Early identification of children with delays in their development is important because there are programs that can help boost their progress in key areas and make them more successful as they start school. Well-child checks are an important time to monitor development in speech, motor skills like walking and hand-eye coordination, and social skills like smiling, playing with others, and using their imagination.
Recently, formal questionnaires have been developed for parents to fill out that help families and their doctor track a child’s progress in these key areas. Parents are experts on their own children, and these questionnaires are a good way to tap into that expertise.
While checking for appropriate development is an important part of every well-child visit, the American Academy of Pediatrics recommends a standardized form, such as the Ages and Stages Questionnaire (ASQ), be used to screen every child at 9, 12, and either 24 or 30 months. There are many reasons these tests are beneficial. Primarily, it is patient-centered as parents get the chance to observe the child and complete the questionnaire. Additionally, the ASQ is standardized, meaning it can normalize a child’s development by comparing it with thousands of other children their same age (not just a sibling or other kids in the neighborhood). Studies also show that the test is more sensitive, i.e. it can identify subtle differences.
The goal of the ASQ is to identify children early who will benefit from extra help. Since this test is very sensitive, some children who score below normal may actually be developing fine, causing unnecessary worry for parents. Doctors and communities should balance the benefit of finding children who will benefit from early identification of delays with the risk of abnormally labeling children who have normal development. One common reason for an abnormal test result would be filling out the form early. When you are talking about a 9 month old, filling out the form even a month early may have a big impact, as babies can develop new skills daily!
For children whose ASQ score suggest a developmental delay, the clinician and family should make a decision together about how to proceed. They should search for other factors that may influence test scores such as: gestational age, health or illnesses, hearing and vision, sibling development, and family and past medical history. One conservative option is to monitor and retest the child at the next visit. Another option is a referral to Birth to Three, a program with staff specially trained to identify and work with children who have delays. If you have concerns about your child’s development and would like more information about resources in your county, you can contact Wisconsin First Step at 1-800-642-7837.
Using Ages and Stages, health care providers and families can work together to reliably identify delays in speech, motor, or social development and use local resources, such as Birth to Three, to get children appropriate help. For more information, contact your primary care doctor.
Your child’s Pediatrician is a wonderful person to let you know if your child is meeting milestones or has delays. As a parent you may just “know” something is not right. We seen it with our daughter even though we were told constantly from our daughters Ped. that she was just fine and developing right on schedule. I finally followed my “Mommy Instinct” and contacted Early Intervention (an Illinois resource for developmental delays) and had her evaluated. She qualified for speech, occupational therapy and physical therapy. Not only that we also had her vision checked after 2.5 yrs of being told that she would eventually grow out of her eyes crossing. She has a VERY high prescription and will likely require surgery to correct the crossing eyes but will always need to wear glasses. We are awaiting on our consult coming up!
Delay defined means: to postpone until a later time. So if you find out your child has a delay in any aspect do not panic! It is only a delay and eventually with therapy they will catch up! It may take a bit longer than you wanted them to but they will catch up to your other children or the kid in play group! It also does not mean that eventually they will not get into the college or be whatever they want in the future! So do not go freaking out right now!
Therapy for delays is an amazing thing! Do not think that it is a waste of time since they are “just playing”. Play is how children learn. When they sat at my house singing songs, rolling balls, blowing bubbles I at first was thinking, “what a waste of time”! I was so wrong! I started to see results quickly! While we were doing sign language they also gave me lots of other ways to communicate with her as well and taught us ways to work with her to keep her progressing.
I am very happy to say that today my daughter just turned 6 and is caught up! She just got rid of her IEP (individualized education plan) and is not receiving any more therapy. She is happily in a Dual Language program and is learning Spanish very quickly and teaching me it as she goes! OH BOY!!! She has amazing coordination and takes dance and cheer-leading! She did ballet, tap and jazz for awhile but just changed to hip hop… she is amazing at break dancing! She also loves to play soccer and baseball at home and now has the coordination to play… of course she still runs the bases backwards but she hits the ball right outta the yard! We also are able to go to restaurants now without her shutting down because of the noise! She just lost 4 teeth this week and even now I can still clearly understand her! LOL She has come a long way because of being evaluated and getting therapy!
If you suspect your child may have any delays do not hesitate to have them checked out. The sooner you get them services needed the better! Good luck to all of us parents… we hold the future in our hands and our hearts!