents have the professional background or the ability to stay home like I did. However, early intervention offers a low-cost service to address developmental issues from the start. This can make a huge difference, especially to be school- or preschool-ready with your child’s peers.

To start the early intervention process, do the following:

• If you’re concerned about your child’s development, start by making a list of concerns and questions.
• Talk to your pediatrician about your concerns. If something is off, they can provide a referral for an evaluation.
• Contact your state’s early intervention center. Their information can be found here.
• Connect with the service coordinator assigned to you once your child’s information is in your state’s early intervention system.
• Consent to an evaluation to determine the need for early intervention. Your service coordinator will help set up the evaluation. Confirm the evaluation a day or two before.

If your little one does qualify for early intervention, know that this is not a reflection of you as a parent or your parenting skills. This has everything to do with what your baby needs to develop and grow. Providing your child the support they will need to flourish early on is one of the best things you can give them.

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